Unit Toolkit

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Unit Toolkit

Patient Calculators

Below are helpful calculators frequently used:

Full Hemodynamics (CPO, PAPI, FICK) FICK CO/CI Calculator Corrected Calcium Tidal Volume & Respiratory Calculators (Extubation Criteria)

FICK CO/CI Calculator

Weight (in kg):

Height (in cm):

Age (in years):

S_aO₂ (ABG, %):

S_vO₂ (mixed, %):

Hemoglobin (g/dL):

Heart rate (bpm):

CO: L/min

CI: L/min/m²

SV: mL/beat

Corrected Calcium Calculator

Serum Calcium (mg/dL)

Albumin (g/dL)

Normal Albumin (g/dL)

Corrected Calcium:
mg/dL

*Payne formula from 1973. Please note this formula has its downfalls, specially when there are aberrations in pH, magnesium, phosphate, and albumin binding capacity, as well as in other situations like existing chronic kidney disease and end-stage renal disease. When in doubt, send it out (Ionized Calcium).

Impella/Full Hemodynamics Calculator

Weight (in kg):

Height (in cm):

Age (in years):

S_aO₂ (ABG, %):

S_vO₂ (mixed, %):

Hemoglobin (g/dL):

Heart rate (bpm):

PA Systolic:

PA Diastolic:

PA Mean:

PCWP:
Use PAD?

P_aCO₂:

P_mvCO₂:

A-Line MAP:

CVP:

Vent PEEP:

Thermodilution CO:

P_aO₂:

P_vO₂:

Impella P-Level:

Impella Flow:

ABG PH:

ABG HCO_3^-:

ABG Base Excess:

Respiratory Support/Vent Mode:

Rate:

F_iO₂:

PEEP:

Tidal Volume:

Heart Rhythm:

Room Number:

_FickCO: L/min

_FickCI: L/min/m²

_FickSV: mL/beat

CPO: Watts

PAPi:

P_v-aCO₂:

BSA: m²

Respiratory & Extubation Parameters Calculator

Maryann's Helpful Guides

Below are helpful guides that Maryann put together to help walk us through what needs to be done:

Transfer Within Facility Patient Discharge When Your Patient Expires Heart Patient Transfer GIP Bed Placement for CMO & Hospice House Transfer

Transfer Within Facility

When a physician rounds on your patient and suggests a downgrade, they should enter an "in-facility transfer" order. Only enter the transfer order yourself if the physician provides a verbal directive. If you find a note in a consult or progress indicating a transfer, treat it as a verbal order. Ensure you have received the order from Cardiology and inform the primary doctor as a courtesy.
Inform your charge nurse and/or the Health Unit Coordinator (HUC) about the transfer so they can promptly request a new bed.
After receiving a bed assignment, attempt to provide a report to the receiving unit and document the communication in the patient's notifications.
Inventory all patient belongings for tracking purposes.
If the patient requires stretcher transport, notify the HUC to arrange for it. Ensure all patient transfers are conducted with a portable monitor.
Note the telemetry box number and confirm with the Central Monitoring Unit (CMU) at 203832 that the patient is being monitored. Finalize the telemetry handoff with the receiving nurse. Remember to document in the patient's notifications the details of the report given, the telemetry box used, and confirmation that the CMU is monitoring the patient.

Patient Discharge

If your cardiologist approves discharge, he will either note in his documentation that the patient may be discharged or he will inform the nurse verbally. If the MD is not at the hospital, place a 'Physician to Nurse' order stating that the patient may be discharged. If the discharge directive is in the MD's notes, treat it as an official order.
Contact the primary hospitalist or the intensivist to ask for discharge orders and medication reconciliation.
Always check the patient's chart for any written prescriptions or documents related to tests or devices that the patient may need to take with them.
Review the medication reconciliation for any medications being sent to Publix or other external pharmacies. Ensure that if the patient is receiving Brilinta, this prescription is filled and delivered to the patient's bedside.
Open the "Nurse View" in Cerner and complete the nursing discharge documents. Arrange any follow-up appointments possible for the patient. Modify the medication list to include the next dose and then sign. Once all the RED asterisks change to GREEN checks, you are ready to sign, submit, and print.
Print out the papers and highlight the medications, follow-up appointments, and educational information.
Review all educational materials with the patient at the bedside, especially regarding new medications and their side effects. Document in AdHoc, under "Discharge," that all educational material was reviewed, appointments were communicated, and all questions were answered. Also, note that the patient expressed understanding of all reviewed material. Add a note that the patient was taken via wheelchair to the front lobby where they were picked up by family in a private vehicle, or by transport, etc.
Remove all IVs, document that they were removed, and ensure to "inactivate" those lines in the patient's chart.
Lastly, remove the patient's ID band and ensure it is shredded. Inform the HUC that you are leaving the floor with the patient and provide a mask for the patient.

