Guide for Level of Nursing Care | Patient Capacity Management Center

UNIT	PATIENT POPULATION	ADMITTING SERVICES	UNIT SPECIFIC NURSING INTERVENTIONS	UNIT APPROVED MEDICATIONS	UNIT APPROVED THERAPIES
C6 Heme/Onc	Oncology/Hematology NOT requiring Critical Care Acute Care populations listed for C5 MSP Surgical Service patients	Oncology Hematolgy BMT Pediatric Surgery Orthopedic Surgery Urology OHNS Plastic Surgery Neurosurgery	Chemotherapy protocol-based interventions Q4H VS/Assessment Post procedure VS: Q15 mins x 1 hr, then QH x 3H PCA initiation/dose increase/med change: Q2H VS x 12H CR monitoring NOT for rhythm	Chemotherapy and Biotherapy PCA/PCEA Ketamine gtt: not >5mcg/kg/min (End-of-life care max of 10mcg/kg/min in consult with IP3) Narcan: < 2mcg/kg/min Octreotide: for portal HTN or coag tx for esophageal varices Precedex (for MIBG pts by CCRN) Albuterol: Q3-Q6H or continuous nebs up to 15 mg/hr Electrolytes: only for replacement tx Heparin gtt: no titration Hypertonic 3% NS for nebs only Midazolam (SZ mgmt only)	CPAP/BiPAP: end-of-life care in consult with IP3 and CCRN mgmt
C6 BMT	BMT pts Oncology/Hematology boarders	BMT Oncology Hematology	Q4H VS/Assessment Post procedure VS: Q15 mins x 1 hr, then QH x 3H PCA initiation/dose increase/med change: Q2H VS x 12H	Chemotherapy and Biotherapy PCA/PCEA Ketamine gtt: not >5mcg/kg/min (End-of-life care max of 10mcg/kg/min in consult with IP3) Narcan: < 2mcg/kg/min Octreotide: for portal HTN or coag tx for esophageal varices Albuterol: Q3-Q6H nebs or continuous Electrolytes: only for replacement tx Heparin gtt: no titration Hypertonic 3% NS for nebs only Midazolam (SZ mgmt only)	CPAP/BiPAP: end-of-life care in consult with IP3 and CCRN mgmt
C5 MSP	Newborn to 21 yo > 2000 gm General med pts GI disorders Renal dysfunction Liver dysfunction Cystic Fibrosis Eating disorders Epilepsy disorders Diabetes mellitus Pain disorders Pediatric surgical Physical rehab Pregnant adolescents: non-OB admission	Peds Hospital Medicine Adolescent Medicine Liver Transplant GI Renal Transplant Hospitalist/General Peds covers these Sub-Specialties: Dermatology Endocrine Peds GI Immunology Infections Disease Liver (medical) Neurology Ophtho Pain Renal (medical) Rheumatology	Q4H nursing Post procedure VS: Q15 mins x 1 hr, then QH x 3H PCA initiation: Q2H VS x 12H Trachs: established, stable (not on positive pressure) CR monitoring for rate only Solid organ/islet cell TP: stable, admit for bx or non-ICU indication	Albuterol: Q3-Q6H or continuous nebs up to 15 mg/hr PCA/PCEA Electrolytes: only for replacement tx Heparin gtt Hypertonic 3% NS for nebs only Midazolam (SZ mgmt only)
C5 TCUP	Posterior spinal fusion: no ICU indication ENT/T&A Liver dysfunction > 1yr post-TP Renal dysfunction > 1yr post-TP Renal TP immediate post-op if > 20kg and/or > 5yo Extensive DC teaching Trachs: recent after 1^st PICU trach change Hemo/Peritoneal Dialysis: no ICU indication Solid organ/islet cell transplant: no ICU indication Neuro-surg: no ICU indication Spinal fusion: no ICU indication	TCUP/PICU Attending Pedi Surg Peds GI	Q2H-Q4H VS Complex wound care Complex pain management Cardiac monitoring (rate and rhythm)	Dopamine: not > 3mcg/kg/min	Hemodialysis Peritoneal Dialysis HFNC (flow limits by age apply, see policy) Stable CPAP/BiPAP PCA/PCEA
C4 PICU	Critical airways Hemodynamic instability Liver TP: immediate post-op Renal TP: immediate if pt <20kg and/or <5yo Splenectomy: immediate post-op Pancreatectomy: immediate post-op Hypoplastic cardiac repaired Pulm HTN: established regimen	PICU Attending/Fellow	Assessment >Q2H Mechanical ventilation Large volume resuscitation catheters Massive transfusion protocol	Albuterol: Q1 – Q2H nebs Adenosine Dopamine Dobutamine Esmolol Heparin gtt Hypertonic 3% NS gtt Insulin gtt Ketamine gtt Magnesium Sulfate Midazolam Milrinone Narcan gtt > 2mcg/kg/min Pecedex (on acute only for MIBG pts by PICU RN) Propofol Vasoactive infusions Insulin infusions	CRRT ECLS CPAP BiPAP Hemodialysis Peritoneal Dialysis PCA/PCEA
C4 CICU	Cardiac anomalies: newly diagnosed Pulm HTN > 1 yo	Cardiology	> Q2H monitoring cardiac rhythms	Adenosine Esmolol	PCA/PCEA
C4 CTCU		Cardiology May board hospital medicine patients	Monitoring cardiac rhythms Arterial lines	Milrinone gtt after initiation/stabilzation in CICU	PCA/PCEA CPAP/BiPAP: stable home therapy
C3 ICN	preterm infants Infants less than one year old Pancreatectomy (Neonate) Pulm HTN w/up <1 yo Hyperbili admits (pedi med service)	Neonatology NBN (Pedi Medicine)	Umbilical catheters		Cooling – total body ECMO