1. Welcome toPediatrics CTUHeather BhanAugust 2012

2. OUTLINE 3. PAEDIATRIC CTU MUMC Pediatrics CTU is separated into three teams: Team One (pager 5301) and Team Two (pager 5302): General paediatric inpatient teams Team Three(pager 5303): Level Two Nursery 4. PAEDIATRIC CTU Our Wards & Who we find there: 3C: General Paediatric & Paediatric Surgery Ward 3B: General Paediatric, Adolescent Medicine &Haematology/Oncology Ward 3Y: General Paediatric & Paediatric Surgery Ward 3Y: Step Down Unit 3D : Express Unit & Medical Day Care 4C: Postpartum Ward Well Newborn Unit Level Two Nursery 5. A DAY ON CTU 7:15 - Handover (3H40) 8:00 - Teaching Except Wednesday 9:00 - Patient Care 10:00 Team Rounds After rounds are finished, time to complete orders, notes and new consults 3:00 - Subspecialty/ Bedside teaching/ Simulation 4:30 - Handover 3C 10 6. MULTI-DISCIPLINARY ROUNDS Team 1: Tuesday 13:00-13:30 Team 2: Tuesday 13:30-14:00 Team 3: Thursday 13:00-13:30 7. TEAM LISTS Team lists are located on the Shared Drive through Citrix If you do not have access, please contact Skye Levely(slevely@mcmaster.ca) Please update the lists everyday and include any overnight /weekend instructions Team lists MUST be printed off with ALL new admissions andbe ready for the new day team BY 7:15am Remember: The patient lists contain confidential information!Do not leave printed copies in the handover rooms or on 3C! 8. HANDOVER Handover starts promptly at 7:15 (3H40) The on-call residents briefly review working-diagnoses of newadmissions and any over-night team issues Should limit handover to the pertinent positives/negatives, impression and plan Handover to on-call team occurs at 4:30 3C10 Please remember that off-service paediatric residents crosscover CTU on-call and may not know the patients on the ward.Each patient should be handed over Please highlight any sick patients and any tasks/labs that needto be reviewed overnight 9. ST JOSEPHS CTU St Josephs Level 2 Nursery & Postpartum ward consults Labour and Delivery General pediatricoutpatient clinic someafternoons 10. A DAY ON ST. JOSEPHS CTU 7:30 - Handover (3OBS Conference Room) 8:00 - Teaching (Monday/ Thursday) 9:00 - Patient Care 10:00 Team Rounds After rounds are finished, time to complete orders, notes anddo new consults 1:00 - Teaching/ Clinic/ Patient Care/ Consults 5:00 - Handover (3OBS Conference Room) 11. DOCUMENTATION Every patient requires a daily progress note DO NOT TAKE PAGES OUT OF THE CHART TO WRITE YOURNOTE FOR THE DAY AND THEN RETURN Leave the sheets in the chart and write your note at the chart On Fridays, each patient should have a more detailed noteoutlining the treatment plan for the weekend, especially ifthe patient is to be discharged Please try to have planned weekend discharges organized (ieprescriptions given to parents, appointments booked, dictationcompleted etc). 12. DOCUMENTATION CONTINUED Remember: Exactdetails (eg labs andvital signs) are partof the electronicchart and nursingnotes It is important tocapture these, BUTis more importantto highlight trendsand interpretation 13. DOCUMENTATION CONTINUED The most important part of your note isthe impression and plan Outline the rational for pursuing one treatment vs. another, or for changes in management plan Include the working differential diagnosis, (especially on chronic patients) and why they are still in hospital 14. DOCUMENTATION CONTINUED With admission order sets on call please admit as follows: Admit to General Paediatrics, Team 1 (or 2) under Dr.MRP, with Dr. On-call staff to cover until 8am 15. DICTATIONS Your green book has templates forpaediatric dictations Every consult and discharge requires adictation to be done within 24 hours ofadmission/discharge When dictating, ensure that youindicate the admitting staff (NOT Team1 or Team 2) and please SPELL THEIRNAME