| Abstract: |
SummaryIntensive Care Units can provide efficient and effective care to the critically ill patients by implementing well admission, discharge criteria’s, policies and procedures.As standards for ICU, specify that Individual ICUs should create policies specific to their unit. So, each ICU should have clearly defined policies and procedures and define the scope of services it provides and the patient population it serves, as approved by their professional staff.Looking to our ICU’s, they are still lacking the complete set of documents of policies and procedures done inside these units .So, we found that there is an urgent need to fulfill these requirements in order to improve the efficiency and safety in patient care and to facilitate the daily running in our busy intensive care units.Policies include admission criteria ,discharge criteria, leveling of ICU according to experience of staff , capacity , optimal unit size , patient care activities , regulations including visiting time, discharge summary, transportation, isolation precautions , communication skills with patients and their relatives and implications of nursing practice.Procedures include endotracheal intubation , CVP catheter insertion , nasogastric tube insertion , drawing blood samples , drawing ABG samples , arterial line insertion , under-water seal drainage , tracheostomy dressing , cardioversion, , emergency defibrillation, nebulizer settings, pulse oximetry , suction , face masks , enteral feeding, ……………..etc .We have done a study on the working team in our postoperative ICU in the New Hospital of Surgery to evaluate the level of their knowledge and attitudes from the policies and procedures that should be fulfilled inside the ICU .This study included 47 individuals of the teamwork of ICU , they were evaluated before and after the training program that included three main topics that are : Communication skills with the patients and their relatives, Infection control procedures and Nursing care procedures.Our study revealed that there is non significant increase in number of individuals who appear sympathy with patients and their relatives during telling bad news, do proper hand washing before and after dealing with any patient, wear protective face masks before any respiratory maneuver, do periodic cleaning of uniform of ICU, use antiseptic technique on endotracheal suction and measure the length of nasogastric tube before its insertion.There is significant increase in the number of individuals who Use body language to explain special message to relatives , do Skills to inform relatives the news by telephone , explain the condition to the patient or relatives simply without complicated medical terms , use special words to express sorrow to relatives in case of telling bad news about their patient , handle violence directed to ICU from relatives in case of telling bad news properly , sterilize the hands properly before surgical maneuvers , Sterilize equipments properly, care of isolated patients properly , disposal of waste products of isolated patient ,sterilize thermometers after each use, do Peripheral cannulation using antiseptic technique , remove CVP correctly , connect 100% oxygen for 2 min before suction , do suction not more than 5 seconds at one time , measure cuff pressure every 8 hours , put sample of ABG in ice if delay time >2min , test correct position of nasogastric tube every time before injecting food in it , keep food not more than 24 hours , use activated charcoal in gastric wash , use antiseptic technique during S.C injection and who take blood culture with complete antiseptic technique.ConclusionOur ICUs need complete set of documents for all the policies and procedures performed daily in these units.In our study, we found some pitfalls either in the thoughts of the team towards certain points or in the practice of procedures .So, we tried to change these false concepts and pitfalls in practice through carrying out our study.
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