Adult Acute Care Medicine

Transcription

1 Adult Acute Care Medicine Acute Care Medicine (3 West) Patient population includes the specialization in the care of nephrology, gastroenterology, hepatology, and general medicine adult patients. 26 Beds 1:5 3West offers excellent learning opportunities for nurses to develop their skills and integrate clinical assessments with complex pharmaceutical and diagnostic data in a fast-paced environment. Acute Care Unit (4West) Adult medical-surgical population who may benefit from an extended observation period. This unit provides an alternative to discharge or hospital inpatient admission. 12 Beds 1:4-5 The environment is fast-paced, facilitating admissions, treatments, transfers, and discharges. It is one of three units that make up the Emergency Services Transition Units (ESTU) team and flexibility to rotate and work in any of the three units is ideal. Pulmonary/Infectious Disease - 6 Bedtower (6BT) Patient population includes adult medicine patients with pulmonary or infectious diseases. The patient population of 6 BT includes, but is not limited to, patients requiring medical care for COPD, pneumonia, asthma, cystic fibrosis, as well as those patients with AIDS, meningitis, and sepsis. 31 Beds 1:4-5 RNs have competency in administering chemotherapies and biotherapies for non-oncology conditions. 6BT is also the landing zone for pulmonary hypertension patients, as UNCH is a newly accredited center for pulmonary hypertension care. Geriatric Medicine - 8 Bedtower (8BT) Patient population includes Geriatric and General Medicine patients which includes, but is not limited to, patients requiring medical treatment and diagnostic evaluations of both acute and chronic diseases with physiological and cognitive age related changes. 31 Beds 1:5 8 Bedtower utilizes a multi-disciplinary approach in a patient and family

2 centered care environment. We also work closely with the Palliative Care Team. We provide a supportive work atmosphere with nurses committed to excellent health care and collegial interactions. In addition, we also enjoy a top tier employee satisfaction rating! Adult Acute Care Surgery GI Surgery Acute Care (4 Anderson North) Primary population is focused on bariatric surgery patients and on patients who require surgical procedures/treatments for gastrointestinal disease. 20 beds 1:6 Our medical teams are nationally recognized for their cutting-edge surgical procedures and treatments of gastrointestinal disease. Average length of stay is 5-7 days. Utilizes an innovative practice, Partners in Practice model of care, which pairs a licensed RN with a certified nursing assistant who together assume the care of 6 patients. Transplant Unit - 5 West (5W) Abdominal Transplant/Urology/Plastic Surgery: The surgical population includes abdominal transplant which encompasses liver/kidney/pancreas transplant patients, plastic surgery including reconstructive grafts and tissue injuries, and surgical urology including cystectomies, nephrectomies, and other urological procedures. The medicine population includes patients that have diagnoses of end-stage liver and end-stage kidney disease as well as posttransplant patients, who have hospitalizations related to their transplant. 15 beds 1:5 Our unit is a leading performer (#1 in the hospital) for patient satisfaction. We are truly a medical/surgical unit - & care for both populations. Orthopedic/Trauma - 5 Bedtower (5BT) Orthopedic and Trauma unit - Patient populations include complex and blunt trauma injuries, multiple orthopedic fractures, and orthopedic trauma. 28 beds 1:5 AACN Silver Beacon Excellence Award winning unit.

