[sagreeg]

Hello Iris
Thanks for that info. We have very good staffing levels, but I was looking for a specific tool. I have something from way back in 1993, and this was mainly 3 criteria out of five for a 1:1 nurse/patient ratio. I understand that when patients are extubated, and all very stable post cardiac surgery these patients are normally transferred to a HDU, but there is no HDU at this moment. The Cardiac ICU is a 8 bedded unit, only adults, Paeds are in a separate unit.
ps. What is IMO? Pardon my ignorance

Originally Posted by irisRN

i think it all depends on your staffing. If you have the ideal number of nurses, then your kids who are intubated and on drips would have a 1:1 ratio. When we do 2 patients to a nurse, they can both be extubated, or one intubated/one stable. We never do 3:1 ratios...i think that would be very unsafe in the ICU setting. I personally have never had 2 intubated patients at the same time, but i guess anything is possible if we were short on staffing. typically, the assignment is 1 extubated/1 stable, 2 stables, or 1 sick intubated pt per nurse.

The other thing to consider is that not all PICUs are the same. I have visited other PICUs at big hospitals...and their patients would go to our floor, not the icu. And, vice versa...if one of our chronics come through their ER, they would be prompt to transfer them out of their hospitals and into our icu.

As far as RT goes...they are usually a phone call away, they come and check on our patients a few times per shift. The nurses do all the suctioning, most vent changes, ETT taping, etc. If we need them for any of these things, its pretty easy to get them to the bedside. I actually like that we can do these independently and not have to wait until a RT comes by, and that if we need them, they come pretty quickly. Its a good system, IMO.

[irisRN]

no worries...

IMO: in my opinion

[PIVputterinner]

I work in a PICU that has 33 beds. We take care of 2 ventilated patients most of the time. We do have respiratory therapist but usually there are 3 RTs for 33 patients. They take care of the vents, but the RN's usually take care of the airways, blood gases, and aerosols for non vented patients. One of the reasons we can do this is all are ventilated patients are sedated, and hands are restrained. Patients that are un-stable or require q1hr labs are 1:1 care patients. Sometimes when we are slammed with admissions we triple stable patients. No one likes doing that, but it can't always be helped.