Introduction

Welcome to the PICU Nursing webpage.

The nursing team in PICU enjoy a wide variety of patient groups to challenge their expertise and provide their services as the only stand-alone tertiary/quartenary paediatric ICU in New Zealand. Patient groups include cardiac, respiratory, neurological, infectious, elective surgical and trauma cases. Some of the services offered on the unit include ECMO, renal replacement therapy, transport services, and oscillation.  Accordingly, the team enjoys educational opportunities to support expert practice.  In addition, 50% of our nursing staff hold a postgraduate course in critical care.

Nursing Structure

Our Normal Nursing shift

Each shift has a dedicated shift co-ordinator plus a runner or resource nurse.  There is coverage by a healthcare assistant for a minimum of 8 hours most days and also unit clerk coverage. The normal shift is a 12 hour self-rostered day or night.

Wherever possible patients are assigned with consistency in mind and also have a primary nursing programme. The team listen to a brief handover from the previous shift and then a nurse to nurse handover at the bedside focuses on more detailed patient information.  Nurses may look after one ICU patient or 2 High Dependency patients. They may also set up for an emergency admission or an elective surgical admission.

The multidisciplinary team do rounds at approximately 8.30am to plan care.  Once a week we have multidisciplinary rounds where nurses may present their patient.

Family Centred Care

Family Centred Care is an overarching team philosophy within the unit and staff care for critically ill children in partnership with the child's family/whanau.  Parents' presence at the bedside of their critically ill child is accepted as the norm, and parents are not asked to leave for any procedures ranging from insertion of intravenous lines to resuscitation.

Initiatives / Innovations / Research

PICU is a new and progressive unit with a significant focus on quality.  Introduction of a primary nursing model for complex children, the implementation of a Bereavement Team and weekly multidisciplinary team meetings are just some of the initiatives undertaken in 2004/5.

In addition, we have a medical emergency team consisting of a PICU nurse and Registrar and a Medical Registrar who attend deteriorating children on the inpatient units in Starship Hospital.  We also attend all paediatric cardiac arrests at Starship. Currently we are looking to broaden our outreach support

We have an active research programme and are continuing to expand.  The current focus is cardiac surgery and impact to the brain, specifically looking at early detection of brain damage in the infant post cardiac surgery.  We have also done some research into nursing management of pain in relation to ventilator weaning which was recently presented at a combined ICU and anaesthesia conference.

HDU Opening

In June 2010 PICU opened a 6 bedded High Dependency Unit (HDU) which admits patients with acute medical and surgical conditions or have an acute reversible single organ failure and are at risk of developing complication. Such patients are typically nurse at a 1:2 staff to nurse ratio and require a high level of observation and monitoring, with frequent interventions which are not available on the ward. The HDU patients are under the shared care of the primary team and the PICU consultants.

Related Documents / Links

PICU Career Pathway

NZ Nursing Council

CEBHA