Reply To: Overflow/off-service patients + PD patients

  • Amy Spence

    November 19, 2019 at 5:39 pm

    We have hem/onc/SCT (28 beds). We also have pediatric medicine, surgical/neurosciences, PICU, CVICU, NICU, CCDH (center for congenital diaphragmatic hernia) units. See below for answers.


    Amy Spence MS, RN, CPN, CPON®

    Johns Hopkins All Children’s Hospital

    Education Specialist 7S/Infusion Center



    ——Original Message——

    Hello All:

    For those of you that work in children’s hospitals with multiple floors…

    We have doubled our Hem/Onc/SCT unit from 24 to 48 beds (October 2019) (we decided to keep a mixed vs. separate unit of Hem/Onc/SCT).  

    Our census is all over the place and of course we are getting some off service patients (several bilirubin patients; cellulitis; fracture), especially as we gear up for winter/flu/RSV season as a hospital.  

    What are some of the off service patients that your dedicated Hem/Onc/SCT unit might accept? 

    Also, if you have an ONC patient that needs PD (peritoneal dialysis), would that patient stay on your Hem/Onc/SCT unit or would the patient be admitted to the surgical/kidney floor? Who would be responsible for setting up/taking down the PD if kept on your unit? We have historically only kept those patients on our surgical/kidney floor but now that we have more beds one of our attendings wants the patient on Hem/Onc but the learning curve is high.

    Same lines as above, what about external EVDs? Typically our brain tumor patients go to the neuro inpatient unit post surgery but I am anticipating that ask too (to have external EVDs on our unit).

    Thanks for any advice! 
    Mary Lynn

    Mary Lynn Rae, MSN, RN, CPHON
    NPD Practitioner/Clinical Educator Hem/Onc/SCT
    Ann & Robert H. Lurie Children’s Hospital of Chicago
    225 East Chicago Avenue,
    Chicago, Illinois 60611-2991