Hi,
At the beginning of each shift, how nurses distribute current patients in the unit?
According to my experience, there several factors that are considered such as if the patient is on ECMO, mechanically ventilated, on a particular isolation precaution...
Also, there are nursing to patient ratios as guidelines but their account for the number rather than specific features of the patient.
Any other criteria or methods?
Thanks in advance for your input.
Hi, Im an Registered Nurse from Hong Kong ICU unit
Actually Nurse is being divided into almost 4 group.
The 1st group would be those seniors who got the skills handling ECMO, cardiac case
The 2nd group would be those who can handle cardiac case like IABP, impella, pace-maker
The 3rd group would be those who can handle CRRT case (needed in ARF)
The last group would be those who cannot operate CRRT case, mostly new comers from ICU or junior
And i do think it is the basic skills for ICU nurse to take care mechanical ventilated case. For the ratio problem, mostly one on one but when it is needed, maybe 1:2.
For Nurse who need to handle 2 patients, the patients may be much more 'easily' to care, like single organ failure or Neuro case
Hope i can help u
Dear Dr. Fortunatti,
Heart-centered greetings
When Nurses shortage is critical, many important variables would be secondary!
Thank you very much!
In most cases 1:1
Patients with complex needs are handled by most senior staff.
Nurses who have completed special training like dialysis will be assigned accordingly.
Former ICU nurse here with background in ciritical care in North Carolina, US and Alberta, Canada. Stability of patients is a large factor in whether the ICU nurse has 1 or 2 patients. When a patient is hemodynamically unstable, on multiple vasoactive infusions, and sometimes on additional modalities, such as dialysis, ECMO, or BiVad, there is one nurse to one patient. If patients are more stable hemodynamically with no other modalities as mentioned above, even if intubated, there is a growing standard of one nurse with two stable intubated patients.
Some Nursing staff make use of procedure schedule.A patient that needs more attention/procedures will be attended to by all the Nurses assigned to each of the procedure
We are using Acuity tool for Critical areas and Telford method
Hi. I am a Critical Care Nurse att Malmo University Hospital in Sweden. I work in a general ICU with 10 patients. There are two patients in each room and each room has one CCN and one nurse assistant. Most of the patients are mechanically ventilated and several with CRRT.
By offering longer and more frequent shifts and also apply technology to aid in this regard.
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