ICU Protocols

[taprn86]

I work in a small hospital's ICU and we are looking for ways to make our job more efficiant. We have tried to get our doctors here to get us more protocols so we don't have to call them with every little thing. What are some protocls that your hospitals use that help make your job easier?

[MunoRN, RN]

I'm not sure how an ICU would function without at least some protocols, so I'm probably stating the obvious with some of these, but here are the one's we use: Sepsis, DKA, Therapeutic hypothermia, post STEMI, Post OHS, LVAD, IABP, CRRT, OHS A-fib, non-OHS A-fib, Long term vent, short term vent, Potassium replacement, Magnesium replacement, phosphorus replacement, GI bleed, ETOH w/d, Opiate w/d, overdose, acute stroke, Traumatic brain injury, Licox monitoring, insulin protocol (non-DKA), and I'm sure there are more but these are off the top of my head.

[classicdame, MSN, EdD]

this is where a good educator is needed. Someone needs to check the nurse practice act to be sure all policies are consistent with that. Then collect standards from various organizations/agencies (CCRN, Infusion Nurses Society, etc.) Then collect evidence from research. Then write the policies and procedures. In my state a protocol has a specific designation so is not used often (it is a communication approved by MD for NP,PA to follow, not the staff nurse). Once you have a draft you give it to the medical executive committee (or whatever committee needs to approve it). If any particular MD has input they need to state it at that time. Sometimes I include MD's in the planning phase, but they tend to state what they WANT, not what best evidence calls for. I do not see how any ICU is exisiting without this documentation in place.