REPORT OF OBSERVATION IN THE INTENSIVE CARE UNIT

ROOM OF THE GLENEAGLES HOSPITAL

BY :

JUNAIDI ABDILLAH, S.Kep.,Ns

(dr. H. ANDI ABDURRAHMAN NOOR HOSPITAL)

&

MUHAMMAD APANSYAH, S.Kep.,Ns

(PAGATAN COMMUNITY HEALTH CENTERS)

TANAH BUMBU – SOUTH KALIMANTAN

GLENEAGLES HOSPITAL SINGAPORE

28 SEPTEMBER – 13 OCTOBER 2017

I. PRELIMINARY

A. Gleneagles Hospital

1. Welcomed by Nursing Director and Nursing Management

Departement

2. Introduce myself

3. Provide uniform and ID card Access

4. Invited to get around and introduced Gleneagles Hospital

facilities and services

 Some among them is :

 Annexe block (Accident & Emergency)

 PCC

 Lecture theatre

 Radiology service

 Laboratory service

 ICU

 NICU

 Transplant unit

 Operating theatre

 Wards

 4,2, single Bedded room to the Gleneagles Suite

 Cafetaria on lobby and level 3

 Car park on basement

 ATM

 Every patient room have hand rub and hand wash

  Fire Alarm, fire extinguisher

 Etc

5. There are several types of specialist working here, among

others are :

1) Anaesthetist

2) Cardiologist

3) Cardio-thoracic surgeon

4) Dental

5) Dermatology

6) Ear, nose, throat

7) Endocrinology

8) Gastroenterology

9) Geriatrics

10) General surgery

11) Haematologist

12) Hepato-bikiary surgery

13) Infectious diseases

14) Intensivist

15) Internal medicine

16) Nephrologist

17) Neurologist

18) Obstetry and gynekology

19) Pediatrician and PAED surgeon

20) Orthopaedic
 21) Oncology

22) Opthamologist

23) Respitatory med

24) Rheumatology

25) Urology

26) Plastic surgeon

27) Psychiatrist

B. The ICU

 What's found

1. ICU room consisting of :

a) The capacity has 21 rooms / patient bed

b) 3 (three) nurse station

c) Main office (sister offce)

d) Drug storage room

e) Meeting room

f) Charging station room

g) Linen room

h) Kitchen space

i) Warehouse room

j) Clean utility room

k) Medical equipment room

l) Pantry
 m) Toilet

n) Fire extinguisher

2. Facilities

a. In every patient room has been equipped with oxygen

centralization, integrated computer, three kind of elecric
plugs (white : for normal, yellow : UPS, red : always on),
medicine cabinet, storage cabinet, bed elctric
multifunction, patient call button, code blue button,
medical and non-medical waste bin, wastafel, seats for
visitors, curtain and sliding door for patient privacy.

b. There are 2 isolation room which is equipped with a

possitive pressure system

c. Wastafel set with hot and cool function, antiseptic liquid,

dryer tissue, waste bin, at each patient room and nurse
station.

d. ICCA at some point of the place

e. Centralized air conditioning

f. Telemetry monitor and Trolley emergency in each nurse

station

g. List of patient monitor in front of each nurse station

h. File cabinet in each nurse station

i. Specified trolley (open heart, chest tube, IA & CVL,

Dressing)

j. And other advanced medical devices

 3. ICU description

A part of the hospital where seriously ill patients can get care
and treatment by specially trained and dedicated staff. The
ICU staff includes doctors, nurses, and other personel which
are related with ICU service.

4. Special characters of ICU nurses

a. Fast respon to help patient

b. Demonstrate coordination skills and ability based on

competency

c. Good attitude in any condition of patient

d. Use therapeutic communication skill with effectively

e. Putting forward the patient safety

f. Respect patients rights and preserve dignity

II. ATTACHMENT TO THE ICU

A. Activities

 Orientation and induction into ICU

 Observe the daily ward activities perform by nurses

 Observe how the nurse managers, Clinical sisters or staff

nurses in charge manage the unit

 Understand model of care used for care of patients

 Management of patient in emergency

 Familiar with protocols and process of care delivery for

patient including infection control protocol
B. Observation

1. There are about 55 staf work in icu and consist of nurse

manager, clinical nurse, senior staf nurse, staf nurse,
enrolled nurse, administrator, porter and other.

2. Enrolled nurse always prepare the completeness of

medical equipment that doctor or nurse need, but they not
include to take a case or do the medical treatment.

3. They work in 3 shift, in morning shift started from 07.00 –

15.15, next shift 13.00 – 21.45 and night shift from 21.00
until 07.30 in next day.

4. For visiting hours is from 08.00am to 08.00pm

5. Maximum 2 visitors for 1 patient in one time

6. The nurse have chance to get a meal times for one hour in
one shift. They alternately going to the cafetaria or other
place.

