Staffing & Patient Acuity

  1. 0
    Hey all!

    CVICU RN here and was just wanting to get a feel of how other CVICUs staff. Currently where I work our post-op hearts are 1:1 for 6 hours (which we changed about a year ago from 4 hours). In order to keep the patient 1:1 they have to be pretty unstable (ie/ lots of pressors, oxygenation/ventilation issues etc).

    Also, how do your units staff for patients with IABP? Ours aren't always 1:1 but I've heard of many hospitals that keep IABP pts 1:1.

    Info would be greatly appreciated!
  2. 11 Comments so far...

  3. 0
    Fresh post ops in our hospital are 1:1 until extubated. IABPs are always 1:1.
  4. 0
    I wish our fresh heart post-ops patients were 1:1! Sometimes even our balloons are paired (as long as the patient is stable and paired with a very stable patient.)
  5. 0
    IABP always 1:1. Fresh open hearts are 1:1 usually until the next morning when the swan is removed. Sometimes they are 1:1 longer if they are unstable.
  6. 0
    Quote from tk0224
    Hey all!

    CVICU RN here and was just wanting to get a feel of how other CVICUs staff. Currently where I work our post-op hearts are 1:1 for 6 hours (which we changed about a year ago from 4 hours). In order to keep the patient 1:1 they have to be pretty unstable (ie/ lots of pressors, oxygenation/ventilation issues etc).

    Also, how do your units staff for patients with IABP? Ours aren't always 1:1 but I've heard of many hospitals that keep IABP pts 1:1.

    Info would be greatly appreciated!
    My hospital we have 1:2 ratio with IABP
  7. 0
    Quote from tk0224
    Hey all!

    CVICU RN here and was just wanting to get a feel of how other CVICUs staff. Currently where I work our post-op hearts are 1:1 for 6 hours (which we changed about a year ago from 4 hours). In order to keep the patient 1:1 they have to be pretty unstable (ie/ lots of pressors, oxygenation/ventilation issues etc).

    Also, how do your units staff for patients with IABP? Ours aren't always 1:1 but I've heard of many hospitals that keep IABP pts 1:1.

    Info would be greatly appreciated!
    My hospital we have 1:2 ratio with IABP
  8. 0
    1:2 with IABP last week I somehow ended up with two( stable) pt both with IABP. I had alot of charting but otherwise it was fine.
  9. 0
    We 1:1 fresh hearts for 6hrs, then longer only if warranted (very unstable...). IABP in itself doesn't buy 1:1 for us...most often they're paired with another stable/"easy" pt; only 1:1 if extremely unstable (lots of pressor titration, CRRT, etc).
  10. 0
    We are pretty spoiled. We staff post op hearts 1:1 for a while. Ex: come in at 1300 extubated at 1500 and then they are 1:1 until the next morning. We are in the process of revamping a bit and I'm sure that will change. We operate on a lot of high risk people who are pretty sick for a while though...
  11. 0
    We're pretty spoiled with our post-ops as well. We single our post-ops until extubated and dangled (mobility is HUGE in our ICU). If a pt is extubated toward the middle or end of the shift, they are usually left 1:1 for one more shift. My hospital is a large university hospital (and union) with very high acuity. The last CVICU I worked at was smaller and did more standard cases, mostly valves and CABGs. They were doubled as soon as they were extubated, sometimes sooner.

    Our balloon pumps are generally 1:2 but those are often some of our more stable patients - many of our IABP pts have them placed to optimize them for VAD surgery.


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