Rural ICU's and education

[wendyssmile]

Hello, I work at a rural hospital with a four bed ICU. I am developing a competency program. One of the biggest educational weaknesses are hemodynamics. We put in myabe

2-4 PA catheters a year. According to the literature an annual review is not enough because of the infrequency of use. I was wondering how often hemodynamic education and review in smaller ICU's . What are the educational tools used ?

Thank you

[nowplayingEDRN]

Wendy,

Your ICU is large by comparison of ours here at West Point, which due to deployments has been shaved down to ONE bed. Under normal circumstances, we have 2 beds. And we NEVER use PA caths. If it looks like a pt will need one, we ship them out to a larger facility. We do quarterly training here and brush up on technique and procedure by refering to the AACN Procedure Text...they have a skills check list with each procedure. I don't know if this helps you, but that is how they do things here and we assign different staff to develope inservices on different procedures.

Christie

[gwenith, BSN, RN]

Wendy you are in a difficult situation any more frequently than yearly and you will have the staff up in arms - ergardless of the literature. One way would be to have a Very detailed procedure/guidebook on line for staff WHEN they get one. But what are the core competenies you are wantign your staff to achieve? Do they do the wedge pressures or Cardiac outputs? Can you certify the more senior nurses to carry the burden as they are more likely to have experience and make them responsible for preceptoring newer staff this way the more senior staff enhance thier skill without getting bored witless in the meantime and the new staff get the training. You are not alone in the infrequency fo SG caths - this is common and has led to some facilities anly allowing medical staff to do the wedges and outputs.