3 Acute Burn/Wound - 5 East (5E) Patient population consisting of acute level burn, wound, and plastic surgery patients. 15 Beds 1:5 5 East functions partly as an extension of the NC Jaycee Burn Center caring for adult acute care patient with burn injuries. GI Surgery Acute Care - 6 East (6E) Patient population includes GI surgery and general surgery acute care patients. 14 Beds 1:6 Our medical teams are nationally recognized for their cutting-edge surgical procedures and treatments of gastrointestinal disease. Average length of stay is 5-7 days. Utilizes an innovative practice, Partners in Practice model of care, which pairs a licensed RN with a certified nursing assistant who together assume the care of 6 patients. Neuroscience Acute Care - 6 Neurosciences (6NSH) Patient population consisting of medical and surgical patients with an age range from young adult to geriatric; admissions from predominately Neurology, Neurosurgery and Otolaryngology/Head & Neck Surgery 34 Beds 1:5 Day & Night JCAHO certified Primary Stroke Center acute care unit Surgical Oncology Acute Care - 7 Neurosciences (7NSH) Surgery acute care unit specializing in providing exceptional care for patients with gastrointestinal, breast, endocrine and head/neck cancers 24 Beds 1:6 Utilizes an innovative practice, Partners in Practice model of care, which pairs a licensed RN with a certified nursing assistant who together assume the care of 6 patients.

4 Adult Oncology General Oncology - 4 Oncology (4 Onc) Patient population includes patients requiring medical treatment and diagnostic evaluations of both solid tumor and hematological malignancies and the management of the side effects of their treatment. 34 Beds 1:3 or 1:4 The nurses on 4 oncology are highly skilled and manage not only the technical aspects of caring for an oncology patient but the emotional support as well. A typical patient is receiving transfusions, antibiotic therapy, electrolyte support and other side effect management. Our nursing staff works together as a part of large interdisciplinary team including physicians, pharmacists, a chaplain, recreational therapists, physical therapists, a dietician and care managers. Bone Marrow Transplant Unit (BMTU) Patient population includes adult patients undergoing transplant for hematologic cancers, solid tumors, metabolic diseases and blood disorders. These patients often receive transfusion and electrolyte management and antibiotic therapies. 24 Beds 1:3 The BMTU is a very team-focused environment in which good communication and patient care are highly valued. The BMTU utilizes a multi-disciplinary approach to caring for our patients. As a BMTU nurse, you will have the opportunity to apply a vast array of skills in the process of caring for patients that you have the opportunity to get to know over admission periods that often last weeks to months in duration. Heart & Vascular Acute and Critical Care CardioVascular Acute Care - 5 Anderson (5 And) Patient population specializes in the care of Cardiology, Thoracic and Vascular patients. Post-surgical Vascular includes amputations, lower extremity bypass grafts, and aortic/thoracic aneurysm repairs. Postsurgical Thoracic includes Lobectomies, Lung and Esophageal resections. Cardiology includes both medicine and surgical to include patients with diagnosis of Congestive Heart Failure, NSTEMI, pre and post cardiac catheterizations with and without interventions. 12 Beds 1:5

5 Our health care teams are led by renowned physicians who are among the country s leaders who pioneered national standards for endovascular aneurysm surgery. 3 Anderson/ Intermediate Coronary Care Unit (3 And/ICCU) Patients on this unit include myocardial infarction, heart failure, and arrhythmia. Also included in our care are pre and post cardiac catheterization and electrophysiology procedures such as pacemaker placement, implantable cardioverter-defibrillator placement and ablation. All nurses on the unit rotate through the ICCU and are experienced with multiple vasoactive infusions and invasive devices, including arterial lines and chest tubes 19 acute care and 6 progressive care = 25 beds total 1:4 Days Acute and 1:3 ICCU 1:5 Nights Acute and 1:3 ICCU AACN Gold Beacon Excellence award winning unit. The cardiac telemetry system for the hospital is also located within this unit. Cardiothoracic Step-down Unit (CTSU) Patient population specializes in the care of post-surgical cardiac and thoracic patients consisting of post-coronary artery bypass grafts (CABGs), heart valve repair/replacements, ventricular assist device patients, heart transplants, lung transplants, aortic/thoracic aneurysm repairs, and esophageal and thoracic surgeries. 13 Beds 1:3 Nurses manage patients with ventricular assist devices, including those used for destination therapy and bridge to transplant. Our Cardiothoracic Stepdown Unit offers nurses broad opportunities for education, responsibility, and professional growth while working with patients who need specialized care. Cardiac Intensive Care Unit (CICU) Patient population specializes in the management of patients with a variety of cardiac conditions including: myocardial infarction, hypothermia s/p arrest, acute decompensated heart failure/ cardiomyopathy, pre and post cardiac transplant, LVAD workup and readmissions, cardiogenic shock, unstable dysrhythmias, complicated ablations, trans-aortic valve repairs and multi-organ system failure. 13 Beds 1:1 or 1:2 CICU Charge nurse also carries the code pager, responds as part of the Adult Rapid Response Team and Cardiac Response Team throughout the hospital

