do you chart vent settings?

[bigreddog1934]

i feel like this may be a no brainer for the more experienced here, but i had an icu nurse really dig into me about this the other day. i almost never have charted these and its only been an issue recently. does it vary from hospital to hospital?

[MikeyJ, RN]

The ICU at the hospital where I am charts vent settings on a respiratory chart that is kept next to the ventilator. There are some nurses who chart the vent settings on the narrative charts to protect themselves because the respiratory chart can be accessed by everyone (MD's, respiratory therapist, nurse).

[ZooMommyRN, ADN, RN]

We chart ours hourly in a computerized flowsheet, we also chart BiPap settings as well

[moosicle]

We do; some in my unit chart settings in multiple locations.

This brings up a concern fir me; can a nurse chart too much? I mean , if respiratory charts it and I chart in a separate location but someone makes a typo, does this suspicion when something goes wrong and the chart is audited. If it is that error prone, should vent settings be cosigned like a dangerous drug instead of recharted?

I fear everyday that repetitive charting is putting my license at risk.

Sorry if a little off topic.

[Altra, BSN, RN]

I chart vent settings when we intubate someone, change the settings, and when the patient leaves the ER.

[ZuZuTrauma]

In our ICU, we chart vent settings every 4 hours as a given and more if there are changes made. It's good practice. We also put the blood gases next to the vent setting it was done with-- gives you a nice picture.

[nursebrandie28, BSN, RN]

we chart vent settings, if i don't know them, i ask the erp or the rt.....

i don't think it is always necessary, but i just into the habbit because i know without a doubt when i call report to the icu, that is generally the first thing they ask...!!!

[helloworld]

Not everyone in our ED does, but as a new nurse all my preceptors (Ihave about 3) have taught me to chart the vent settings each time I chart vitals (which is hourly) or any time they are changed or there is a significant change in the pt's condition. Also, every time I call report to the ICU or CCU on a pt on a vent or a BiPap, they always ask me the settings.

i feel that my notes should tell the pt's story, and the vent settings are part of that story.

[AlabamaBelle]

There is a place on the graphics portion of our flowsheets to chart vent settings. We chart on initial assessment and any changes that occur thereafter.

[RN1989]

I always chart vent setting at least once per shift along with cm mark on ETT. Any changes in settings/condition get charted whether it is me or RT or MD that change the settings. If you don't chart the settings you can't document that the vent was even working or that you knew that it was set correctly. Would hate to not chart vent settings and get called to court and asked why.

[edmia, BSN, RN]

We always chart the initial vent settings in the ED when we do our intubation note. We do a narrative note that states when and by whom the patient was intubated, the drugs pushed and by whom, the ET size and placement at the lips (ie- #7 ET, 23 at lips secured to Left corner of mouth) and then do the whole vent settings after that. Mode, FIO2, PEEP, Rate, etc.

After intubation, most of our patients are promptly admitted to a step-down or MICU, so as long as we have our initial settings in, we're good. It has to be part of the report of course.

If there's a change before they go up, I would chart it in my narrative note as well (ie- PEEP increased to 10 by RT).

Vent settings are always adjusting to the patient's state, so I don't think our ED charting is used as the guideline for that patient, but it can be used to see how a patient is doing based on the history of the vent settings. Not sure how ICU does their charting, I'm sure they have a flowsheet of some sort that they fill out if changes are made.

[RazorbackRN, BSN, RN]

Yes. Hourly.