Joint commission and PICU

Specialties PICU

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Does anybody know if there is a joint commission standard about an age cut off for pediatric icu? Or if they require acls for picu nurses who admit adult patients? Just curious because our picu is planning on admitting a 24 year old tomorrow and I honestly do not feel comfortable when nobody has acls and I've never been inserviced on the bolt. Thoughts or opinions?

Peple don't under a dramatic biological change from peds to adult. Relax

I understand that but it's more about my license and the fact that there's no inservice on the equipment.

I understand that but it's more about my license and the fact that there's no inservice on the equipment.

Then that is the question you need to ask first.

By "bolt" are you referring to a Camino ICP monitor? Regardless, if you are being asked to care for a patient with monitoring devices with which you aren't familiar, then.yes, she should be trained on its use.

Specializes in NICU, PICU, PACU.

Our PICU takes people in their low 20's if they are comp care patients. If you are unfamiliar with the equipment I'd be getting your CNS or Educator to find someone to I service you or come and help you. Why is a 24 year old

Coming to you?

Because the icu isnt inserviced on the Camino...umm hello neither are we! Thankfully the adult icu is forced to take them because joint commission is actually supposed to show up tomorrow.

Specializes in SICU, trauma, neuro.

We have young adult SICU pts overflow in the PICU (and burn unit) quite often when we're full. We're a level 1 trauma and stroke center, so we can't just send pts to another hospital. ACLS for an adult is (I'm assuming) the same as for a 16, 17 yr old kid. Assumption is based on while legally considered a child, their body is fully mature.

Edited to add: Typically we move the most stable patients there. So for example the post tPa stroke pt who just needs frequent neuro checks, vs the multiple GSW pt who is being massive transfused and getting 3 neuro monitoring devices put in their head

Specializes in NICU, PICU, PACU.

Ummm , hello, so who knows how to use it? And if it isn't something routinely used at your institution why is it being used now?

Specializes in Critical Care, Education.

For the most part, accreditation agencies do not dictate operational decisions. For instance, there is no actual requirement to have any 'pediatric' departments at all. Some organizations just mingle pedi patients with the general population and others may have both Pedi & Adolescent department. The important thing is to ensure staff competency.

They do require 'specialty' departments to defined scopes of service & admission/DC policies. So there should be documents available with this information - age range of patients served, types of clinical services provided, & qualifications & requirements for patient admission and discharge criteria. I would advise you to refer to these documents.

Then, since it would seem that this particular patient is outside the normal scope of service, talk to your supervisor to see how he is going to be managed. They may be floating adult ICU nurses to care for him. If this is not the case, find out how they are going to provide 'just in time' training and support for staff who are unfamiliar with the technology &/or interventions required.

It's always a good idea to make sure you have all the facts before jumping to conclusions or expecting the worst. Assume positive intentions. No one is going to deliberately put this (or any) patient at risk. Everyone wants the same thing... quality care and good outcomes. You'll come across as much more professional by if you react to unexpected events with a logical and reasoned approach to your patient advocacy.

We took care of 50 year olds who had issues related to CF, CHD or other chronic conditions of childhood.

Specializes in NICU, RNC.
ACLS for an adult is (I'm assuming) the same as for a 16, 17 yr old kid. Assumption is based on while legally considered a child, their body is fully mature.

This is exactly what I was going to say.

Specializes in SICU, trauma, neuro.
This is exactly what I was going to say.

I mean, I've never worked in PICU/peds or taken PALS, but when taking BLS they say if there is evidence of puberty, use the adult protocol. So wouldn't a mature teen get the adult ACLS protocol vs the weight-based PALS? ACLS doesn't change for an 18 yr old vs a 35 yr old vs a 60 yr old.

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