6 Cardiothoracic Intensive Care Unit (CTICU) Patient population specializes in the care of post-surgical cardiac and thoracic patients. The main population served consists of coronary artery bypass grafts (CABGs), heart valve repair/replacements, heart and lung transplants, ventricular assist devices including ECMO, aortic/thoracic aneurysm repairs, and complicated esophageal and thoracic surgery patients. 9 Beds 1:1 or 1:2 CTICU nurses are educated to successfully manage and care for patients with advanced hemodynamic monitoring and supportive devices such as pulmonary artery catheters, temporary and permanent pacemakers, and ventricular assist devices. Adult Medical/Surgical Progressive and Critical Care Medicine Progressive Care Unit (MPCU) Patient population includes adult patient admissions from 8 different medicine services with an age range from young adult to geriatric. Primary medicine services admitting to MPCU include pulmonary and infectious diseases, renal, liver and GI patients, oncology and hematological diseases, geriatrics, general medicine and family medicine. 24 Beds 1:2 or 1:3 The MPCU provides an intermediate level of care between the intensive care setting and the acute care medical units. RNs have the opportunity to attend classes to gain competency in administering chemotherapies for oncology patients. Medical Intensive Care Unit (MICU) Patient population include patients with diagnoses (but the unit is not limited to) sepsis, drug overdose, DKA, renal failure, liver failure, respiratory failure, ARDS, GI bleed, pneumonia, COPD, pancreatitis, and intracranial hemorrhage. 30 Beds 1:1 or 1:2 The MICU has a rapidly growing oncology patient population which offers RNs the additional experience of developing oncology critical care subspecialty skills. The MICU provides support for the Medicine Service Adult Rapid Response Team (RRT) by designating a first-responder RN during all shifts who responds to RRT calls from the designated areas.

7 Intermediate Surgical Care Unit (ISCU) Patient population includes step-down level of care to all general surgery services as well as Neurology, Neurosurgery, Otolaryngology, Plastics, Gynecology, and Urology patients 18 Beds 1:3 ISCU is also a primary unit for the UNCH Stroke Program Surgical/Trauma Intensive Care Unit (STICU) Primary patient populations include trauma, abdominal transplant, GI surgery, acute care general surgery, ENT, plastics, and gynecologic surgery. 16 Beds 1:1 or 1:2 Open Access for Acute Care General Surgery. AACN Gold Beacon Excellence Award winning unit. Neurosciences Intensive Care Unit (NSICU) Patient population includes Neurology and Neurosurgery patients 16 Beds 1:1 or 1:2 NSICU is a Level One Trauma Unit and part of the UNCH Stroke Program. NSICU nurses participate in the UNCH Brain Attack Team (BAT) providing neuro-critical care nurse rapid response for hospitalized patients suspected with stroke. NC Jaycee Burn Center Patient populations include burn injured acute care and critical care patients with major skin disorders of all ages. 21 Beds 1:1, 1:2, 1:3 The Burn Center provides care along the full continuum of the most critically injured through acute and into the rehabilitation and reconstructive phases of burn injury and survival. In addition, the Burn Center conducts clinical and basic science research, which contributes to our understanding of survival and recovery from serious burn injuries.

