South Florida Hospital News
Tuesday September 17, 2019
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May 2008 - Volume 4 - Issue 11

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Challenges and Trends in the ICU at Broward General Medical Center

With the expansion of Broward General Medical Centerís Atrium Intensive Care Unit (ICU) in December 2005, the unit grew from eight medical beds and nine surgical trauma beds to a total of 24 beds averaging 600-700 patient days per month. The Intensive Care Unit oversees medical, surgical, trauma, neurosurgical, liver transplant, re-implantation and stroke patients. Currently, the unit is staffed with a nurse manager, four assistant nurse managers, a clinical nurse specialist, 75 nurses, 10 secretaries and 10 patient care associates.

Because of the amount of growth the unit has encountered and the wide-range of areas the unit manages, the ICU faces the challenge of longer orientation time for nurses. The orientation used to last between eight and12 weeks. Orientation now runs 14 to 20 weeks. Although the length of training involved is extensive, it ensures that nurses are able to safely care for all of the patients in the unit.

Another challenge is staffing the ICU with qualified nurses who are up for the challenge to work in a high acuity, fast paced unit. More than half of the nursing staff has worked in the ICU for more than 5 years and of those nurses, more than half have been there over 10 years. A keen eye is needed to make sure the staffing schedules are balanced according to the nurses skill levels and years of experience. The ICU staffs 13 nurses each shift for a census of 24 patients.

Although the Atrium ICU faces challenges of training and staffing, it has seen some positive quality indicators. These include: the Ventilator Acquired Pneumonia (VAP) rate decreased from 6.7 to 4.8%, the Bloodstream Infection (BSI) rate decreased from 4.3 to 3.35% and the Hospital Acquired Pressure Ulcer (HAPU) rate decreased from 5.4 to 2.5% in the last year.

In an effort to address challenges, the ICU management team has added weekly meetings with the new staff, their preceptor, a member of the management team and the CNS. These meetings help to identify early obstacles in the preceptor/preceptee relationship so difficulties faced by new RNís can quickly be addressed. The result is a positive outcome for our staff and our patients.

Elaine C. Miller, Nurse Manager, Atrium ICU, can be reached at (954) 712-6367.
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