The registered nurse (RN) or licensed practical nurse (LPN) admits all children on arrival to the unit. Unlicensed assistive personnel (UAP) may complete admission tasks that are consistent with their job descriptions as delegated by the registered personnel.
The RN is accountable for the nursing assessment and must validate data obtained by the UAP.
All assessment data gathered become a permanent part of the child’s medical record.
Children are assigned a bed, crib, isolette, warmer, or bassinet appropriate for their chronologic age, developmental age, and/or clinical condition.
Children should be assigned to rooms based on gender, developmental age, diagnosis and seriousness of condition, communicability of illness, and projected length of stay.
Each child must wear an identification band throughout the length of hospitalization. In the event that it is not possible to place an identification band on the child’s extremity, other arrangements must be made to identify the child at all times (e.g., identification band taped to isolette).
Principles of family-centered care should be used by all healthcare providers during the admission process and throughout the course of the child’s hospitalization (see Chapter 1).
A healthcare prescriber’s order is required for admission to the intensive care unit (ICU). All children are placed on cardiorespiratory monitoring (and additional monitoring as necessary). Discontinuation of such monitoring is based on further evaluation of the child’s status by the healthcare prescriber.
Emergency medications anept in a well-secured, easily accessible location on the unit.
Bed, crib, isolette, warmer, or bassinet
Blankets, linens, bath towels, and washcloths
Disposable wash basin or prepackaged bathing product
Toiletry items (e.g., comb, soap, lotion, toothbrush, toothpaste, as applicable)
Water pitcher and drinking glass
Diapers and wipes (if needed)
Diaper scale (if needed)
Bedpan, urinal, or specimen hat (if needed)
Identification band for child (and family members, if institutional policy)
Scissors
Measuring tape (for head circumference in patients younger than 2 years of age, recumbent length measurement, and abdominal girth measurement)
Scale:
Infant scale for child 2 years of age and younger
Standing scale for child 3 years of age and older
Bed scale as indicated by the child’s condition
Thermometer
Sphygmomanometer and blood pressure cuff (appropriate size for child)
Stethoscope
Pulse oximeter (as needed)
Child and family welcome and orientation brochures
Patient admission documentation forms
Patient property envelope (if needed)
Personal protective gear (i.e., gowns, gloves, masks, goggles/eyewear)
Electrocardiogram lead patches
Intravenous infusion device
Intravenous pole
ICU-specific supplies and equipment:
Unit-specific supplies and equipment:
Oxygen delivery supplies:
Suction supplies:
Appropriate-sized sterile suction catheter (the catheter diameter should not exceed half the diameter of the airway)
Age
Catheter Size
Neonate to 18 mo
5 to 8 Fr
18 to 24 mo
8 to 10 Fr
2 to 7 yrs
8 to 10 Fr
7 to 10 yrs
10 to 14 Fr
11 yrs to adult
12 to 16 Fr
Sterile container for sterile fluids
Sterile gloves
Sterile normal saline or sterile water
Water-soluble lubricant
Portable or wall suction machine with tubing and collection container
Intubation and ventilatory support supplies and equipment:
Appropriate-sized laryngoscope and blades
Appropriate-sized endotracheal tube
Ventilator
Cardiorespiratory monitor and recorder supplies:
Appropriate-sized electrodes
Cardiorespiratory monitor
Recording tape
Additional supplies:
Defibrillator and external pacer
Noninvasive equipment and monitoring supplies (e.g., pulse oximeter)
Invasive equipment and monitoring (e.g., hemodynamic monitor; see Chapter 45)
Emergency drugs and supplies
Emergency drug calculation sheet, based on child’s weight, height, and allergy status
Length-based resuscitation tape (e.g., Broselow tape)
Inform the family regarding guidelines for room assignments:
Circumstances
Room Placement Guidelines
All children
Placement based on admitting diagnosis and the bed availability on the day of admission
Children >1 yr of age
Placed with children of the same gender and developmental age
Very sick children who may require quiet and rest or who may be nearing death
Single-patient room; avoid room near very active and loud children or near children requiring extensive personnel and procedures at the bedside
Immunocompromised children
Room with positive airflow ventilation system; should not be placed in rooms with children who have infections
Children with communicable diseases
Room with negative airflow ventilation system; should not have a roommate
Children with cystic fibrosis (CF)
May not share room with other children (with CF) unless their sputum is negative for Burkholderia cepacia complex bacteria to avoid cross-colonization.
Children with Methicillin-resistant Staphylococcus aureus (MRSA)
Single room or may share a room with another child who has MRSA and employ contact precautions.
Children requiring respiratory isolation
Room with a negative airflow ventilation system
Determine if an adult family member will be spending the night at the bedside. Ensure cot or sleep chair is available. Ensure family members have been identified as visitors per institutional policy and have received information about visitor policies (see Chapter 118).
PROCEDUREPreparing the Environment
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