8 Emergency Department Emergency Department (ED) Patient population includes patients ranging from minor illnesses and injuries to critical medical and trauma patients to neonates to elderly. Care is also provided to psychiatric/behavioral health patients. 80 Beds Level I Trauma Center and Comprehensive Stroke center serving as NC s primary referral hospital as well as serving as the community hospital for Chapel Hill/Orange County. The ED sees over 70,000 patients per year. Hillsborough Hospital Medical-Surgical Intensive Care Unit (2 Bedtower) This unit provides adult inpatient care for critical care patients for both medical and surgical admissions. This is a mixed unit caring for patients requiring intensive care, step-down and medical telemetry. Nurses in this unit also provide hospital-wide support for clinical emergencies. 18 (9 ICU/Step-down, 9 medical telemetry) 1:2 ICU level, 1:3-4 step-down level, 1:4-5 medical telemetry level UNC Health Care Hillsborough Campus is a brand new community hospital which is an extension of UNC Medical Center focusing on many of our elective surgical programs. The 68 bed facility will combine a community hospital culture with the innovative procedures and care for which the UNC Medical Center is known. Medical-Surgical Acute Care Unit (3 Bedtower) This unit provides adult acute inpatient services for both surgical and medical admissions. Surgical patient population includes Hip/Knee Joint Replacements, Spine, and Urology admissions. 25 1:5-6 UNC Health Care Hillsborough Campus is a brand new community hospital which is an extension of UNC Medical Center focusing on many of our elective surgical programs. The 68 bed facility will combine a community hospital culture with the innovative procedures and care for which the UNC Medical Center is known.

9 Neonatal Critical Care Center Newborn Critical Care Center (NCCC) Patient population includes medically fragile preterm or ill newborns that require medical and surgical care. 58 Beds 1:1-1:3 There is a strong focus on family-centered and developmentally appropriate care. We offer advanced therapies including body cooling, high frequency ventilation, inhaled nitric oxide and numerous pediatric subspecialties. Obstetrics/Women s Health Antepartum (3 Women s) Patient population consists of high risk antenatal patients experiencing complications during pregnancy or postpartum. In addition, patients also consist of post-op benign gynecology and postpartum couplet patients. 13 Beds 1:2, 1:3 Level III Referral Center. Care may be provided to patients with severe pre-eclampsia, diabetes, IV magnesium, and substance abuse. Maternity Care Center (5 Women s & Newborn Nursery) Private room unit providing care for the postpartum patients utilizing the couplet care model, with an emphasis on Patient and Family Centered Care. Infant Rooming-In supported. Medical Care overseen by the Department of Pediatrics and Pediatric Nurse Practitioner s, The Department of Obstetrics and Gynecology, Family Practice, and Midwives. 28 Beds 1 RN to 3-4 Couplets Level III Referral Center, Baby Friendly Designated, 24hr Lactation Consultant coverage, Magnet Certified, Doula Program, North Carolina Maternity Center Breast Feeding Friendly 5 Star Award, IBCLC Care Award GYN/ GYN Oncology (6 Women s) The primary patient population consists of Gynecology and Radiation

10 Oncology patients. The remaining patient population consists of benign gynecology, postpartum, and Med-Surg patients. 22 Beds 1:4 Provides care to patients with acute and chronic medical and surgical problems. Administers and cares for patients receiving chemo and radiation therapy. Labor & Delivery Number of beds Nurse/Provider Ratio 1:1; 1:2 As a level III referral center, UNCH sees both low-risk obstetrical patients as well as a large number of complex cases including sever pre-eclampsia, hemoglobinopathies, and fetal anomalies/ fetal loss. In addition to laboring patients, Labor & Delivery provides care to high-risk antepartum patients as well as the immediate postpartum couplet. 15 labor rooms; 5 triage rooms; 3 ORs; 2 recovery rooms RN will be responsible for labor care, delivery, recovery, circulating c- sections, and PACU. Baby Friendly; Nitrous Oxide; Maternal-Centered Cesareans; Doula program. Pediatric Acute and Critical Care 5 Children s Intermediate Care Patient population includes pediatric cardiology, hematology/oncology, bone marrow transplant and pulmonary patients ranging from ages: 2 days through 21 years. The unit provides care for other acutely ill children requiring intermediate level nursing care. 24 Beds 1:3 for intermediate care patents and 1:4 for acute care patients The nursing staff focuses on the care of pediatric patients with long term illnesses and the developmental needs of the hospitalized child. General Acute Care - 6 Children s (6CH) Patient population includes the care of general pediatrics ranging in age from infancy through 21 years. Specialties of care include gastrointestinal, neurology, nephrology, endocrine, metabolic, and some pulmonary patients. 24 Beds 1:4 The unit has a four bed Epilepsy Monitoring Unit

