Intensive Care Unit and Progressive Care Units

Critical Care nursing is defined as the specialty that deals with human responses to life-threatening problems.  

Our Intensive Care Unit and Progressive Care Units are specially designed, staffed and equipped to meet the needs of critically ill patients.
• ICU – A 16 bed Medical/Surgical ICU
• PCU 2 – A 16 bed Progressive Care Unit
• Nursing staff are specially trained in the care of the critically ill patient
• Critical Care Course offered on site
• Basic Arrhythmia Course and 12-Lead EKG course offered on site
• Designated Critical Care Educator assigned to assist the staff in on-going education and training
• Regularly scheduled In-services and Staff Education to keep all Critical Care staff current in their nursing practice 

Patient care is provided based on nationally approved standards of practice and care to describe the practice of the nurse who cares for an acutely or critically ill patient no matter where that patient is cared for within the healthcare environment. 

The American Association of Critical Care Nurses establishes standards of care and practice for the care of the critically ill patient.  

FLORIDA HOSPITAL - Zephyrhills
CRITICAL CARE (ICU and PCU) NURSE’S STANDARDS OF PRACTICE
(Adapted from AACN)

This scope of practice articulates the contributions of critical care nursing to a patient-driven healthcare system. 
• The scope of practice for nursing care of critically ill patients encompasses the dynamic interaction of the critically ill patient and his or her family, the critical care nurses, and the environment of care.
• A commitment to the vision of a patient-driven healthcare system requires a holistic view of patients and their families and recognition of their multiple facets including physical, emotional, spiritual and cultural dimensions.
• The framework within which critical care nursing is practiced is based on a scientific body of specialized knowledge, an ethical model for decision making and a commitment to interdisciplinary collaboration in the care of patients. 

The Critical Care Nurse will:
• Support and maintain the physiologic stability of patients
• Assimilate and prioritize information sources to take immediate and decisive patient-focused action
• Respond with confidence and adapt to rapidly changing patient conditions
• Respond to the unique needs of patients and families coping with unanticipated treatment, quality of life and end-of-life decision
• Manage appropriately the interface between patient and technology that may be threatening, invasive and complex so that human needs for a safe, respectful, healing, humane and caring environment are established and maintained.
• Monitor and allocate critical care services, recognizing the fiduciary role of nurses working in a resource intensive environment.

As part of an interdisciplinary team, nurses work to create healing, humane and caring environments by insuring that:
• Providers act as advocates on behalf of patients, families, and communities
• Patient and family values dominate
• Practice is based in research and driven by outcomes
• Ethical decision making is supported, fostered and promoted
• Collaboration is embraced
• Leadership is fostered at all levels and in all activities
• Life-long learning is fundamental to professional growth
• Existing talents and resources are optimized
• Innovation and creativity are rewarded
• Diversity is respected

As a patient advocate, the Critical Care Nurse will:
• Respect and support the right of the patient or the patient’s designated surrogate’s autonomous informed decision making
• Intervene when the best interest of the patient is in question
• Help the patient obtain necessary care
• Respect the values, beliefs and rights of the patient
• Provide education and support to help the patient or the patient’s designated surrogate make decisions]
• Represent the patient in accordance with the patient’s choices
• Support the decisions of the patient or the patient’s designated surrogate or transfer the care to an equally qualified critical care nurse
• Intercede for patients who cannot speak for themselves that require immediate action
• Monitor and safeguard the quality of care the patient receives
• Act as liaison between the patient, the patient’s family and health care professionals

As a nursing professional the Critical Care Nurse will:
• Systematically evaluate the quality and effectiveness of nursing practice by participating in quality of care activities and to evaluate changes in nursing practice
• Insure that his/her practice reflects knowledge of current professional practice standards, laws and regulations
• Acquire and maintain current knowledge and competency in the care of acute or critically ill patients
• Uses clinical inquiry in practice by continually questioning and evaluating practice and use of the best available evidence or research findings to develop appropriate plans of care
• Interact with and contribute to the professional development of peers and other healthcare providers and colleagues
• Guide their practice by the ANA’s Code for Nurses, AACN’s Ethic of Care and ethical principles
• Consider factors related to safety, effectiveness and cost in planning and delivering patient care
• Communicate respectfully, honestly, and openly with their colleagues and other healthcare providers, with patients and their families
• Hold self and each other accountable for unacceptable behavior
• Seek solutions as a team – investigate and analyze applying the principles of performance improvement
• Develop a mentoring system among peers, supervisors, physicians, and other providers to build on strengths and enhance personal skills
• Change negative work environments – establish a standard for collaboration and communication in the unit, develop strategies and skills and share their best practices
• Participate in multidisciplinary educational committees to develop organizational policies and strategies
• Recognize and name the experience of moral distress (knowing the ethically appropriate action to take, but are unable to act upon it; acting in a manner contrary to your personal and professional values, which undermines your integrity and authenticity)
• Affirm the professional obligation to act and commit to addressing moral distress
• Be knowledgeable about and use professional and institutional resources to address moral distress
• Develop skill through the use of mentoring and resources to decrease distress
• Implement strategies to accomplish desired changes in the work environment while preserving personal integrity and authenticity

FLORIDA HOSPITAL - Zephyrhills
CRITICAL CARE (ICU and PCU) NURSE’S STANDARDS OF CARE
(Adapted from AACN)

ASSESSMENT – The Nurse caring for acute and critically ill patients collects relevant patient health data.
• Data collection involves the patient, family and other healthcare providers as appropriate
• Admission Assessment for ICU and PCU patients will be initiated within five (5) minutes of admission to the unit and will be completed within one (1) hour of admission.
• The Assessment is systematic and ongoing
• A physical reassessment is completed every two (2) hours and as the patient’s condition warrants for the ICU patient every four (4) hours and as the patient’s condition warrants for the PCU patient

DIAGNOSIS – The nurse caring for acute and critically ill patients analyzes the assessment data and works in collaboration with the patient’s physician(s) and other caregivers in determining diagnoses.

OUTCOME IDENTIFICATION – The nurse caring for acute and critically ill patients identifies individualized, expected outcomes for the patient.
• Outcomes are mutually formulated with the patient, family and other healthcare providers when possible and appropriate
• Outcomes are attainable in relation to the resources available to the patient
• Outcomes are measurable and will include a time estimate when possible

PLANNING – The nurse caring for acute and critically ill patients develops a plan of care that prescribes interventions to attain expected outcomes.
• The plan is individualized to reflect the patient’s characteristics and needs
• The plan is developed collaboratively with the patient, family and other healthcare providers
• The plan provides for continuity of care

IMPLEMENTATION – The nurse caring for acute and critically ill patients implements interventions identified in the Plan of Care.
• Interventions/nursing care is delivered in a manner that minimizes complications and life-threatening situations

EVALUATION – The nurse caring for acute and critically ill patients evaluates the patient’s progress toward attaining expected outcomes.
• Evaluation is systematic, ongoing, and criterion-based