ICU RN's responsible for CRRT or CVVH - page 3

by graciev 13,665 Views | 27 Comments

What do you think about ICU RN's being responsible for setting up, troubleshooting and maintaining CRRT devices? Do you do this in your ICU and if so, what is your staffing ratio? If there are not a large volume of patients... Read More


  1. 0
    I am surprised that you state the scales are inaccurate because this is an operators issue not inaccurate scales. All machines do this if you ignore an alarm! I did go to their website and the FDA and it is training of staff. If you use a ballon pump, IV pump and ignore an alarm you can have issues. The ban isn't because of the machine scales and is suppose to be lifted. They didn't have to recall their machines they are still in use not like the Bxater machines
  2. 0
    In my ICU (which is med/surg/neuro/trauma/anything else!!) in Australia CCRN's set up, troubleshoot and maintain CVVHDF, but if an existing dialysis patient comes in, the dialysis unit nurses will bring down their CRRT and do the therapy. Only CCRN's and those studying to become CCRN's look after patients on CVVHDF except in rare circumstances, and the ratio is ALWAYS 1:1 (but that's the case for all ICU patients anyhow!)
  3. 0
    In my facility the dialysis RN does set it up and is on call for problems. We run CVVHD and CVVHDF so I change the effluent bag, the dialysate and the replacement bags according to the machine and have had to discontinue trx and pack the ports when the filter has clotted off. I would like to learn the set up (it does not look hard). Patients are 1:1 if they are on pressors or staffing allows.
  4. 0
    we are trained to do the set ups. it takes about 15 minutes. the company helped setthe program up and the assists with review. Managing the patient is the hard part not the set up. I do not want to wait for dialysis to come in to set up. I know it can be a political issue but at least I can change filters when I am ready.
  5. 0
    In my unit (30 bed CVICU, largest in the state, and takes the highest risk pt's of the state) we use CVVH A LOT. We use the NxStage Machine (Which I hate by the way, had way less issues when we used Prisma in the past) ICU nurses control all aspects of the machine from initiating orders, to set-up, troubleshooting, changing filters, and discontinuing therapy (we do have a very good clinical engineer program at our facility and an engineer is always on call 24/7).

    Our staffing ratio is always 1:1, for us it pretty much has to be, I can't remember the last CVVH pt we had that wasn't on multiple inotropes, pressors, antiarrhythmics, EF 10% etc. etc.

    We use citrate and CaCal on pretty much all of our systems, but if our pt is real septic we're lucky to have it last 12-24hrs.
  6. 0
    In the Australian ICU I work at, we set up, maintain, troubleshoot and take down the circuits. The ICU I work at uses the Prisma, at the last ICU I worked at we used the Aquarius. It's interesting how two machines that have the same end goal can work so differently! All our patients are 1:1, regardless of ventilatory or other therapy status.
  7. 0
    In the SICU that I work at, which is 40 beds and pretty much 20 of them are all on CRRT, they have a dialysis tech on our unit 24-7. They are responsible for setting up the machine, trouble shooting any issues, and taking down the machine too. As nurses, all we do is record the values and treat the patient's physical issues (titrating meds when BP too low, etc). I have found it to be a very user friendly arrangement, and the techs are very knowledgable at educating the nurses about the machines.
  8. 0
    In my place ICU nurse is responsible for setting up and trouble shooting CVVH,the HD nurse has no role in that.. CVVH is always 1:1


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