what?...q 15 NIBPs with an art line???

Ok, lets see if I can clarify the whole "correlation" thing. I can only speak for my self..... I was taught that, as many have already stated, your A line is your gold standard- that IS your accurate B/P- provided it zeroed appropriately, ect,ect. By "correlating" you are checking to see how close your cuff is to your A line- does it always run 10 higher, is it all over the place?? Then.... if something happens to your A-line- you kinda have some idea where you stand until you can fix your A line problem.
I guess what I am trying to say is that I think when people use the phrase "correlate" they not speaking about the accuracy of the Arterial pressure, but the accuracy of the cuff as compared to the arterial pressure.
Does that make any sense? Maybe I'm just rambling???

PICNICRN, I think you just hit the nail on the head. At my facility we "corrolate", along with zeroing,leveling,square wave tests, to make sure we are getting the most accurate numbers humanly possible for the best care possible!

This ought to be a no brainer. For those who say that they check BP's q 12 hrs, don't take care of me. The best practice is one that requires frequent and close attention. Many people don't even go into the room to check on people but look at a monitor. And don't say it doesn't happen, I've seen a whole lot. Why do both when your art correlates? The term is quality assurance. Art lines are positional, patients move, left arm can be different from right arm, art lines can be in the groin, aux, rad, patient have disease processes that cause vascular changes. Usually the ones crying "too much work or over kill" are those that don't know the difference in over confidence and quality of care. I am willing to bet that the reason that people have to do frequent VS checks both with an art and a cuff, is related to a sentinel event. In health, care you can NEVER....NEVER be too careful. And for the person out there ready to pounce on this, let me tell you. I have worked in all over the US, and when you see people working 2 or 3 jobs or on their 8th day in a row with 4 hrs of sleep its easy to see why those babies in Californai got the wrong heparin. That being said, a good surgeon or sharp intensivist would not give orders blindly, then want to know whats going on with their patients. If your patient is stable, pull the art line and move them to the floor if not them practice taking care of people who are sick and need that close attention. Hey, you might learn something by paying closer attention.

I square my art line at the beginning of every shift and if I think there is a change either in the way the waveform presents, or a sudden change in pressure. But I do not know what a ROSE is. Could you tell me?

Thanks

only reason I can think of to do both is if there is a difference from left to right arms--but even then you'd only need to do it once to determine the difference. Art line is the gold standard--why risk blowing the line for q15min NIBP's- and what are you double charting for....that is a lawyers dream!

Current nursing research does not support this. If you have an arterial line with a good wave form, properly zeroed and calibrated, then you have an accurate directly measured pressure. Who cares what the cuff says in that case? If they don't correlate, then which one are you going to use? I only chart the one I'm using for titration of my drips. As soon as the patient is stable off drips, we try to get rid of the a-line as soon as possible so that we can eliminate that pathway for infection.

Again, there have been studies into this practice and really it's an unnecessary step for the most part. If you have a good art line, then you have a good pressure. The cuff only becomes a relevant measurement if your arterial line is over/under dampened (in which case your cuff and line won't correlate) or if you're going to get rid of the line or cap it for patient ambulation. For legal reasons, only chart one or the other. I was taught this by a nurse who was involved as a witness in a lawsuit against a hospital, and the staff were thoroughly interrogated on why they were charting two blood pressures that didn't necessarily correlate. You might have a cuff of 137/58, and an ABP of 72/66. Which one are you trusting? If the ABP is dampened and inaccurate, why are you even charting it? How do you pick and choose which one is good? In a word, don't chart bad data. It can only hurt you later.

But surely, whether or not you charted it, if you were monitoring it, the information is available to those who go looking. In that case, better to explain why you chose one over the other. The monitor will not state that it was overdampened or underdampened, but we can.

Somewhere in your assessment notes it should state that your a-line is giving a dampened wave form, so there is no reason to chart bad data. As another poster stated, lawyers adore charting discrepencies and having two different pressures in the same set of vitals is a heck of a discrepency.

If your art line is no good then you should talk to your doctor about either getting a new one (if you still need it) or discontinuing it.

Is this where I should throw in whether people use their IABP pressures to titrate inotropes....? Pet peeve of mine that SO MANY PEOPLE write the balloon numbers down and then treat according to NIBP or even IAL.

In my old age I am getting less militant though... I guess as long as you get a trend, the specifics can get lost.

There's no way in hades I am doing q15min NIBPs if I have a properly functioning arterial line. Otherwise you may as well take it out. The person who said don't look after you? Well, at least you'll leave the ICU with 2 arms.

I work on EBP - I have seen no EB clinical practice guidelines stating that q15min NIBP affects outcomes either way. It all comes down to nursing judgement in that case.

OP - you are right to question. "Because that's what we do" is never a good rationale. Doing something is fine, but make sure you have a reason.