Critical Care Cardiac Surgery Data Sheet 1-20-2016.docx -...

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CV Team- Post Op Checklist These are the interventions we need to do to reach our goal for EXCELLENCE and 3 STARS When patient transfers out of unit please place in CV Team Box RN Monitor Check of Height (cm) + Weight (kg) ______________ ______________ RN Initials RN Initials Date of Surgery: _____Time arrived______ Surgeon____________Surgical Procedure: ______________________ Anesthesia MD:___________ On pump time:______ Off pump time: ______ Reversed ________ IV Tylenol_____ HR/Rhythm: _____________ Paced_____ Wires ______ B/P Goal: ________PA Goal:________ CI:________ Drips: _________________________________________________________Ordered in Meditech:______ Blood products _____________________________ Fast track ___________ Any significant events: ____________________________________________________________________ Chest tubes x_____ CT w/Pleuraflow Keep in park position and actuate every 15 minutes. Out position when pt is getting up or sitting up Document temp. within 15 min. of arrival date _________ Time to MedTele_______________ Transferred to Med Tele Date________ Time __________ RN Completing: __________________________ RN Completing: __________________________ RN Completing: __________________________ Immediate Postoperative Report Monitor Check of Height (cm) + Weight (kg) _____________RN Initial ______________RN Initial Date of Surgery: _____Time arrived______ Surgeon___________Surgical Procedure:______________________ Anesthesia MD:__________ On pump time:______ Off pump time: ______ Reversed ________ IV Tylenol_____ HR/Rhythm: _____________ Paced_____ Wires ______ B/P Goal: ________PA Goal:________ EF:________
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