Transportation of Telemetry/Stepdown Patients

  1. For those of you who work monitored telemetry or stepdown areas: when your patients go for inpatient testing, are they transported with a monitor and accompanied by an ACLS qualified RN (or other person)? If not, do you have complete facility wiring so that the rhythm can be visualized en route and during the procedure? If a patient is removed from telemetry for a procedure (or even for showering) who makes that decision (and accepts liability for it)? The doctor? The nurse? A criteria list or decision tree? We're grappling with this issue right now and an idea of nursing standards (and comfort levels!) would really help. Thanks! :kiss
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  2. 19 Comments

  3. by   NurseGirlKaren
    Pt must go with ACLS nurse and monitor unless an order is written specifically that the pt can go without nurse and monitor.
  4. by   ptnurse
    We have no real written policy on this. I make it my own policy to get an order from the M.D. prior to transport. It makes me very nervous to let one of my telemetry patients leave the floor without me. Especially if they are trached.
  5. by   Erinkate2959
    The tele packs that our patient's are on, allow us to monitor them throughout the entire facility so they do not need to be accompanied by an RN. We can watch their status from the floor. If they need to come off the monitor for a shower or for the specific test, there must be a doctor's order.
  6. by   legsmalone
    We go by the MD's order and if they are fragile a nurse absolutely goes with them
  7. by   dhogan
    We have a policy with certain criterias such as the K+ level, vital signs and so forth that have to be within certain limits. Also we have to have a doctors written order to go without telemetry. In most cases they dont wear but we can also monitor from the floor. If the test can not be portable a nurse has to go with the pt if they have a critical rythmn. Utimately if the doctor has all the correct information and they make the decision it is their responsibilty. Right now our biggest problem is if we give the pt a sedative to have CT's or MRI's a nurse has to be with that pt even if the test are 30 mins.
  8. by   ERNurse752
    In the ED, if we are transporting a patient to a floor where they will be hardwire-monitored, they go on a portable monitor with an ACLS-qualified RN.

    If they are just going to be on tele on a med-surg floor, they don't have to go on a monitor.

    If they are just going to testing from the ED, we'll check with the MD first.
  9. by   DIPLOMATICRN4HIRE
    We always transport with an ACLS RN , often with multiple ACLS RNs. Its just been a standard.
    Zoe
  10. by   New CCU RN
    If the patient is going to be monitored at the unit they are being transported to they must go with an ACLS nurse or we also have SEALS who are paramedics that specifically transport pts. But there is usualy only one or two of them on a shift......sooo they run around like crazy and so it sounds better than it is It's not uncommon that your pt;s SEALS trip is waiting for five hrs.

    Now, transporting an ICU patient to testing.... depends on if they are intubated or not. If they are it takes RT, ACLS RN, and MD or SEALS (someone qualified to reintubate) and they almost remain during the entire testing.
  11. by   lee1
    Originally posted by Erinkate2959
    The tele packs that our patient's are on, allow us to monitor them throughout the entire facility so they do not need to be accompanied by an RN. We can watch their status from the floor. If they need to come off the monitor for a shower or for the specific test, there must be a doctor's order.
    Who is watching them on the monitor or anyone's monitor? The RNs who just may happen to be at the station, the set alarm limits, or a monitor tech who really sits there and watches????
  12. by   nursemouse
    lee1, we're also dealing with this issue as well; 24/7 monitoring is hard to maintain. I really appreciate everyone's help with this issue and would certainly welcome more feedback. A separate question/issue would be: is there really a trained person visualizing the monitor constantly, or are staff members who man it responsible for other duties? Thanks! nursemouse
  13. by   Anagray
    on my floor, I believe the MD's are responsible for that decision, because many times a patient will ask to take a shower and the nurse will say that she can not let him do that, unless the doctor has ordered that.
    For procedures, patients get removed off tele ( i also believe as ordered), but the nurse can make a judgement up on that - if a patient has obvious cause for alarm, she will hook him to bedisde and go with the patient to wherever they need to go.
  14. by   Erinkate2959
    On my floor there is no one constantly watching the monitors at all times. There are several different alarms that go off if anything goes out of range or anyone goes into a different rhythm. When this happens, it is the responsibility of the RN's to run to the monitor to see what is going on. Usually whoever is closest. Certainly if a patient is really critical, they will take a portable monitor, an RN, and a critical care tech with them for transport.

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