7. In the beginning shift, clinical sister or staf nurse in charge

will do daily shift assignment, then check the completeness
content of emergency trolley and function of defibrilator.

8. Prepare patient and assist the doctor during medical

exsmination and diagnostic and therapeutic procedure, set
priorities when planning and implementing.

9. Always check safety and comfort also personal hygiene of

patients.

10. Activities in ICU performed by using computers that called

SCM (Standard Computer Manager) and ICCA
(Intellispace critical care and annaesthesia) to incude
patient data in form of assesment, planning, action, patient
 condition observation, medical therapy, rehabilitation
thrapy, laboratory result and others.

11. Documentation created with accurate, concise and relevant

to anticipate and respond what patient needs.

12. There are 2 kind colour of the cover patient medical

records, the orange for patient with capability to infection
and blue one for the normal patients.

13. By admission history nursing assesment there is fall risk

assesment, nutritional assesment, neurovascular
assesment, conscious assesment.

14. Following the activities of related nurses that can contribute

according to their area of expertise and work together as
teams, among others are Anaesthesia spesialist,
Spesialist, ICU nurse, Doctor experts, Pharmacist,
Nutritionist, physiotherapist, IPCN, Speech therapist and
other.

15. The nurse always do "double check" with 2 nurse before

give any medicine or blood tranfution to the patient.

16. INFECTION CONTROL

Guidelines for prevention of infection :

 Standard precautions

 Contact precautions

 Airborne precautions

 Isolation precaution

 Personal protective equipment

17. Hand hygiene have high priority and every employees

should be able to do it.
18. Nurse always do hand washing with 6 steps and 5 moment
before and after meet patient.

19. Using handscound, mask, gown for protective

20. One nurse will in charge for 1 or 2 patient in shift

21. Perform sterilization and disinfection

22. Manage waste by general and hazard with different colour

bags

23. Also manage needle stick to the safety box

24. Cleaning service always stand by in ICU and will fast

response when they have called from nurse or other

25. Porter always ready when nurse need help to delivering

patient to the ward or other palace in hospital, like
radiology etc. they also help to fill the tissue, handrub,
handscrub and other.

26. There are a form for every medical action

27. In order for food of patient, there are I pad called EMOS
(Electronical Meal Ordering System), every nurse can
access it with ID card. There is various menu that patient
can choose.

28. Beside that, patients will be given newspaper to read

29. Nurse always carry BVM when delivering patient who use
ventilator

30. The patient from operating theater will be given warming

blanket

31. Pharmacist assistant will check completeness of medicine

in the drug storage room every day

32. There is no big brown box on the ICU

33. They use disposable circuit ventilator

34. Free vaccinations for employee every year

35. In ICU There is routine activities every month for nurse to

do presentation about case studies, evaluating progress of
communication, skills, interpersonal skills to find solution of
problem and sharing knowledge.

36. Using stickers for patient identity on medical record

37. Every pack of medical instruments have a bar code

38. Every bill of equipment and medical action using scan bar
by Phone integrated that call PIMS (Parkway Inventory
Management System)

39. Hemodialysis, X-Ray and other therapies was performed in

the ICU. They use portable tools

40. The patient can request private nurse with extra charge

41. Condition progress of patient records :

P : Problem

A : Asessment

G : Goal

I : Intervention

E : Evaluation

42. Pharmacist will stand by on ICU to collaborate with

professionals

43. THE CODE

There is 4 code in GEH to process in emergency situations :

1. CODE BLUE
 For medical emergency, it used when the presence of
patient that have eperiencing a darling situation
concerning the patient life.

2. CODE RED

Fire emergency

3. CODE GREEN

Violent patient

4. CODE PINK

Infant abduction

44. PICC (Peripherall Inserted Central Catether); is a long,

thin, flexible tube that used to give medicines, fluids,
nutrients, or blood product over a long period of time.

45. Reverse Barrier Nursing; is special room for patients with

low imun condition, in this case is patient with
mielodisplasia Syndrom

46. Spill kit disposable for special case

III. PICTURE

ICU TEAM
 ICU ROOM

PATIENT ROOM ON ICU

SAFETY DRUG STORAGE
MEDICAL EQUIPMENT STORAGE

STORAGE
TROLLEY
TROLLEY EMERGENCY
ICCA (INTELLISPACE CRITICAL CARE AND ANAESTHESIA)

ABG

EMOS
PIMS
CODE BLUE BUTTON
 TELEMETARY

PATIENT MEDICAL RECORD

 WASTAFEL SET

SPILL KIT

ELECTRIC PLUGGED
PROTECTIVE EQUIPMENT

ROUTINES MEETING
DAILY ACTIVITIES
LECTURE
CAFETARIA
ATM
 UNIFORM

THANK YOU SO MUCH

SEE YOU AGAIN NEXT TIME……. 