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Unit 42 Pediatric Hematology/Oncology

Description of Unit

42 Pediatrics is an 18-bed inpatient unit located on the fourth floor in the North Tower of UF Health Shands Hospital. The unit consists of eighteen private HEPA filter rooms, including two negative isolation rooms. Monitoring capabilities include continuous pulse oximetry, EKG, respiratory rate, and non-invasive blood pressure. Patients can be monitored within the room, centrally at the nursing station, and remote telemetry monitoring from Unit 44. Average bed occupancy is 14 patients per day.

Family centered care is provided to patients on the unit, allowing for one parent to be with their child 24 hours per day. A family resource room is available on the unit for families to congregate, and access information, or communicate via internet. Family showers are located on Unit 45 and laundry facilities are located on unit 44. A family room, sponsored by Ronald McDonald® House, located on the 10th floor, offers a place for families to relax, prepare and eat meals, contact family members, and sleep in the hospital.

Description of Patient Populations

Patients are admitted from admissions as scheduled appointments, the outpatient clinic, the emergency department, and as hospital-to-hospital referrals. Patients are admitted to the unit for stem cell transplants, pre- and post- transplant complications, chemotherapy, and treatment for other immunocompromised or genetic disorders. Types of transplants include: autologous, syngeneic, allogeneic, or matched-unrelated donor (MUD) transplants in the form of cord blood, peripheral blood stem cells (PBSC), or bone marrow. Patients are treated for a variety of hematological, oncological, immunological, malignant, and metabolic disorders. The ages of the patients served are new born to young adults. The average length of stay is six days.

Nursing Care

Nursing care is directed toward prevention and treatment of stem cell transplant complications by focusing on assessment, nursing diagnosis outcome identification, planning, treatment, and evaluation of patients requiring inpatient care. Nursing care activities include: comprehensive care of all body systems, assessment and treatment of comfort (pain, nausea/vomiting, temperature imbalance), treatment of fluid and electrolyte abnormalities, administration and management of intensive medication therapies (antibiotics, antivirals, antifungals, growth factors, chemotherapy, immunoglobulins, immunosuppressants, biological response modifiers, and blood products), and early intervention and treatment of common complications/side effects of transplant/chemotherapy including mucositis, bowel changes, myelosuppression, graft versus host disease, hemorrhagic cystitis, veno-occlusive disease, tumor lysis syndrome, and sepsis. Nurses also provide ongoing education for the patient and their family/caretakers.

Health Care Team

The Medical Director is appointed by the chairman of the Department of Pediatrics. The Medical Director is board certified in Pediatric Hematology/Oncology. The Division of Pediatric Hematology/Oncology consists of attending physicians, fellows, physician assistants, and nurse practitioners. Patients are cared for by a multidisciplinary team consisting of the attending physicians, fellows, residents, interns, physician assistants, nurse practitioners, medical students, registered nurses, patient care assistants, transplant coordinators, pharmacists, respiratory therapists, physical therapists, occupational therapists, social workers, case managers, registered dieticians, chaplains,  patient and family services representatives, child life specialist and the Arts in Medicine and Footprint programs.  Collaboration is fostered by weekly referral meetings attended by medical staff, nurses, pharmacists, protocol/research nurses, and transplant coordinators. There are also multidisciplinary daily rounds on the inpatient unit. Registered nurses and patient care assistants provide bedside nursing care. Unit clerks provide clerical support for the direct patient caregivers. The registered nurse is responsible for guiding care of the patient based upon their individualized plan.

The nursing management structure consists of a nurse manager, clinical nurse leader and unit assistant. The management team provides educational experiences to maintain staff competency as defined by the unit and role specific job descriptions and the departmental education plan.

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