post op care in ICU

[cconvard]

We are a small rural 5 bed ICU. Occasionally we will recover post op ICU patients. We only staff the ICU with two nurses. On this particular day we had a septic patient and another patient with c diff. Should we give the post op patient to the nurse who has the c diff patient or to the nurse who has the septic patient. Are there any policies out there that state that post op pts. should be recovered one on one or with a nurse who does not have a patient who is on isolation. What is best practice for recovering of post op patient in the ICu?

[zambezi, BSN, RN]

If you have to combine patients, I would put the septic patient and the cdiff patient together. We try not to combine our isolation patients with others if possible...we try to keep any type of 'bugs" away from our post ops. Obvisouly, we also continue to practice strict handwashing/stethoscope washing, etc (we keep and isolation stethoscope in the room).

[EastCoast]

As stated I think c-diff/septic is best combo. However, you don't say if how how time consumng each is so i will guess they are both pretty stable. Regarding the Cdiff and enteric precautions, most of the ICU patient we had didn't get up to use BR. I would worry about the immune status of the both and maybe compromising them. I'd keep the postop alone but i guess that leaves you open for an admission which could be disasterous too.

Regarding recovering a post op...checkyour units 'scope of practice/care' that describes the work environment. Unfortunatley when i did ICU we recovered patients but when JCAHO came in they asked for this description and it didn't mention anything about recovering post ops. (oops). As you might guess...when the scope was revised it closed this loophole nicely for the PACU patients.

Our Pacu was infamous (and no offense to any PACU nurses..alot of this was an anesthesia issue) for sending all ICU post ops who were not recovered by 3 or 4 pm on fridays directly to us and everyone in PACU went home. And i do not mean the vented patients that are going to stay sedated. I mean the CEA's and fem pop's who were waiting to be extubated.