PAEDIATRIC CTU• MUMC Pediatrics CTU is separated into three teams: • Team One (pager 5301) and Team Two (pager 5302): • General paediatric inpatient teams • Team Three (pager 5303): • Level Two Nursery
PAEDIATRIC CTU• Our Wards & Who we find there: • 3C: General Paediatric & Paediatric Surgery Ward • 3B: General Paediatric, Adolescent Medicine & Haematology/Oncology Ward • 3Y: General Paediatric & Paediatric Surgery Ward • 3Y: Step Down Unit • 3D : Express Unit & Medical Day Care • 4C: Postpartum Ward – Well Newborn Unit • Level Two Nursery
A DAY ON CTU• 7:15 - Handover (3H40)• 8:00 - Teaching • Except Wednesday• 9:00 - Patient Care• 10:00 – Team Rounds • After rounds are finished, time to complete orders, notes and new consults• 3:00 - Subspecialty/ Bed side teaching/ Simulation• 4:30 - Handover 3C 10
MULTI-DISCIPLINARY ROUNDS• Team 1: • Tuesday 13:00-13:30• Team 2: • Tuesday 13:30-14:00• Team 3: • Thursday 13:00-13:30
TEAM LISTS• Team lists are located on the Shared Drive through Citrix • If you do not have access, please contact Skye Levely (firstname.lastname@example.org) • Please update the lists everyday and include any overnight / weekend instructions • Team lists MUST be printed off with ALL new admissions and be ready for the new day team BY 7:15am • Remember: The patient lists contain confidential information! Do not leave printed copies in the handover rooms or on 3C!
HANDOVER• Handover starts promptly at 7:15 (3H40) • The on-call residents briefly review working-diagnoses of new admissions and any over-night team issues • Should limit handover to the pertinent positives/ negatives, impression and plan• Handover to on-call team occurs at 4:30 – 3C10 • Please remember that off-service paediatric residents cross cover CTU on-call and may not know the patients on the ward. Each patient should be handed over • Please highlight any sick patients and any tasks/labs that need to be reviewed overnight
ST JOSEPH’S CTU• St Joseph’s • Level 2 Nursery & Post partum ward consults • Labour and Delivery • General pediatric outpatient clinic some afternoons
A DAY ON ST. JOSEPH’S CTU• 7:30 - Handover (3OBS Conference Room)• 8:00 - Teaching (Monday/ Thursday)• 9:00 - Patient Care• 10:00 – Team Rounds • After rounds are finished, time to complete orders, notes and do new consults• 1:00 - Teaching/ Clinic/ Patient Care/ Consults• 5:00 - Handover (3OBS Conference Room)
DOCUMENTATION• Every patient requires a daily progress note • DO NOT TAKE PAGES OUT OF THE CHART TO WRITE YOUR NOTE FOR THE DAY AND THEN RETURN • Leave the sheets in the chart and write your note at the chart• On Fridays, each patient should have a more detailed note outlining the treatment plan for the weekend, especially if the patient is to be discharged • Please try to have planned weekend discharges organized (ie prescriptions given to parents, appointments booked, dictation completed etc).
DOCUMENTATION CONTINUED…• Remember: Exact details (eg labs and vital signs) are part of the electronic chart and nursing notes• It is important to capture these, BUT is more important to highlight trends and interpretation
DOCUMENTATION CONTINUED…• The most important part of your note is the impression and plan • Outline the rational for pursuing one treatment vs. another, or for changes in management plan • Include the working differential diagnosis, (especially on chronic patients) and why they are still in hospital
DOCUMENTATION CONTINUED…• With admission order sets on call please admit as follows: • Admit to General Paediatrics, Team 1 (or 2) under Dr. MRP, with Dr. On-call staff to cover until 8am
DICTATIONS• Your green book has templates for paediatric dictations• Every consult and discharge requires a dictation to be done within 24 hours of admission/discharge• When dictating, ensure that you indicate the admitting staff (NOT Team 1 or Team 2) and please SPELL THEIR NAME