General formal handover
This occurs during the 0800 – 0830 handover on weekdays (excluding public holidays) that is attended by the day consultant, day and night registrar, day HMO, ANUM, Allied Health and the bedside nurses.
The night registrar presents the patient and any immediate issues are discussed, including those pertaining to the allied health staff.
This occurs during the 0800 – 0830 handover on weekdays (excluding public holidays) that is attended by the day consultant, day and night registrar, day HMO, ANUM, Allied Health and the bedside nurses.
The night registrar presents the patient and any immediate issues are discussed, including those pertaining to the allied health staff.
Consultant-to-Consultant handover for split oncall/day duty
If it is the same daytime consultant the following day, no specific handover required, unless there were issues overnight and this can be conveyed by telephone/in person.
If a differing daytime consultant the following day, the consultant taking over contacts the preceding daytime consultant after the registrar handover for any additional information/handover. This is to minimise disruptions for the incoming consultant whilst travelling to work/getting ready or delaying the formal handover.
If it is the same daytime consultant the following day, no specific handover required, unless there were issues overnight and this can be conveyed by telephone/in person.
If a differing daytime consultant the following day, the consultant taking over contacts the preceding daytime consultant after the registrar handover for any additional information/handover. This is to minimise disruptions for the incoming consultant whilst travelling to work/getting ready or delaying the formal handover.
Ward Rounds
Expectations:
A. Morning 0830 (0900 on weekend or public holidays)
Multi-disciplinary –
B. Afternoon ~ 1600
This round is attended by the same clinicians as the morning round except the allied health staff. This round can be delayed on the weekend when clinically appropriate to 1900, in which instance two rounds will suffice.
C. Evening ~ 2130
This is an optional round. It is remnant of when the ICU did not have registrars at night, but is beneficial in reducing the number of calls received overnight; particularly when a patient has been admitted since the afternoon round; where there is ICU access issues requiring consultant level triage of referrals; or when there is an unstable patient. The nurses appreciate a quick walk around in these circumstances.
Expectations:
- Document your management plans or amendments decided on the ward round on the ICU observation chart
- Complete the checklist (sedation, sleep, bowels etc) during the morning ward round
- A minimum of two physical ward rounds per day
- Finish by 1100 and review all possible discharges by 1000 (unless extenuating circumstances). If you foresee that you are not able to complete ICU round by 1100, call the outreach consultant for assistance.
A. Morning 0830 (0900 on weekend or public holidays)
Multi-disciplinary –
- Medical – intensivist, registrar, HMO
- Nursing – bedside nurse, ACN, +/- CNC
- To allow the ANUM to attend the “bed meeting”, held at 1000, where patient admissions, discharges and internal transfers are arranged
- To give enough time to the ICU registrar and HMOs to complete their tasks
- To give enough time to the bedside nurses to complete their tasks.
B. Afternoon ~ 1600
This round is attended by the same clinicians as the morning round except the allied health staff. This round can be delayed on the weekend when clinically appropriate to 1900, in which instance two rounds will suffice.
C. Evening ~ 2130
This is an optional round. It is remnant of when the ICU did not have registrars at night, but is beneficial in reducing the number of calls received overnight; particularly when a patient has been admitted since the afternoon round; where there is ICU access issues requiring consultant level triage of referrals; or when there is an unstable patient. The nurses appreciate a quick walk around in these circumstances.