Database of Health Workforce Innovations
703
transforming an adult ICU into an adult and pediatric ICU
UTMB's Blocker Burn Unit is a 6-bed adult burn ICU which shares many staff with Shriners Hospital. The challenge faced was how to meet the needs of the pediatric burn patients who were affected by prolonged closures to Shriners Hospital.
The challenge ahead was to quickly (within several months) meet the critical need of burn patients in the community by offering comprehensive services to burn patients of all ages at UTMB's BBU. Since the BBU is a small unit (6 beds) and with burn patient referrals being unpredictable in nature, it was recognized that the unit's nursing staff must ALL be able to care for both adult and pediatric patient. The only requirement during the training period was to ensure that a mix of adult and pediatric competent staff was scheduled and present on any given shift.s.
In spring of 2009, the BBU began admitting pediatric patients. With careful planning, the BBU ensured that staffing for each shift consisted of experienced adult burn nurses and “former” Shriners Hospital nurses (experienced pediatric burn nurses trained in adult burn care).
The addition of a social worker and availability of a child life specialist for the BBU provided needed expertise and resources.
The challenge ahead was to quickly (within several months) meet the critical need of burn patients in the community by offering comprehensive services to burn patients of all ages at UTMB's BBU. Since the BBU is a small unit (6 beds) and with burn patient referrals being unpredictable in nature, it was recognized that the unit's nursing staff must ALL be able to care for both adult and pediatric patient. The only requirement during the training period was to ensure that a mix of adult and pediatric competent staff was scheduled and present on any given shift.s.
In spring of 2009, the BBU began admitting pediatric patients. With careful planning, the BBU ensured that staffing for each shift consisted of experienced adult burn nurses and “former” Shriners Hospital nurses (experienced pediatric burn nurses trained in adult burn care).
The addition of a social worker and availability of a child life specialist for the BBU provided needed expertise and resources.
A plan to expand the services of the adult burn unit to include pediatrics was implemented. 5 nurses who formerly worked at Shriners Hospital were hired to be employed in UTMB's BBU. 5 adult burn nurses and 5 pediatric burn nurses were subsequently paired to train each other to care for adult and pediatric burn patients.
Pediatric burn nurses were trained in adult care and adult burn nurses were trained in pediatric care.
Pediatric burn nurses were trained in adult care and adult burn nurses were trained in pediatric care.
- Rapid upskilling/reskilling existing and available workers (eg. laid off)
- Longer term upskilling/reskilling other workers
- Alternative deployments for health workers whose normal duties are temporarily suspended
- New roles
- Expanded roles
- Nurse Specialists*
- Physicians - Specialists
Hurricane Ike left a path of destruction when it made landfall in Galveston in September 2008. A 475 bed level-1 trauma center and academic medical center, University of Texas Medical Branch (UTMB) is one of two hospitals on the island, along with the Shriners Hospital for Children. The latter is a hospital dedicated to pediatric burn patients. Both facilities closed for 4 months, and the Shriner's hospital remained closed for 11 months.
- Critical Care
- Hospitals
- Urban/Suburban
The physician staff have joint privileges for both facilities and they provide care to both adult and pediatric patients. With the Shriners Hospital now closed, many of their nurses were in need of employment. The attributes of flexibility, adaptability,
Informal Strategy
Comeau, O. Y., Heffernan, J. M., Sheaffer, J. L., & Sayles, F. M., 2nd (2014). Rising to the challenge: transforming an adult ICU into an adult and pediatric ICU. Critical care nursing quarterly, 37(3), 336–343.
Odette Y. Comeau, MS, RN, CNS, CCRN
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Critical Care Department, University of Texas Medical Branch
United States
USA