The Trauma and Acute Care Surgery
(TACS) Service Line has been designed with nursing and physician staffing
models to not only manage routine daily operations but also surges in acuity
and volume.
Acute changes in patient status should
prompt a brisk response from techs, nurses and physicians plus specialists as
needed.
For Disaster/Mass Casualty
Response Guideline, see: http://uktraumaprotocol.blogspot.com/2013/11/disaster-response-trauma-surgery.html
For the Communication Guideline
(When to Notify) for Blue Surgery (when to call the Chief/Fellow/Attending), see:
http://uktraumaprotocol.blogspot.com/2013/04/communication-guideline-when-to-notify.html
Clinical Nurse Experts (CNE’s) on
the TACS are trained, prepared and directed to assist TACS RN’s. TACS CNE’s are
available every day from 7p-7a, primarily in PavA but can go to PavH as needed.
TACS CNE roles include problem solving, hands-on assistance, directed
instruction, mentoring and general mentoring. TACS CNE’s are specially trained
and experienced in critical care and are primarily responsible for assisting
patients who are deteriorating, complicated or simply in marginal status relative
to their current level of care (Acute, Progressive etc). CNE’s should be called
at the first sign of trouble at night.
The Rapid
Response Team (RRT) has been designed to assist with patients exhibiting signs
and symptoms of clinical decline. The team may be accessed twenty-four hours a
day, seven days a week by any nurse, patient or family member in Chandler. The primary goal of the RRT is to
facilitate a multidisciplinary effort to improve outcomes of adult patients in
acute care settings who have been in ICU, have been identified as having high
acuity, or who have been identified as having a decline in clinical status. RRT
also strives to facilitate communication between acute care nurses and
physicians, and to empower nurses to communicate patient problems using the
SBAR format.
On TACS, RN’s will have access to
both CNE and RRT in many cases, most acute deteriorations and all
codes. The working relationship between TACS and RRT should be additively
beneficial for the nurse and patient. That being said, TACS CNE’s are more
familiar with TACS team members, patients and guidelines and should be involved
whenever RRT is involved.
The following algorithm is
intended to provide general guidance on the integration of bedside RN’s, CNE’s,
MD’s and RRT. See Policy A08-230.
