Published May 23, 2002
This is my first post...I hope I am doing this in the right area!
I need to re write a policy for Adm and Discharge Criteris in our ICU's. I work in a Cardiovascular ICU but we also have CCU patients. I was wondering if anyone had info to share? I'd really apprieciate it! Thanks............................Sheila
Sometimes I would swear that our admission criteria is "the attending wants the patient here". I work MICU/CCU but we also get surgical patients. We generally keep pts for 24 hours post extubation, have to be hemodynamically stable for 24 or more hours, have a family that is low key and doesn't demand the patient stay even when he doesn't have to. If the doc wants them out and we think he needs to stay we usually get our way. It is harder the other way: We know the person hasn't needed the unit in weeks and the attending just keeps saying "Maybe tomorrow".
Good luck with the policy!
Oh I almost forgot. The discharge criteria for neuorsurgical patients is when their hair grows back. I am NOT kidding. Ok so it's not in writing but...
Nancy, you HAVE to be kidding! How does the hospital get reimbursed by Medicare, Mediaid, or insurance companies?
Sheila, I work CV-ICU and we use fast-track orders to discharge our stable post surgical hearts by 9 AM the morning after surgery. If you check the last 2 years of issues of Critical Care Nurse, they have many different RABBIT or Rapid or fast track discharge plans (depending on the different hospitals' names of their specific programs) that may be helpful to you.
I agree with what fedupnurse wrote..sometimes at my hospital the sole d/c criteria from our ICU is "when the attending writes that he can be transferred to the floor".
Last week, I cared for a man s/p bowel resection. We get these pt's a lot in my ICU. Well, by p.o.d 4, the pt was up and walking. The attending blade was asked if pt could go to floor and told the RN that pt needed to be walked and we-the ICU RN's-do a much better job of it than they do on the floors. How's that for a load of crap? And besdies, any day now the other shoe will drop and the pt will go septic and need CVP's checked q 2 hrs, blah,blah, blah...we hear this all the time from this surgeon. He's kept his pt's for up to two weeks in our ICU post-op when pt coulda been transferred to the floor after 4 or 5 days!
I am a military nurse that works in an ICU at a Naval Hospital. If they need a band aid, they get admitted to our ICU.
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