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We still monitor vitals hourly and continue to monitor EKG and I&O as an ICU patient. This is extra work because the transfer patients waiting for a bed are usually your 3rd patient. We have 2 telemetry units, they only work in 2 of the rooms so we are limited to when they can be used, but this allows the patient to walk around in the room. We do occasionally take overflow from the CCU and that is what these were purchased for.
Although a patient's status has changed from a critical to non-critical one, I still do ekg monitoring, I&Os, and vital signs per ICU. With the new cardiac monitors today, all readings are so easily accessible, it's not a problem to continue monitoring the patient, but it would be a problem for that patient to go bad, without being monitored, while waiting for a bed. Although there is not a protocol for this potential problem, I see continued monitoring as a way of ensuring patient safety.
We disconnect our transfer patients from monitors, Sao2 probes, etc, and do vitals every four hours, and I&O every eight hours. In our unit once a patient is on for transfer they are no longer charged for an ICU bed. Our pts biggest complaints is that we have no shower facilities in the ICU. Sometimes it takes 2-3 days to get a bed on the floor unless there is a code and then one just happens to become available.
In our unit, it depends on the nurse. I prefer to "detach" my patient from as much as possible. If they're going to the telemetry unit, I keep them on the heart monitor, if the transfer order is for med-surg, I take them off the heart monitor. Not everyone agrees with me, but I think it's a judgement call. If the patient is someone whose order is to transfer later in the day, I keep them hooked up, or if they've just come off of vasoactives, I continue to watch them more closely. Not too long ago,half of our census was tele overflows. I think all of the patients were hooked up like they were CCU patients, which the patients weren't too happy about. They didn't need the cuff pumping up every hour during the night, nor did they need the alarms buzzing at high volume just because they turned over in bed. Personally, I think we've become too dependant on the monitors as it is. Just my opinion.