6 East Surgical/Transplant/Urology
Description of Unit
6E is a 24-bed inpatient adult surgical unit located on the sixth floor in the South Tower. The unit consists of twenty four private rooms including two negative isolation rooms. Capability exists to monitor patients with continuous pulse oximetry to a central monitor in the nursing station and remote cardiac telemetry to Unit 5W. Average bed occupancy is 71%.
Description of Patient Populations
Patients are admitted to 6E following operative procedures for hepatobilliary diseases, kidney, liver transplants and urology. General surgery patients are also admitted to 6E. The services of 6E have a strong statewide referral base accepting patients as hospital-to-hospital transfers as well as admitting patients from the Emergency Department for acute illnesses. Common admitting diagnoses include but are not limited to acute /chronic rejection, acute renal failure, end stage renal disease, end stage liver disease, urology resections, prostate and bladder cancer, and kidney stones. The average length of stay is 3.59 days.
Nursing care is focused on the assessment, diagnosis, planning, treatment and evaluation of preoperative and postoperative patients and non surgical patients from admission to discharge with emphasis on renal, gastrointestinal and nutritional assessment, airway management, patient/family education and support, post-operative care, and initiation of the rehabilitation process. The 6E unit/role specific job descriptions identify the patient populations/common diagnoses served, equipment utilized, skills required to perform treatments/procedures, clinical parameters monitored, safety precautions initiated, and emergency events encountered. Nursing activities consist of: pain management including patient controlled and epidural analgesia; wound management including Vacuum Assisted Closure Systems, JP and Duval drains; respiratory management including pulse oximetry, oxygen therapy and chest tubes; cardiac management including remote telemetry; nutritional management including TPN, NG-tube/G-tube/J-tube feedings; assessment and management of abdominal/GI drainage systems including G-tubes, J-tubes, ostomies, pancreatic drains, NGs; management of renal drains including ileal conduits, foley catheters, renal stents; prevention of post-operative complications and skin breakdown, medication management, safety precautions and patient/family education and support.
Health Care Team
The Transplant and the Urology services consist of attending physicians, fellows, chief residents, residents, interns, physician assistants, and medical students. Scheduling of rotations is maintained through the Department of Surgery and the Department of Medicine. Transplant Coordinators, Patient Care Resource Managers and Case Managers serve as liaisons between the Surgical staff, Medical staff and multidisciplinary team, providing continuity of care for patients from admission through clinic follow-up. Available support services for 6E patients include: Transplant Coordinators, Respiratory Therapy, Physical Therapy, Occupational Therapy, Nutrition Services, Wound Therapy as well as Patient and Family services. Collaboration is fostered by weekly patient care conferences attended by nursing staff, medical staff, Patient and Family Services personnel, Rehabilitation Services staff (PT, OT, Communication Disorders when indicated) and Dietitians as well as by participation in daily service rounds. There is also a Comprehensive Unit Based Safety Program team that meets monthly.
The nursing management structure consists of a Nurse Manager and Clinical Leader with support from a Unit Assistant and central Administrative Coordinators. Department of Nursing staff is provided training experiences to attain and maintain competence as defined by the unit/role specific job descriptions and the departmental education plan. Registered Nurses and Patient Care Assistants provide nursing care. Support Technicians provide clerical support for the direct patient caregivers and also provide rehabilitation support to patients. The Registered Nurse is responsible and accountable for guiding care of the patient based upon an individualized plan. Nursing care and rehabilitation support delivered by the PCA and Support Technicians are coordinated under the direction of the Registered Nurse. The unit leadership group promotes autonomous, accountable nursing practice by supporting staff involvement in unit practice decision making.