SICU Education Committee launches newsletter
Welcome to our first Shared Governance Education Committee newsletter!
We are thrilled to share topics of current importance, information on timely and relevant SICU patient care interventions, updates on the activities and actions of the Shared Governance Committee, Trauma team, and Champion Committees, as well as highlight and welcome newly oriented team members Relevant links to SharePoint documents, policies or SOPs and educational resources such as the Society of Critical Care ICU Liberation Bundle are included throughout the document Hyperlinks can be seen in red, bold, underlined text
Please let us know if you have any additional ideas or content suggestions You can now email the Shared Governance Education Committee at SICU Education@uchealth com
Enjoy this month’s newsletter!
EducationCommittee
Infusion Verify Update
SICU nurses have recently been tasked with the trial of verifying infusions/fluids on an hourly basis
The hourly infusion verify has been well adopted by the nurses as standard work and will clearly lead to more accurate fluid balances
A preliminary audit of electrolytes, antibiotics and ordered KVO’s/bolus fluid in a handful of patient charts in EPIC showed a documentation deficit of 500-800mL/day versus what had been ordered, suggesting the need for diligent fluid management and documentation
Of note is early audit data does not include a review of continuous IV fluids, drips or blood, suggesting the impact of missed documentation on fluids could be greater than initially found.
SICU leadership will continue to gather data and will share the results once scientifically robust, ensuring accuracy and relevance
Continuing diligence in hourly infusion verification, fluid documentation and pump management is highly encouraged and appreciated
Infusion Verify Update
Hemodynamic Monitoring in the SICU
SICU Critical Care Chronicles
Champions Corner
ICU Liberation Bundle
SICU Shared Governance
Trauma Team Updates
New Staff Highlight
Podcast Pick
Links & Things
Consideration for Hemodynamic Monitoring in the SICU
Hemodynamic monitoring with a PAC (pulmonary arterial catheter) is not a frequent occurrence Please use this information as a guide to familiarize yourself with the process, policies and procedures In addition, you can view prior education on Swan Ganz catheters HERE.
Best practice considerations
Asses Q4 hours:
Hemodynamic equipment
Parameters of PAC (unless ordered otherwise or patient’s condition dictates)
Document these in the EMR:
CVP
CO & CI via thermodilution
PAOP
PVR
SVR
Placement of PAC in cordis (swan marker in relation to introducer hub) in cm
Tighten connections
Transducer at phlebostatic axis (4th intercostal space, mid chest)
Stopcocks covered with non-vented caps
Alarms set to appropriate levels
Medications/fluids can be administered through the INFUSION PORT on the PAC (often WHITE) or, in the case of limited vascular access, the RA/CVP port (often BLUE) can be used
UCMC & WCH Policy References:
SOP# UCH-ACMC-CLIN-SOP-118-02 POLICY# WCH-PCS-006-05
SICU Critical Care Chronicles
Registration for upcoming SICU educational events and offerings being presented by Maggie Calhoun, Clinical Nurse Educator, is now open via OneTouch under SICU Critical Care Chronicles in the Learning tab
Ventilators, BiPaps, ABGs and SBTs
Our first session will be led by Jeremy and Rachel, RRT They will dive into ventilator modes, things commonly seen and used in SICU - SBTs, BiPap, ABGs and more, including use of the lung SIM for hands on learning This session will be 2 hours
Date: March 5 at 0800 & 1600
SICU Rx
Critical care pharmacy will discuss SICU Rx specific to transplant medications (thymo, tacro etc), critical care drip optimization and titration (think pressors, paralytics, sedation etc)
Date: March 26 at 0800
Neurological Trauma: What Do I Need to Know?
Presented by Dr Valerie Sams will present on this topic More details to come
Date: May 27 at 0800
Champions Corner
The second half of 2024 saw the development of new SICU Champion teams designed to efficiently address areas of concern and opportunities for improvement in the unit As shared in prior email notifications, the following teams were created:
Blood Culture Champion
CHG Champion
Epic Champion
PAR champion
Pressure ulcer champions
Relevant updates from each champion team will be shared in this newsletter.