11 Pediatric Surgery Acute Care - 7 Children s (7CH) Patient population includes the care of general surgeries for pediatrics ranging in age from birth through adolescence. Specialties includes general pediatric surgery, traumas, ear/nose/throat, neurosurgery, oral-maxillofacial, orthopedics, urology, burns and transplant cases. 24 Beds The unit also cares for medicine and oncology pediatric patients. Pediatric Intensive Care Unit (PICU) Patient population includes critically ill children from neonates up to 18 years of age who require intensive monitoring and nursing care. Patients represent all medical and surgical specialties. 20 Beds 1:1 or 1:2 All RN nursing staff collaborates with a variety of interprofessional team members to provide excellence in patient- and family-centered care. The PICU is an ECMO center for neonatal and pediatric patients. Psychiatry Service Acute Psych - 3 Neurosciences (3NSH) Patient population includes adult patients over 18 years of age with psychotic disorders. Our unit specializes in helping psychotic disorder patients develop an evidence based plan of care that will lead to a productive life both while receiving treatment on the unit and after discharge. 18 Beds 1:4 Days 1:5 Nights The nursing staff strives to provide a rich therapeutic patient environment while identifying symptoms which negatively impact the patient s life, developing a plan to reduce these symptoms, and educating the patient about their illness. The care provided within the unit is individualized and structured with a focus on patient safety and medication management.

12 Geriatric/Crisis/Perinatal - 4 Neurosciences (4NSH) 4 NSH North is a Psychiatric Crisis Unit Patient population are aged 18 to 55, have short length of stays and often have co-existing substance abuse issues. 4 NSH South is a Geropsychiatry Unit Patient population are generally over 55 years of age, medically and psychiatrically complex. 4 NSH Perinatal is a unit devoted to women of childbearing age with peripartum or postpartum depression. North-Crisis - 15 Beds : South-Gero 12 Beds : Peri 3 beds 1:5 on Crisis ; 1:4 on Gero ; 1:3 Perinatal Patients come from across the nation seeking treatment on the perinatal unit as it is a one of a kind unit for postpartum depression. Child Adolescent Unit - 5 Neurosciences Hospital (5NSH) 5 NSH North is an Adolescent Psychiatry Unit with patient population from ages NSH South is a Child Psychiatry Unit with patient population of children ages NSH North 14 Beds / 5 NSH South 8 Beds Adolescent/North-1: 4-6 Child/South-1: 4 Patients come from across North Carolina to this unit Eating Disorders Unit (EDU) Patient population includes patients of all ages with eating disorders (typically longer-stay unit). 6 Beds 1:3 Patients come to this unit from across the United States, primarily Virginia, North Carolina and South Carolina. Wakebrook Inpatient Unit Patient population includes those with psychotic disorders. We also accept patients with a variety of behavioral health diagnoses, including dementia, depression, bipolar disorder, and substance abuse. Patients must be at least 18 years of age and meet medical criteria. Average length of stay is 11 days. Though the unit currently has a capacity of 16, it will expand in May 2016 to 28 beds. 16 beds (28 beds after 5/2016) Robust interdisciplinary programming in place. Improvements are currently underway with the planned initiation of training for staff to use

13 of the Recovery Model for treatment and milieu management. ly, we will add a second outdoor space, a new gardening therapy area and new sensory tools in the next year to enhance the patient experience and quality of care.