CCU nurses performing their own CVVHD?

zambezi, BSN, RN · Jan 23, 2005

Hello...there are other threads on this very subject in either the SICU or CCU forums...

But to answer your question, we run our own, but the dialysis RNs set up and prime the machine..we have to know how to troubleshoot and give the blood back but if it clots off, the dialysis RNs come to reinitiate treatment...I know from previous postings that other places have the unit RNs do the whole deal...

Ruby Vee, BSN · Jan 24, 2005

i am not a dialysis nurse but would like some information regarding cvvhd and ccu's. our ccu currently has an outside dialysis company performing our dialysis. we are looking into the purchase of our own machine so that we can perform our own cvvhd. the company we have gotten info from has agreed to all inservicing, nursing education, and support etc. but we are told that there are no other hospitals that perform their own cvvhd, that it is all done by an outside agency. does anyone know of any other hospital that performs it's own cvvhd? thanks for your time, darinda rn:rolleyes:

i worked for years in an icu where we did our own dialysis. some of the nurses were trained in dialysis; most weren't. so when there were dialysis patients, the dialysis nurses took care of the patient and did the dialysis. it worked pretty well. it was a lot of fun to do dialysis! the place where i am now, we do our own cvvhd and everyone is trained in it. dialysis nurses from an outside agency come in and set up the machine and access the patient, but then the icu nurses continue to monitor the machine, the patient, change the bags, etc. cvvhd isn't difficult -- it's generally tolerated better than regular hd.

suetje · Jan 30, 2005

I am not a dialysis nurse but would like some information regarding CVVHD and CCU's. Our CCU currently has an outside dialysis company performing our dialysis. We are looking into the purchase of our own machine so that we can perform our own CVVHD. The company we have gotten info from has agreed to all inservicing, nursing education, and support etc. but we are told that there are no other hospitals that perform their own CVVHD, that it is all done by an outside agency. Does anyone know of any other hospital that performs it's own CVVHD? Thanks for your time, Darinda RN:rolleyes:

You are smart to take the entire responsibility on yourselves. Why? Doing everything yourselves makes you the most knowledgeable about the machine , troubleshooting and the therapy. Doing it all makes you the expert. There are a good number of ICU's who do all of it, and there are others who have an outside company set up the machine and act as a resource, and even others who have an in-house dialysis staff that sets up the machines for the ICU.

darinda · Jan 31, 2005

:chuckle Thank you for taking the time to respond. If I have any other questions I will certainly be back! Sincerely, Darinda

You are smart to take the entire responsibility on yourselves. Why? Doing everything yourselves makes you the most knowledgeable about the machine , troubleshooting and the therapy. Doing it all makes you the expert. There are a good number of ICU's who do all of it, and there are others who have an outside company set up the machine and act as a resource, and even others who have an in-house dialysis staff that sets up the machines for the ICU.

suetje · Jul 15, 2009

I can assure you that MOST places do their own. About 1/3 have outside agencies that set up the machines only. And, even that job, (if you choose the right machine) is super simple. The problem with outside contracts is that they primarily only set up the machine, and then you're on your own, even though they get 'paid' to help you troubleshoot. Well, they are not there on the night shift, so you end up having to manage it by yourself anyway. the best way is to do everything yourself. But keep in mind also, that if your docs do not order it often, no one gets very expert at doing it. So make sure you have 1) the simplest machine;l 2) the best company support of that machine (I'd call around and ask about them) and 3) a committment by your docs to place most of your ICU/ CCU pts on CRRT (or, as you call it, CVVHD) so they get the best therapy and you have a chance to hone your skills too. Hope that helps!

chatty-rn · Jul 16, 2009

I work in a hospital based chronic dialysis unit and cover call at the hospital. When the ICU first got CRRT (prisma) the call dialysis nurse would go in and set it up (any time of day) and ICU nurses then ran it- monitor, change settings, etc. If it clotted off, dialysis was called back in just to set it up. It was a pain as it only takes about 15 minutes to set up and prime. Sometimes, esp if septic, would clot off 2-3 times the first hour, and then the lines would not work good. So if CRRT was started, dialysis call pretty much planned on staying at the hospital the first night. This went on about 2 years, then we let the ICU nurses take over completely, set up, connect, monitor, everything!! They call us if they have something with the catheter itself but now it's pretty rare anymore that we get called. Much better situation, let ICU do it all