T |
P |
C |
CARE HANDOVER (ADMISSION)
|
REQUEST EXPERT ASSESSMENT ON PATIENT ADMISSION TO ICU |
An ICU bed is requested by activating the RRT (Rapid Response Team) to assess whether the patient is considered critical to be admitted in the ICU, using pre-defined criteria. |
RRT ACTIVATED; PATIENT SIGNALIZED (IF MULTIDRUG-RES. BACTERIA) |
X |
|
1 |
ASSIGN BED TO PATIENT |
The RRT receives the bed request, and if the patient meets the recommended criteria for ICU admission, the bed is allocated according to prioritization. The secretary proceeds with the electronic health recording of the patient's admission to the ICU. |
PATIENT BED ALLOCATED; CARE HANDOVER PERFORMED; ELECTRONIC HEALTH RECORD COMPLETED |
X |
|
1 |
TRANSPORT PATIENT TO ICU |
Transport of the patient from the unit of origin to the ICU, under the supervision of the responsible team at the moment. |
PATIENT'S ARRIVAL IN THE ICU |
X |
X |
2 |
ACCOMMODATE PATIENT ON BED |
In the ICU, accommodation of the patient in the allocated bed. |
PATIENT ACCOMMODATED ON THE BED |
X |
X |
2 |
PATIENT ASSESSMENT (1st)
|
ASSESS CONDITION OF TARGET ORGANS |
The first patient assessment is carried out mainly by professionals from the medical, nursing, physiotherapy, and nutrition teams. In the ICU, the patient's needs are related to the dysfunctions of one or more target organs: heart, lung, kidney, their combinations, and the advanced therapies offered to them: hemodynamics, ventilatory support, hemodialysis, etc. Most of the time, the patient arrives with little or no condition to communicate (sleepy, intubated), and the ICU team receives information from the RRT, verbally, during the care handover, and from the patient's medical health record. |
TARGET ORGANS DYSFUNCTION EVALUATION PERFORMED; CONSULTING REQUESTED; EXAMINATION REQUESTED; ADVANCED THERAPY(S) REQUESTED |
X |
X |
2 |
PATIENT ASSESSMENT (2nd)
|
COMMUNICATE WITH FAMILY MEMBER |
Team communication with the patient's relatives and/or companions upon admission and throughout their stay. It covers the behavior guidelines in an ICU and on specific patient care. It also aims to investigate the clinical aspects of patient diagnosis. |
COMMUNICATION WITH FAMILY MEMBERS PERFORMED |
|
X |
1 |
ASSESS (SPEECH THERAPY) |
When requested by the medical team, an assessment is performed by the speech therapist. |
DIAGNOSIS BY THE SPECIALIST PERFORMED |
X |
X |
2 |
ASSESS (NUTRITIONIST) |
When requested by the medical team, an evaluation is performed by the nutritionist. |
DIAGNOSIS BY THE SPECIALIST PERFORMED; PATIENT ORIENTED ON EATING OR FASTING |
X |
X |
2 |
ASSESS (PHYSIOTHERAPY) |
When requested by the medical team, an evaluation is performed by the physiotherapist. |
DIAGNOSIS BY THE SPECIALIST PERFORMED |
X |
X |
2 |
ASSESS (CONSULTANT DOCTOR) |
When requested by the medical team, an evaluation is performed by the consultant doctor. |
DIAGNOSIS BY THE SPECIALIST PERFORMED |
|
X |
1 |
ASSESS (CLINICAL PHARMACY) |
Evaluation of the medical prescription by the clinical pharmacist when drugs are reviewed concerning the patient's conditions. |
MEDICAL PRESCRIPTION REVISED |
X |
X |
2 |
PATIENT ASSESSMENT AND CARE
|
CARRY OUT CARE PROCEDURE |
Care procedures typically performed in the patient's bay, such as catheter insertion, etc. |
CARE PROCEDURE UNDERTAKEN |
X |
X |
2 |
CARRY OUT ADVANCED THERAPIES |
After assessing the dysfunctions of the patient's target organs and/or reassessments over the length of the patient's stay in the ICU, life support is offered through advanced therapies, such as Hemodialysis, Extracorporeal Membrane Oxygenation (ECMO), Mechanical ventilation, among others. |
ADVANCED THERAPIES PERFORMED |
X |
X |
2 |
CARRY OUT PHYSIO/ RESPIRATORY THERAPY |
If prescribed, perform motor and/or chest physiotherapy. |
PHYSIOTHERAPY PERFORMED |
X |
X |
2 |
DEVELOP PRESCRIPTION |
Medical prescription: registration of patient clinical decision-making in the electronic health record. |
