Surgical Care Unit
January 2018
Surgical Care Unit
Surgical Care Unit
Children's National Hospital
Washington DC
,
WV
United States
Photo Caption: Row 1(left to right): Dr Randall Burd, Brittany DeWolf, PT, Eliana Maldonado, RN, Olayemi Ogunraiyewa, PCT, Mehalia Brown, Stephanie Schneider, OT, Catherine Williams, RN
Row 2: Dr Ivan Gutierrez, Julie Kelly, RN, Erika Hilborn, RN, Tiffani Pietrucha, RN, Janae Haug, RN, Meghan Mesa, RN
Row 3: Devon Haas, RN, Dr. Jarod McAteer, Ginger Winder, RN, Griselda Diaz, Amy Ballin (child life), Marie Ritzo, Yirgalem Habteslase
Row 4 (down staircase and across top) Elizabeth Waibel (NP), Raven McLeese, RN, Sara Talvacchio, RN, Barbara Floyd, RN, Modupeola Oluwole, RN, Lianna Colon, RN, Jason Woods, Catherine Walsh, NP, Caitlin Coogan, NP

 

 

 

The SCU is a part of our organization's level one burn and trauma center that cares for pediatric burn patients. Burn rehabilitation begins on day one after injury and extends for weeks or years, necessitating efforts by many services and team members. These patients are often fearful and anxious, requiring countless hours of physical and occupational therapy as well as ongoing mental and psychosocial support. This safety award nomination is based on the extraordinary teamwork and excellent care of a 16-year-old burn patient by our SCU DAISY Team.

A massive explosion and fire in a local apartment building collapsed four floors of apartments, killed seven, and injured 30 people. Our patient was among those injured and sustained second-third-degree burns to her face, neck, chest, and arms. The patient had arrived in the United States (U.S.) less than 24 hours earlier from her home in Ethiopia to finish her last year of high school. She was admitted to the SCU severely traumatized- physically and emotionally. She had no family, place to live, money, or resources. In short, the SCU Team demonstrated safe, high-quality clinical care along with extraordinary care and compassion for the patient and family.

This patient experience illustrated potential safety risks to the SCU Team and offered an opportunity to rethink our approach to comprehensive multidisciplinary pediatric burn care. While caring for the patient referenced above, the nurses recognized opportunities for improvement. They collaborated with community partners to improve safe clinical care for the burn patient population and all SCU patients. On the SCU, physical therapy (PT) sessions often occur in stairwells or busy hallways, affording little to no patient privacy and limited access to emergency response systems. The SCU Team recognized the need to assist patients with physical and psychological rehabilitation in a centrally-located, all-inclusive therapy space. With the pediatric burn patients in mind, the SCU Team advocated and fundraised over $50,000 to create a PT gym through partnerships with the District of Columbia (DC) Fire Fighters Burn Foundation and Ryan Kerrigan's Blitz for the Better Foundation.

To create the safest space possible, the gym design includes bright lighting, slip-resistant flooring, emergency and monitoring equipment, double-wide doors, and noise reduction to diminish stress for patients and providers. A fully functioning gym with a treadmill, bicycle, stairs, weights, game center, and TVs for distraction, the gym allows for safe, patient-focused, developmentally appropriate therapy goals to be designed and achieved. The gym affords each patient the opportunity to actualize their total rehabilitation goals in a dedicated space designed solely for their safety and privacy in mind. This nomination demonstrates the SCU Team's outstanding commitment to and advocacy for the utmost safety of patients entrusted in their care.

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The Surgical Care Unit (SCU) cares for our most vulnerable pediatric burn patients. Burn rehabilitation begins day one after injury and can extend for weeks or years by a specialized team. Patients are often fearful and anxious, requiring countless hours of physical and occupational therapy (PT/OT) and ongoing psychosocial support.

One year ago, a massive explosion and fire in a local apartment building collapsed four floors of apartments, killed seven, and injured 30 people. The SCU admitted a 16-year-old patient who had sustained second-third-degree burns to her face, neck, chest, and arms. The nurses saw she was severely traumatized- both physically and emotionally. PT sessions often occur in the unit, which has busy hallways/stairways that afford limited access to emergency response systems and little to no patient privacy. She was extremely self-conscious and often refused PT/OT sessions outside of her room. She was anxious about therapy sessions because of pain and deeply concerned about the perceptions of others toward her altered physical appearance. Her experience sharply illustrated the potential safety risks of PT in the hallways and spurred the nurses to rethink approaches to comprehensive burn care.

The nurses advocated for a centrally-located, all-inclusive therapy space to better promote both physical and psychological rehabilitation for patients. The SCU Team collaborated with community partners to improve safety and quality for the burn population and all patients. Nursing partnered with the District of Columbia Fire Fighters Burn Foundation and Ryan Kerrigan's Blitz for the Better Foundation to advocate and fundraise over $50,000 to build a special gym with pediatric burn patients in mind. PT occurs during daytime hours when inpatient units are at peak productivity and traffic levels. A noisy environment can interfere with communication, affect cognitive performance and concentration, and contribute to stress and fatigue.

Standard hospital floors and stairwells are often slippery and noisy, and lighting is less than optimal. To create the safest space possible, the SCU gym design includes bright lighting, slip-resistant flooring, emergency and monitoring equipment, double-wide doors for easy access with ambulation-assist devices, and noise reduction to diminish distraction and stress. With a treadmill, bicycle, stairs, weights, game center, and TVs for distraction, the gym allows for patient-focused, developmentally appropriate therapy goals to be designed and achieved. The gym allows each patient to actualize their total rehabilitation goals in a dedicated space solely designed with their utmost safety and privacy in mind. In the past seven out of eight quarters, SCU also demonstrated a low number of patient falls with injury and outperforms national benchmarks in this patient safety outcome domain.