When Your Patient Expires

Notify Life Link within 1 hour of death and chart the "FL-" number in notifications and on the expiration record. (Life Link number: 1 (800) 643-6667).
Inform the Administrator on Duty (AOD) about the time of death and the funeral home, if known.
Text the primary and consulted doctors about the time of death.
After the family has left the bedside, remove all lines and catheters, unless the medical examiner needs to be involved; in that case, leave all lines intact.
Chart under AdHoc - Patient Care 2 - Expiration Record. Fill out as much information as possible. As the bedside nurse, you are the pronouncer of death, and the cardiologist, intensivist, or attending MD during the code will sign the death certificate.
Once the Expiration Record is completed, navigate to Task at the top left of Cerner, select reports, choose Expiration Record report and face sheet report, and print both from printer WHCCU02T.
Place an identification tag with the patient's sticker on both the white post-mortem bag and tie one to the patient's toe.
Call the operator by dialing "0" and request for the orderly to be paged.
Ensure the patient is in the room in the bag, with all papers printed and signed by the nurse, ready for pick-up.
Once the patient has been picked up by the orderly, go into PM conversations, select discharge, and then enter the time and date in the deceased section.

CVICU Heart Patient Transfer

Order should be entered by the MD or verbally given to the nurse, who then enters a "Physician to Nurse" order with the exact wording "De-line and transfer."
Confirm and then initiate the "PA transfer to CVU" orders. If they are not present in the order screen, immediately contact the PAs to have them entered. No transfer can occur until this is completed.
Discontinue CVICU post-op, vent weaning, and vent management orders before transferring the patient to CVU.
Chart all belongings under AdHoc - Patient Care 2 - Patient Belongings.
De-line the arterial line and the Swan-Ganz, chart the removal, and inactivate the lines.
Remove the Foley catheter and chart the removal and inactivate the item (unless it is to be kept in per MD order).
Using a black Sharpie marker, mark and date/time the patient's chest tube Atrium.
Collect the humidifier and suction tubing and accompany the patient to CVU with these items.
Escort the patient on the portable monitor and transfer via wheelchair on portable monitor.
Upon the patient's arrival in the new room, co-sign a skin assessment and note the telemetry box number, and contact the Central Monitoring Unit (CMU) at 203832 to confirm the patient is being monitored.
The nurse is to enter the telemetry box number into the chart and sign off on skin and telemetry boxes, as well as document who received the report under notifications.
All nurses are responsible for cleaning and organizing their rooms and monitor wires, ensuring all wires are accounted for and coiled at the monitor. All body fluids and IV fluids left in the room are to be emptied by the nurse.

GIP Bed Placement for CMO

Resource persons for this process would be Barb @ 204748 and Terry with Good Shepherd Hospice at 1 (863) 287-7158.
First, call the transfer center at 1 (727) 561-2449 for a new FIN. While on the phone with them, the charge nurse or HUC should discharge the patient from PM conversation in Cerner. The discharge disposition should be listed as Hospice (General Inpatient Care).
Give the new FIN to the HUC and the hospitalist/intensivist.
The charge nurse or HUC notifies the Transition Unit at 1 (727) 734-6655 and informs them we have a GIP Hospice patient. They will then check the patient into the room under GIP scatter bed with insurance coverage listed as Hospice Care.
Print a new arm band with the new FIN number and remove all old arm bands.
Initiate the Power Plan on the new hospice inpatient FIN.
Perform a new admission database under the new FIN.
Chart a brief assessment of the patient and ensure to scan all meds under the new FIN.

Patient Now Transferring to Hospice House

If your patient is transferring to Hospice House, have the physician complete the Discharge Medication reconciliation.
The physician should perform another discharge summary for this hospice level of care encounter.

Amber's CGS MCS Corner

SCAI Shock Staging Tool, and CGS -> MCS Algorithms:

SCAI Shock Classification Tool

Systolic Pressure:

Mean Arterial Pressure:

Serum Lactate:

Serum ALT:

Blood pH:

Pressors/inotropes:

MCS Devices:

Persistent Hypotension after therapy?

Out of Hospital cardiac arrest?

Unit's Commonly Used Forms/Files

Below are the most commonly used files in the unit. For consents, please ensure they are the most updated revision. (All uploaded with most recently available revision dates, on 4/2025)

CABG Hourly Sheet Unit Report Sheet High Chest Tube Drainage Worksheet Javi's Expanded Report Sheet NIH Stroke Scale Packet

General Procedure Consent (English) General Procedure Consent (Spanish) General Anesthesia Consent (English) General Anesthesia Consent (Spanish) Blood Consent or Refusal Form (English) Blood Consent or Refusal Form (Spanish)

Bostick 2 Fax Cover Letter

Unit Toolkit

Patient Calculators

Maryann's Helpful Guides

Amber's CGS MCS Corner

Unit's Commonly Used Forms/Files

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