Psychiatry — Unit 52

Unit NT 52MS is a 10-bed adult inpatient medical-surgical unit located on the central wing in the fifth floor of the Patient Services Building, North Tower. The unit has all private rooms. Monitoring capabilities include continuous pulse oximetry on the unit and remote cardiac telemetry monitoring from Unit 64. Patients requiring close monitoring are assigned near the nursing station.

Description of Patient Populations

Patients admitted to unit NT 52MS are medical-surgical patients that may have concurrent psychiatric issues requiring inpatient hospitalization and care. The unit primarily serves medicine patients (Hospitalist/Psych services). Patients include transfers (ICU, IMC, or clinic/hospital transfers), and admissions from the Emergency Department. Common admitting diagnoses include pulmonary diseases, cardiac diseases, diabetes, acute infections, morbid obesity, pneumonia, sickle cell crisis, kidney diseases, and psychiatric conditions such as suicide risk, substance abuse, and mood and thought disturbances.

Nursing Care

Nursing care is focused on the assessment, diagnosis, planning, intervention, and evaluation of the medical patient from admission to discharge. Emphasis is made on the holistic delivery of care and focuses on the importance of a head to toe assessment. Patients and family are given emphasis as recipients of education and teachings as well as their collaboration in the delivery of their care. Nursing activities focus on the care of the patient across the continuum from admission to discharge with the goal to return the patient to the optimum level of health. Nursing care includes but is not limited to pain management, ambulation/physical activity, and nutritional support as required by patient condition, infection control, medication administration, skin care, management of medical IV lines, drains, tubes, implementing safety precautions and promote patient/family education and support.

Health Care Team

Patient care on NT 52MS is a collaborative approach in the progression of care with the intent of decreasing length of stay and improving patient outcomes. Multi-disciplinary collaboration is emphasized between the nurses, physicians, social services, rehab services and nutrition services with the intent to safely plan and progress discharge planning at the time of admission leading to the day of discharge. Interdisciplinary resources that are available on Unit 52 include: respiratory therapists, physical and occupational Therapists, dietitian, pharmacists, WOCN nurses, rapid response teams (STAT nurses), Patient-Family Services, IV nurse, and Pastoral Services.

The management team comprises of the Nurse Manager and the Clinical Leader, with support provided by the Unit Assistant under the supervision of an Associate Vice President of Nursing Services. The Nursing staff is provided with opportunities for training and learning experiences to enable competency as defined by the role in the job description and departmental education plan. There is an emphasis towards advancement of degrees as well as national certifications. Registered Nurses (RN) and Patient Care Assistants (PCA)/Mental Health Tech (MHT) provide nursing care. Support Techs (ST) provide clerical support and help guide patient mobility. The RN is responsible for guiding care of the patient based upon an individualized plan. PCA and ST meet the basic requirements for their positions and function in accordance with their unit-based job description, as described in the Hospital Plan for the Provision of Nursing Care.

Staffing Plan

Nursing care on NT 52MS is based on the total patient care delivery model (as described in the Hospital Plan for Nursing Care) with co-worker assistance. The PCAs are assigned patients under the direct supervision from the nurse. Clerical coverage (support tech) is available 24/7. Skill mix is 67% RN, and 33% PCA/MHT. Nurses to patient ratio is 1:5 for both days and nights. Patient care assignments are made each shift as described in the Hospital Plan for Nursing Care. Patient care assignments are based upon patient safety concerns, patient/family requests, monitoring capabilities, and skills required. Patients requiring sitters (1:1 observers) for violent or non-violent reasons & Baker/Marchman Acts are coordinated thru the Central Staffing Office. Additional considerations for staffing include: complexity of the patient’s condition (frequency and length of time for procedures, physical care needs) as reflected in the Quadramed system, infection control issues, continuity of care, and transport requirements

Unit staffing is based upon budgeted nursing hours per patient day (HPPD) which is formulated using national benchmarks and historical unit acuity data. Daily staffing is adjusted based on unit census and feedback from nurses to account for special circumstances that increase patient acuity, such as the need for a sitter, increased number of 1:1 patient, etc. Additional staffing needs are met on Unit 11-5 Medicine as described in the Hospital Plan for Nursing Care. The Nurse Manager or designee, in accordance with the Hospital Plan for Nursing Care and nursing policy, determines the need for additional shifts/overtime.

Requests for scheduled Paid Time Off (PTO) will be reviewed on a case-by-case basis and will consider the staffing needs of the unit. Requests are granted only if minimum staffing numbers are maintained with coverage that does not include overtime.

Staff attendance at meetings, education offerings, and other activities are coordinated to prevent any interruption in patient care.

Reviewed & revised: 2/26/2021