1. 6. Patient Record
1.1. Transcription Reports:
1.1.1. 1. Operative reports: Detailed records of the steps taken during an operation.
1.1.2. 2. Pulmonary Function test results: Give information about how the lungs are functioning.
1.1.3. 3. Imaging reports (CT/MRI): Used to prepare for and evaluate after surgery.
2. 7. Admission, Transfer and Discharge
2.1. 1. Admission process: Patients are admitted through emergencies or elective procedures.
2.2. 2. LOS: The Length of stay of patients 3-7 days, depending on the complexity of the surgery and patient recovery.
2.3. 3. D/C supports:
2.3.1. 1. Home care services: Some patients, especially after major surgeries like lobectomies, may require assistance with daily activities such as dressing, bathing, or managing post-surgical care at home.
2.3.2. 2. Oxygen therapy: Patients with lung conditions or those recovering from lung surgery may require oxygen therapy to help them breathe more easily as their lungs heal and regain functions.
3. 8. Confidentiality and HIM:
3.1. Outside providers:
3.1.1. 1. Radiology reports: Chest X-ray or CT Scan imaging reports are used to diagnose conditions like pneumothorax and to evaluate the patient's lung function before or after surgery. The providers are Radiology departments, private image centers, or outpatient clinics. It is required to see up-to-date images of lungs and monitor post-surgical recovery.
3.1.2. 2. Pathology report: Like biopsy results, are essential for diagnosing cancer and determining the stage and type of cancer, which influences treatment plans. The providers are pathology labs at hospitals, oncology centers, or private diagnostic labs. It is required as its results guide treatment decisions such as whether surgery, chemotherapy, or radiation is needed.
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5. 1. Health Care Professionals
5.1. MRP:
5.1.1. 1. Thoracic Surgeon: Professional in surgical interventions on chest organs, such as lung cancer resections or correcting structural anomalies.
5.1.2. 2. Pulmonologist: Specializes in finding and treating problems with lungs and breathing, like asthma, COPD, and pulmonary fibrosis.
5.2. Nursing Staff:
5.2.1. 1. Registered Nurse (RN): Administers medications, checks patient's vital signs, and manages care plans in the ICU.
5.2.2. 2. Nurse Practitioner (NP): Offers advanced care by diagnosing, treating, and monitoring patients with serious illnesses.
5.3. Allied HC Workers:
5.3.1. 1. Respiratory Therapist: Plays an important role in managing ventilator support, oxygen therapies, and other respiratory interventions.
5.3.2. 2. Physiotherapist: Supports patient recovery by assisting with mobility and chest physiotherapy to prevent complications like pneumonia.
6. 2. Organization of Hospital/Care Units
6.1. ID of dept: In many cases, M&T procedures are considered outpatient unless other complicating factors necessitate inpatient monitoring.
6.2. Purpose/diagnoses: Diagnose, treat, and manage diseases, injuries, and abnormalities in the chest cavity, including the lungs, esophagus, trachea, and diaphragm.
6.2.1. 1. Lung cancer (Lobectomy): This surgery removes a section of the lung to treat early-stage lung cancer.
6.2.2. 2. Pneumothorax (Chest Tube Insertion): A collapsed lung is treated by placing a chest tube to release trapped air or fluid, helping the lung expand and making breathing easier.
6.2.3. 3. Esophageal Cancer (Esophagectomy): Part or all of the esophagus is removed to treat cancer. The thoracic Unit supports patients in healing, managing pain, and restoring nutrition after surgery.
6.3. Org structure: Falls under the surgical services or Cardiothoracic Division, with a multidisciplinary team approach including surgeons, pulmonologists, nurses, and allied health professionals.
7. 3. Staffing and Scheduling
7.1. Staffing pattern: Primary nursing model for post-surgical patients requiring complex care.
7.2. Staffing ratios: Typically, 1:1 or 1:2 nurse-to-patient ratios due to the critical nature of care.
7.3. Coverage: Inpatient thoracic units demand 24/7 care to handle the complexity and unpredictability of patient's conditions, while outpatient services are more predictable and can operate with standard daytime hours.
7.4. Premiums:
7.4.1. 1. Evening and Night Shift Premiums: This unit with 24/7 care needs staff for evening and night shifts to monitor patients and manage complications. Shift premiums help attract staff for these less desirable hours.
7.4.2. 2. Weekend shift premiums: Hospitals run 24/7, so thoracic staff need to work weekends to provide consistent care. Weekend premiums help ensure enough staff are available during these times.
8. 4. Risk Management:
8.1. Specific risks:
8.1.1. 1. Respiratory complications: Patients who have chest surgery might have trouble breathing, like getting pneumonia or other issues. Watching them closely helps prevent these problems.
8.1.2. 2. Post-operative infections: Chest surgery can cause infections at the cut or inside the chest.
8.2. Hospital codes:
8.2.1. 1. Code Blue: Cardiac or Respiratory arrest, this code is used when a patient in the thoracic unit experiences a life-threatening cardiac or respiratory arrest, which can occur due to complications like respiratory failure, or pneumothorax.
8.2.2. 2. Code Red: Fire, this code alerts staff to a fire emergency.
8.2.3. 3. Code white: Violence or Aggression, this code is activated in situations involving patient or visitor violence.
9. 5. Communication
9.1. Communication challenges: Patients on ventilators face difficulty in verbal communication.
9.2. Communication devices:
9.2.1. 1. Communication Boards: Assist non-verbal patients in conveying needs.
9.2.2. 2. Translation Devices: Help doctors and nurses to talk to patients who speak different languages.