Precautions and Protocols For Pediatric Acute Care

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Precautions and Protocols For Pediatric Acute Care

• By Judi Smerilson, PT

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What are the current protocols in pediatric acute
care?

• What is the time frame post-op before a patient
  can be placed in sitting or prone?
• What are the precautions for orthopedic
  injuries?
• When are patients on contact precautions allowed
  out of their rooms with therapy?

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How do we make sure all acute care staff are
following the proper precautions and protocols?

• Where are the precautions and protocols posted?
• What format can we use to get the information to
  all staff so that it is easily accessible?

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Who should determine the precautions and
protocols?

• Doctors have specific protocols based on
  surgeries performed
• Nurse Practitioners are aware of protocols and
  precautions that the doctors want followed

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Procedure

• There are currently no written guidelines for
  post surgical precautions and protocols. I
  gathered information from various doctors and
  nurse practitioners throughout the hospital to
  ensure that proper precautions and protocols were
  being followed. I compiled a chart that each
  therapist can carry with them to reference when
  needed.

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Summary

• A chart was created that therapists could carry
  with them to look up precautions and protocols.
  References were included.

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References

• Orthopedic protocols received via email from Dr.
  Gregory Mencio, orthopedic surgeon
• Surgical Protocols received via email from Amy
  Gann, ARNP General Surgery
• Trach Protocal received via email from Kimberly
  Huffman, ARNP ENT Surgery
• Infection Control Protocols received via email
  from Tracy Louis, ARNP Infection Control per CDC
  recommendations and Vanderbilt Policy
• PICC line protocol received via email from
  Kathleen Polis, ARNP PICC Services
• Cardiac Protocols received via email from Judy
  Berger, ARNP Cardiac Surgery and verbally from
  Dr. Debra Dodd, cardiac surgeon
• Cardiac Catheterization Protocol received
  verbally from Dr. Debra Dodd, cardiac surgeon
• Lumbar Puncture Protocol received verbally from
  Dr. Avery Mixon, oncology

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Assessment

• In reviewing current operating procedures all
  staff were not aware of all precautions and
  protocols. There was no written reference for
  specific surgical protocols. I developed a tool
  that could be used and accessed by all acute care
  therapists.

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Recommendation and Plan

• All acute care therapists will be provided with a
  copy of the chart of precautions and protocols
  for easy reference. A copy will be placed in the
  Acute Care Orientation Manual.