Unit 55 Medical/Surgical

Description of Unit

55MS is a 34-bed inpatient adult medical surgical unit located on the east wing of the fifth floor in the North Tower Patient Services Building. The unit consists of 14 private rooms, including 2 private negative air-flow isolation rooms, and 10 semi-private rooms. 4 of the private rooms are dedicated to vascular surgical patients who meet criteria and are typically monitored by Telemetry, ECG and pulse oximetry. Capability exists to monitor all patients in the unit with continuous pulse oximetry captured by a local central monitor in the nursing station and through remote cardiac telemetry on Unit 54. Average bed occupancy is 83%.

Description of Patient Populations

Patients are admitted to 55MS following operative procedures of the vascular, ophthalmology, ENT, maxillofacial and cardiothoracic systems. The services of 55MS have a strong statewide referral base accepting patients as scheduled admissions, hospital-to-hospital transfers as well as admitting patients from the Emergency Department for acute illnesses. Common medical diagnoses include: Coronary artery disease, Acute Coronary Syndrome, Congestive Heart Failure, Pneumonia, Respiratory insufficiencies, renal failure, endocrine dysfunction including diabetes, thrombolytic drug therapy. The unit is also trained to care for many medical service patient populations with diagnosis including (but are not limited to): COPD, diabetes, pneumonia, sickle cell, UTI, bacteremia, acute MI, etc.

Average length of stay is 3.31 days.

Nursing Care

Nursing care is based on the total patient care model with holistic delivery of care and focuses on the importance of a head to toe assessment. A charge nurse is present on each shift. Unit management prepares the schedule with the assistance of a team consisting of unit staff nurses. Daily staffing levels are planned based on average daily census.  Meetings, staff education, performance improvement activities, etc. are factored into the scheduled staffing.

Patient and family members are a primary focus as participants for education and teaching as well as their collaboration in the delivery of care. Nursing education includes teaching about: pain control, ambulation and/or physical activity (ROM-active or passive), provision of nutrition through assistance of feedings or through parenteral or enteric feedings through an nasogastric tube (NGT) or Dobhoff tube (DHT), infection control, administration of medications, and basic skin care.

Nursing staff assesses and manages wound care therapies (including Vacuum Assisted Closure (VAC) Systems, Jackson-Pratt, Davol drains); respiratory management, (including pulse oximetry, oxygen therapy and chest tubes) and cardiac management (including remote telemetry).  Nursing also assesses and manages patient nutritional and medication management which include Total Parenteral Nutrition (TPN), NGT/Gastric tube/Jejunal-tube feedings as well as abdominal/gastrointestinal drainage systems including Gastric tubes, Jejunal tubes, and stomas/ostomies.

Health Care Team

Each surgical and medical service on the unit consists of attending physicians, fellows/chief residents, residents/interns physician assistants, nurse practitioners and medical students. The scheduling of the rotation is maintained through the Department of Surgery. Case Managers serve as liaisons between the surgical, medical staff and multidisciplinary team, providing continuity of care for surgical patients from admission to clinical follow-up.   Available support services for 55 MS patients include: respiratory therapy, physical therapy, occupational therapy, nutrition services, enterostomal therapy, Diabetic Education. The Lift Team is also available for assistance when needed. A collaborative care model consists of nursing staff, medical staff, patient and family services personnel, rehabilitation services staff (PT, OT, RT) and dieticians providing an interdisciplinary communication approach to facilitate patient wellness.

The nursing management structure consists of a Nurse Manager, Clinical Leader, and Charge Nurse with support from the Unit Assistant. 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 (PCA) provide nursing care. Unit Support Technicians provide clerical support for the direct patient caregivers as well as serve as patient mobility assistants. The Registered Nurse is responsible for guiding care of the patient based upon an individualized plan. Nursing care delivered by the PCA is coordinated under the direction of the Registered Nurse. Patient care is provided 24 hours a day without interruption.

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