PRESCRIPTION DEVELOPED; CONSULTING REQUESTED; PATIENT ORIENTED ON EATING OR FASTING;EXAMINATION REQUESTED;ADVANCED THERAPIES REQUESTED |
|
X |
1 |
Nursing prescription: patient care, after assessment of their needs. |
SET ADMINISTRATIVE TIME OF DRUGS |
Determine time slots for drug administration, according to the medical prescription. |
TIME SETTED FOR DRUG ADMINISTRATION |
X |
|
1 |
DISPENSE DRUGS |
In possession of the drug’s schedule, request it at the Satellite Pharmacy and distribute them on each patient's bed. |
DRUGS DISPENSED |
X |
|
1 |
PREPARE DRUGS |
At the nursing station, preparation of the drug to be administered to the patient. |
DRUG PREPARED |
X |
|
1 |
ADMINISTER DRUGS |
Administering the drug prepared to the patient. |
MEDICATED PATIENT |
X |
|
1 |
FEED PATIENT |
Offer the diet to the patient, according to recommendations such as food consistency and drug interactions. |
PATIENT FED |
|
X |
1 |
TRANSPORT PATIENT TO EXAM OUT OF ICU |
Transport the patient for examinations in the Hospital's Radiology unit. In this case, the Radiology team accompanies the transport. |
EXAMINATION PERFORMED |
X |
X |
2 |
CARRY OUT EXAM ON THE BEDSIDE |
X-ray tests or blood collection for laboratory tests on the patient in bed. |
EXAMINATION PERFORMED |
X |
|
1 |
SEND SAMPLES FOR ANALYSIS |
Sending the exams for laboratory analysis. |
SAMPLE SENT |
X |
X |
2 |
RECEIVE EXAM ANALYSIS |
Receipt of clinical reports by the laboratory or imaging by Radiology. |
CLINICAL REPORT RECEIVED |
X |
|
1 |
DAILY BED CLEANING |
Daily cleaning of physical spaces in all ICU rooms, including the patient's bay. |
PATIENT BAY SANITIZED |
|
X |
1 |
CARE ASSISTANCE
|
PROVIDE REGULAR CARE |
Constant care assistance, monitoring, (re)assessing, and intervention on the patient, promoting greater quality in the care offered, 24/day, during their stay in the ICU. This function exerts a control aspect in other functions related to direct patient care. |
PATIENT ASSISTED;PATIENT ASSESSMENT PERFORMED |
X |
|
1 |
CARRY OUT ROUND |
A multidisciplinary round is held around the patient, when the daily plan is defined, based on the exchange of information between professionals and, often, with the patient/family member. |
DAILY PLAN PREPARED;PATIENT PRE-DISCHARGE CONDITION IDENTIFIED |
|
X |
1 |
UPDATE PATIENT CHART |
Registering in the electronic health record all care decisions and interventions made on the patient and their response to treatments. |
PATIENT CHART UPDATED |
X |
X |
2 |
CARE HANDOVER (DISCHARGE)
|
CONFIRM PATIENT DISCHARGE |
After the Pre-discharge notice (i.e., the patient can be discharged within 24 hours), the responsible physician confirms discharge. |
PATIENT DISCHARGE OF ICU CONFIRMED;PATIENT DISCHARGE PLATE VISIBLE |
X |
|
1 |
TRANSPORT PATIENT TO WARDS |
After confirmation of ICU discharge and availability of the bed in the hospital ward, the patient is transported to the new bed. |
PATIENT TRANSPORTED TO HOSPITAL WARD |
|
X |
1 |
RELEASE BAY (REMOVE EQUIP, ACCESS. AND BELONGINGS) |
After the patient leaves the ICU, they remove equipment and accessories used by the patient in the bay to clean and deliver their belongings. |
PATIENT BAY RELEASED FOR TERMINAL CLEANING |
|
X |
1 |
TERMINAL CLEANING (PATIENT BAY) |
Cleaning the bay (bed, furniture, curtains, floor, ceiling, etc.) upon patient discharge and leaving. At the end of cleaning and supervision, the bay must be in its default configuration to receive a new patient. |
PATIENT'S BAY CLEANED |
X |
X |
2 |
SUPERVISION TERMINAL CLEANING |
After terminal cleaning, the supervision team checks, according to protocols and bioluminescence test, whether the environment is properly clean. |
CLEANING SUPERVISION PERFORMED |
X |
|
1 |
REPORT BED RELEASE/AVAILABILITY |
Once the supervision accepts the terminal cleaning, the secretary is informed that the patient bed is free for future demands. The secretary inserts this information into the hospital system. |
PATIENT BED RELEASED |
|
X |
1 |