Prioritization of Patient Care (Group Project)

Step 1: You are the nurse manager on a new unit that will open today.This unit has 18 rooms, 10 are private rooms and 8 are double rooms.Two of the single rooms have negative pressure (601 & 602).The list below tells you what patients are being transferred to your unit.You need to assign patients to their new rooms. In your assigned work group, complete the room assignments for these patients noting rationale for why you assign each patient to a specific room.Submit to your faculty by due date. Diagnosis AdditionalConsiderations SEX AGE Mr. L Right lobectomy – yesterday Has 2 chest tubes with minimal bubbling in the water seal bottle. Orders to ambulate to door and back again today.IVLR at 125ml/hour 126/86P 84R 16T 99.2 M 49 Ms. D Post-operative dehiscence Wound infection for MRSA.Wet to dry dressing twice daily.Self-care with assistance 130/72P 88R 20T 99.9 F 55 Mr.LD Legionnaire’s Disease Reports productive cough, shortness of breath. chest pain, nausea& vomiting IV of D5W @125 ml/hour B/P 128/84, T 101.4, P 100, R 24. Zithromax 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5 M 23 Ms.S CHF Shingles – left sided abdominal rash with open lesions.Reports pain at rash site B/P 131/94, T 99.4, P 118, R 32 Pulse oximetry86% Crackles in both bases of lung, SOB F 73 Ms. PT Cirrhosis Pulmonary tuberculosis 138/88P 92R 22T 100.7 F 54 Ms. H DM UTI CHF Being admitted.BS 640mg/dl IVNormal Saline 0.9% @100ml/hr Change to D5W when glucose level is down to 250-300 mg/dl. Blood sugar every 2 hours 102/72P108R 24T 98.9 F 72 Ms. T Thyroidectomythis am To come to floor from PACU96/72P 76R 18T 97.8 F 24 Mr. A Acute renal failure continuous cycler-assisted peritoneal dialysis (CCPD) started yesterday flank pain, N&V 112/80P88R 20T 98.4 M 69 Ms. M Left Mastectomy Hemovacin place to be discharge in the am 122/78P 92r 16t 97.8 F 55 Ms. NM Neisseria meningitis IV cipro400 mg I.V. q 12 h B/P 118/94, T 101.4, P 118, R 32 O2 via nasal cannula @ 2L/m Seizure precautions F 22 Unit 3 Prio ritiz atio n Proj ect Mr. D Dehydration stool positive for Clostridium difficile IV LR 125 ml/hour 92/64P 116R 28T 100.1 M 79 Mr. H Hepatitis A Incontinent of stool & urine Nausea & vomiting & fatigue B/P 128/94, T 99.4, P 118, R 32 M 89 Ms. G Guillain-Barre’ B/P 122/68, T 99.6, P 92, R 18 Bilateral leg weakness. No respiratory compromised at this time F 22 Ms. MI MI Coming from CCU Experiencingintermittent PVC 108/72P 76 irregR 16T 98 F 61 Mr. B Laminectomy L3 & L4 One day post-op.Orders to ambulate today 134/88P 92R 20T 100 M 52 Mr.C Colectomywith a colostomy One day post-op. NG tube 128/72P98R 20T 97.9axillary M 45 Ms. C Cervical cancer Radium implant.Foley catheter 114/72P 76R 18T 98.8 F 55 Ms. Fx Fractured left femur External fixator applied two days ago Fat emboli. Oxygen via Venturi mask 132/92P100 R 20T 99.0 F 39 Mr. T TURP One day post-op Continual Bladderirrigation OOB today. IV to be d/c 128/88P 92R 16T 99 M 71 Ms. R Rheumatoid Arthritis Noted to be in severe pain with the joints of both hands swollen, reddened and stiff.Unable to use upper extremities for self-help activities.130/90P 82R 24T 98.9 F 37 Mr. I I & D of infected left arm Has a history of drug use 3 years ago is still smoking.Is very demanding about his care; up and about on the unit.Watches the clock to see that his medications and every shift dressing changes are on time.150/98P 76R 18P 97 M 32 Mr. V Venous Stasis Ulcers Has venous stasis ulcers of lower right and left extremities, skin around the ulcers is thickened, brown without redness.Noted no palpable pedal pulses, 4+ pitting edema.Complains of severe pain.142/90P96R 18T 99.4 M 81 Ms. F Fever of Unknown Origin Just admitted from the Emergency Room. Lives locally but has been travelling with a church group for the past ten days. B/P 161/94, T 103.4, P 118, R 32.Complains of extreme fatigue.Blood, urine& sputum cultures have to be obtained F 19 ASSIGNING PATIENT ROOMS Room Patient Rationale for Assignment 601 Negative Pressure Ms. PT Patient has pulmonary tuberculosis and requires airborne precautions 602 Negative Pressure Ms. F Fever of unknown origin after travelling, private room to provide safety to others until diagnosis is made 603 Mr. LD Legionnaire’s Disease fall risk due to weakness 604 Mr. H Patient having incontinence, nausea, and vomiting. Hepatitis A is spread fecal-oral and requires enteric precautions 605 Ms. NM Patient requires droplet precautions 606 Ms. C Patient has radium implant, placed in private room to reduce risk of radiation exposure to other patients and visitors 607 Mr. D MRSA requiring contact precautions 608 Ms. S Open shingles requiring airborne precautions 609 Ms. D MRSA contact precautions 610 Ms. Fx 611A Mr. C 1 day post-op, stable patient 611B Mr. B 1 day post-op, low grade fever ordered to ambulate today 612A Ms. G Needs telemetry and pulse-ox monitoring, stable at present time Stable condition but has Guillian Barre which makes her a fall risk 612B Ms. MI Requires ongoing nursing assessment and telemetry monitoring 613A Ms. R Stable condition at this time, needs assistance with ADL’s 613B Ms. H Requires ongoing nursing assessment and telemetry monitoring 614A Mr. A Stable patient that can accept roommate if another admission arises, placed in room by self to allow room for equipment 614 B Mr. T Stable post-op with a low-grade temp 615A Ms. T Thyroidectomy s/p 615B Ms. M Stable at this time, awaiting d/c in morning 616A Mr. B Stable, post-op laminectomy 616B 617A Mr. L Due to empty beds on unit placed in room by self to allow room for medical equipment 617B 618A Mr. I Due to being up and about on unit and demanding behavior patient placed in private room to prevent disturbing other patients 618B Step 2: Your staff consists of the following.Which staff members are you going to assign as a team? Which patients are you going to assign to which team member? Provide rationales for your decisions about patient assignment to staff members. 1. RN for two years, on a telemetry unit Team 1: RN (2yrs), LPN (1yrs), CNA (10yrs) 2. RN for 5 years, on a medical surgical unit