Page 4 - Guide to PICU

Nursing Duties – What is Different in PICU?

 There should be one staff member out on the floor at all times. This is not a suggestion, it is
an expectation. Things happen fast in PICU and someone should always be monitoring the

milieu. Being out in the milieu allows you to see and hear the subtle changes that may lead
to escalation if left unchecked.
 Always do your assessments – NGASR, DASA, STRATIFY (if they have had a fall).

 Patients in PICU usually have a high DASA and often have a high NGASR. Please make sure
you are updating the Care Plan regularly.
 It is especially important that we identify and physical/medical issues upon admission.

Don’t assume it was done in MHESU. All patients are to have a documented head-to-toe
assessment upon admission and daily.
 Know the side effects of the medications you are giving and monitor your patient closely.

We see a lot of adverse effects of medication in PICU.
 Ensure their dignity, where possible. You should not be changing or bathing a patient in
their room with the door open.

 We need to keep everyone safe including housekeeping. Always let them know if there is a
patient they need to be careful with, whether it is safe to go in a patient’s room alone and
when there are AWOL risks on the unit.

 All patients are on at least, q15 but one staff should be out on the floor at all times. High
intensive observation should be the norm. If you are the one in the nursing station, please
keep monitoring the camera and checking in with your colleague out on the floor.

 You can take a WOW and do your documentation out in the milieu. Please do not leave
your computer open or any papers on the WOW. Please make yourself familiar with the
Observation of Patients policy as there are specific areas that apply to PICU only.

 When more than one patient is in the lounge, please watch what is going on, preferably in-
person or via camera. Many patients are sexually, verbally or physically inappropriate and
staff need to ensure all patients feels safe.

 Even if you need to be in the nursing station, keep a constant eye on the cameras. Things
can happen in an instant on PICU.
 Do not speak to patients with the nursing station door open. AWOL happens easily. Either

speak through the window or go out in the hall.
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