Scope of Service DAY SURGERY UNIT (DSU)

Unit Description No. of Beds Nurse Patient Ratio

: : :

DAY SURGERY UNIT 8 BEDS AND 6 RECLYNER CHAIRS 1:2 (pediatric) 1:3 (adult)

Scope of Service The Day Surgery Unit provides nursing care to adult and pediatric patients in the pre-operative period and then during the post-operative period as a Phase II Recovery. Patients will be discharged home upon meeting DSU discharge criteria. Frequent Procedures/Services/Functions Oxygen therapy and pulse oximetry Pain management Patient assessment and evaluation Wound care if needed IV fluid administration if needed Preoperative and postoperative management of care. Holding patients for admission when they are not well enough for discharge Patient and family teaching

Hours of Operation Normal working hours are 6:30 a.m. 4:00 p.m. and 8:30 a.m.-6:00 p.m. Saturday to Wednesday CRITERIA FOR ADMISSION TO SERVICE The main criteria for admission to DSU are that the patient requires a hospital stay. Preoperatively the patients are seen in the Pre Anesthetic Clinic to determine suitability for day surgery. Post surgery the patient must go to the Phase I Recovery Room, be extubated and fully conscious, hemodynamically stable meeting Phase I Recovery Room discharge criteria before they are returned to DSU. The patient will be discharged home as soon as he/she meets the DSU discharge criteria STAFFING PLAN Number and Mix of Staff Head Nurse (RR/DSU/PAC) Assistant Head Nurse (DSU/PAC) Staff Nurse I Ward Clerk PCA

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Scope of Service DAY SURGERY UNIT (DSU)

There are permanent charge nurses who rotate weekly in this role. The charge nurse delegates the patient assignments based on patient acuity and skills mix of the nurses. The following factors are utilized when determining patient assignments: Complexity of patient's condition and required level of nursing care. Dynamics of patient's status, including the frequency with which the needs for specific nursing care activities change. Complexity of assessment required by patient. Type of technology employed in providing nursing care. Degree of supervision required by each nursing staff member based on his/her previously assessed level of competence. Availability of supervision appropriate to the assessed and current competence of nursing staff member. Relevant infection control and safety issues.

Method of Adjusting to Staffing Variances When staffing shortages occur, the nurses readjust their patient assignments and recover adult patients on a 1:3 ratio and pediatric patients on 1:2 where appropriate.

During periods of excessive staffing, staff nurses will be floated to surgical units, Pre Anesthetic Clinic or Holding Bay QUALIFICATIONS OF STAFF Qualifications/Licenses/Certifications Required of Staff Registered Nurse: Registered Nurse License or registration from country of origin Current BCLS Ward Clerk Arabic/English PCA Arabic/English How are in-services/continuing education programs provided to maintain staff competency? Staff meetings are held weekly. Continuing education is offered through NER. Educational needs are identified through mandates, treatment protocols, performance improvement activities, regulatory agencies, new technology, new equipment, new products and individual input. Required Competencies Initial Competencies - Orientation Checklist

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Scope of Service DAY SURGERY UNIT (DSU)

Organizational Competencies Day Surgery Unit competency based check off

METHOD OF COMMUNICATON WITH OTHER DEPARTMENTS/PROGRAMS Internal and External Methods of Communication Internally and externally, communication is accomplished via direct verbal communication, telephone, e-mail, fax and written memos. Internally, staff and the Head Nurse/Assistant Head Nurse have additional communication via a written communication book. Describe Collaborative Relationships with Other Departments The Head Nurse/Assistant Head Nurse and staff participate on multidisciplinary committees, as well as Hospital wide performance improvement groups. The Head Nurse and Assistant Head Nurse regularly attend the Peri- Operative Collaborative Practice Meeting GOALS OF DEPARTMENT To provide highly skilled, culturally sensitive and appropriate patient care to pediatric and adult patients going through DSU, incorporating teaching and education for the patient and family members so they feel comfortable with surgery.

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