Blood Culture Champions
No update
CHG Champions
This team has reviewed the UCMC policy on CHG bathing and reviews CLABSI occurrences for commonalities and prevention opportunities
EPIC Champion
No update
PAR Champion
Emma is working to locate the SICU PAR stocking info/map, eliminate duplicates, review how we stock and have high use items on the both the high & low side PARs equally In addition, she is creating a binder with the item numbers required to request items not regularly used
Pressure Ulcer Champions
*HAPI Survey conducted in December with results shared with the unit
*This team reviews all HAPI occurrences to determine commonalities and prevention opportunities
*Education materials from Molnlycke are now available on the UCMC SICU Share Point site and linked in this newsletter
ICU Liberation A-F Bundle
ICU Liberation provides a bundle of evidence-based practices (EBPs) targeting improved patient outcomes by reducing the negative effects of pain, agitation/sedation, delirium, immobility, and sleep disruption (PADIS) in critically ill patients” (Society of Critical Care Medicine, n d )
Key elements in the ICU Liberation Bundle are:
Assessment, prevention, and management of pain
Both spontaneous awakening trials and spontaneous breathing trials
Choice of sedation and analgesia
Delirium assessment, prevention, and management
Early mobility and exercise
Family engagement and empowerment
The Critical Care Shared Governance Committee has been working with UCMC leadership and medical teams to determine the best strategies for implementing the A-F Bundle in all ICUs The timeframe and logistics are unique to each critical care area Continue to follow along with the SICU Shared Governance Committee for education about the bundle, the nursing role in the bundle and how it will impact our daily practice
Trauma Team Update
The UC Health Trauma Survivors Network is proud to announce the start of our in house support through our Snack and Chat program This program is designed to provide family members and caregivers of trauma survivors an opportunity to take a self-care break. We want them to join us for coffee/tea and snacks, while enjoying a perfect space for a relaxing break and where family members and caregivers can meet and offer support to one another and talk to trauma staff members at a personal level It will give them a small break from staying in the patients room while offering an opportunity for us to provide education and additional resources for support while in the hospital and post discharge
Trauma Faculty and Staff are welcomed and encouraged to attend! Chaplains, social work, pet therapy, volunteers and anyone else that would like to attend to support our trauma families are welcome to attend
Tammy Galyon and Gina Menninger will be the leads for the program All you have to do is show up and say hi! If you have resources you think these families could benefit from, please bring them to share
We really hope to see all of you there at some point throughout the year! We hope to make this program as successful as possible supporting as many families as we can We will be sharing the dates throughout the hospital through marketing and will really hit the units at the beginning of the snack and chat week to remind everyone that this is happening Your help is needed to spread the word! Flyers will be available coming soon!
The snack and chats will be initially occurring on the third Wednesday of the month from 130-230 on 2T I have scheduled them out for 6 months, with plans to evaluate the program and extend it to the SICU Eventually, the goal is to offer this monthly both on 2T and in SICU
Please reach out to Regina Menninger, RN, BSN, with any questions or concerns E: regina.menninger@uchealth.com
Shared Governance
Shared governance is off to a great start for 2025 We have drastically increased our committee membership and hope to continue doing so.
Charge committee has been established and is off to a great start Our goal is to create a few more committees by the end of the year to continue bringing forth the voices of SICU nurses while addressing the needs of our unit
Looking ahead, we have wonderful educational opportunities through the Education Committee and our Educator, a Deep Dive from Safety Committee, and fun events through the Job Enjoyment Committee Be on the lookout for more information to come
Minutes, documents, charters, etc for each USG committee are available on the UCMC SICU SharePoint site Please follow this site for easy and quick access to relevant information.
If you are interested in becoming a member of Unit Shared Governance or have ideas to pass along, please reach out to Lori Gamble, Kaitlin Silver, or Amy Watkins
Links & Things
Thank you to our representatives from Molnlycke for providing us with their Skin Protection & Wound Management Guide for the Bedside Clinician This guide provides useful information for the care and treatment of many skin and wound challenges faced by our patients You can find this file in the UCMC SICU Share Point site using this LINK The file is located in the Education Council/Education Documents/Pressure Champion Documents folder
Consider furthering your development as a critical care nurse by joining the Greater Cincinnati chapter of the American Association of Critical Care Nurses (AACNGCC) The AACN-GCC is one of over 240 chapters of the world's largest specialty www.aacngcc.nursingnetwork.com
New Staff Highlights
In each issue of this newsletter, we will congratulate nurses and PCA’s who have completed orientation since the prior edition Starting this month, we are congratulating those who have accomplished this task since December 15 Please extend your welcome, your patience, and your knowledge to each of them as we work to build the strongest team at UCMC!
Sydney Bahr, RN
Brady Eckert, RN
Grace Elo, RN
Ashley Harper, RN
Ashley Snyder, RN
Amy Stapleton (PCA)
Kelsey Szarek, RN
Mackenzie Wessel, RN
Sydnie Wisniowski (PCA)
Podcast Pick
Tune in to Up My Nursing Game on Spotify (or other platforms) to listen to the episode on Spontaneous Awakening Trials and the A-F Bundle.
Have a good podcast you listen to to increase your ICU knowledge? We’d love to hear about it!
Email Lori Gamble at lori.gamble@uchealth.com so we can share it with everyone and feature relevant episodes in future newsletters
Unless otherwise ordered by the healthcare team, undisturbed wound healing Mepilex Border Flex dressings do not need to be changed until or unless THREE borders are saturated
