6 West Orthopedics

Description of Unit

6 West is a 24-bed inpatient adult medical surgical unit located in the south tower. The unit consists of all private rooms, including two negative isolation rooms. Capability exists to monitor patients with continuous pulse oximetry to a central monitor in the nursing station and remote cardiac telemetry monitored on 5 West. Budgeted occupancy is 71%.

Description of Patient Populations

Patients are admitted to 6 West for the following operative procedures: total knee replacement, total hip replacement, total elbow replacement, orthopedic trauma and malignant bone tumor removals such as osteosarcoma. Patient population includes adolescents (> 14 yrs), adult, and geriatric.

Nursing Care

Nursing care is focused on the assessment, diagnosis, planning, treatment and evaluation of preoperative, postoperative and non- surgical patients from admission to discharge with emphasis on post-operative care, functional assessment, pain management, patient/family education and support and initiation of early rehabilitation process. The 6 west unit/role specific job descriptions identify the patient populations/common diagnoses served, equipment utilized, skills required to perform treatments/procedures, clinical parameters monitored, safety precautions initiated, and emergency events encountered. Nursing activities consist of: pain management including patient controlled analgesia, epidural analgesia and paravertebral blocks; wound management including Vacuum Assisted Closure Systems, JPs, and hemo-vac drains; respiratory management including pulse oximetry and oxygen therapy; cardiac management including remote telemetry; medication management, safety precautions and patient/family education and support.

Health Care Team

The Orthopedic Surgical Services consist of attending physicians, fellows, chief residents, residents, interns and medical students. Scheduling of rotations is maintained through the Department of Surgery. Patient Care Resource Managers and Case Managers serve as liaisons between the surgical staff, medical staff and multidisciplinary team, providing continuity of care for patients from admission through clinic follow-up. Available support services for 6 west patients include: respiratory therapy, physical therapy, occupational therapy, nutrition services, wound therapy as well as Patient and Family services. Collaboration is fostered by daily patient care rounds attended by nursing staff, medical staff, patient and family services personnel, rehabilitation services staff.

The nursing management structure consists of a Nurse Manager and Clinical Leader with support from a Unit Assistant and central Administrative Coordinators. Department of Nursing staff is provided training experiences to attain and maintain competence as defined by the unit/role specific job descriptions and the departmental education plan. Registered Nurses and Patient Care Assistants provide 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 an individualized plan. Nursing care delivered by the PCA is coordinated under the direction of the Registered Nurse. The unit leadership group promotes autonomous, accountable nursing practice by supporting staff involvement in unit practice decision making.

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