PSCs

General Documents:
Charge nurse roster for days
Charge nurse roster for nights
Cover page for Death Pack  (associated hospital forms on intranet)


Documents for New Admissions:
Only the following documents are included in the new admission packet:

1. The "For Your Information" folder, updated and provided by Child Life Services.  To replenish, call 2-1230 or email jennie.ott@uchospitals.edu
2. The PICU welcome sheet, given to families inside the FYI folder.  Glossy full color copies of the PICU welcome sheet are available at the front desk.  To replenish, order through the copy center (email purchasing.xerox@uchospitals.edu, reference file PICUWelcome2017).
3. The visitor information sheet, and verification form for parents/guardians to complete on admission.  Copies of this form are maintained at the front desk.  To replenish, print double-sided on plain white paper from this PDF.
4. The telemetry strip page, for nurses to place in the bedside chart and use as indicated.  This is replenished through supply chain (Form 54.60 R2/12).
5. The receipt of child form, for nurses to place in the bedside chart for use upon discharge.  Copies of this form are maintained at the front desk.  To replenish, print on plain white paper from this PDF.  This form is also available through supply chain (Form 44.14 R5/07).  

For additional resources, the most up-to-date information can be downloaded from the hospital website.  Here you can find links to campus maps and parking information (including a PDF of rate information) to print and distribute to families on request.  You can also refer families to the Comer Patient and Family Visitor site for more information.

No additional forms aside from those listed above are to be distributed without prior authorization by the PICU Medical Director.  Approved forms must be submitted electronically for central posting through this site.

Team Assignment for Two-Team Rounding:
To enhance communication within the PICU in the two-team rounding structure, the daily team assignment sheet will identify which team is admitting on a given day, and will identify members of both teams with associated contact information.

The night shift clerk will fill in the fields of the team assignment sheet to reflect the rounding team for the upcoming day, including the team members on both rounding teams.  The fields that need to be changed every day include the DATE, the ADMITTING TEAM (Green or Blue, alternating every other day), and the overnight fellow and pager number.  Most other fields on the table will require less frequent updates, depending on how often the physicians rotate.  The phone numbers will remain constant and do not need to be changed.

After updating the daily team assignment sheet, the night clerk will print copies and post them in the clear plastic sleeves throughout the unit on the 3rd and 4th floors.  The plastic sleeves are located at each nursing work area on the cabinets, in the physicians’ work rooms (K469 and K467) inside the doors on the wall to the right as you enter, and at the main desk on the 3rd floor.  The team assignment sheets should be updated and posted by 07:00 every morning.

Small colored magnets (reversible, green on one side and blue on the other) will indicate the patient's team assignment on the door frame of each patient room.

Updated attending and on-call fellow schedule available on amion.com

Team assignment sheet
Printable instructions (with team assignment sheet template)

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