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

  • Julie Moreton

    Member
    November 22, 2019 at 9:05 am

    I provided some answers for our institution below. We are struggling with this problem as well (minus adding in 24 additional beds)! 

    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? We also take VEEGs, post op T&As, peritoneal dialysis patients, and other clean off service. 

    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? The HemeOnc unit. Who would be responsible for setting up/taking down the PD if kept on your unit? Our HemeOnc nurses – there is no one else trained besides our PICU.  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. Very high. We have two PD machines we have to use in Peds here and we have a great deal of difficulty maintaining competency on both machines…it is a very low volume but very high risk procedure. 

    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). EVDs stay in our PICU/stepdown unit. 

    Thanks for any advice!
    Mary Lynn

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    Mary Lynn Rae, MSN, RN, CPHON
    NPD Practitioner/Clinical Educator Hem/Onc/SCT
    Ann & Robert H. Lurie Children’s Hospital of Chicago
    312-227-4224
    mlrae@luriechildrens.org
    225 East Chicago Avenue,
    Chicago, Illinois 60611-2991
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    Julie Moreton, MSN RN CPHON CPN CLNC
    President, Palmetto-APHON Chapter
    Nursing Education Specialist
    Prisma Health Children’s Hospital – Midlands
    Columbia, SC
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    Original Message:
    Sent: 11-19-2019 05:26 PM
    From: Mary Lynn Rae
    Subject: Overflow/off-service patients + PD patients

    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
    312-227-4224
    mlrae@luriechildrens.org
    225 East Chicago Avenue,
    Chicago, Illinois 60611-2991
    ——————————