CIWA: OK to reassess in less than 4 hours?

[dreamingoftheocean]

I was always under the impression that you needed to recheck AT LEAST every 4 hours but could recheck sooner. For example, I come on for my shift and always assess CIWA with my nursing assessment then recheck in 4 hours if patient is fine in the mean time, in 1 hour if they need a prn follow up or at any point it becomes clear symptoms are emerging that would score them to high enough to get a prn medication.

Is it wrong to do more often than the set schedule? In my hospital setting I get the occasional detox patient and am not in a specialty setting. Would like to know what other nurses are doing and hoping I'm not totally off in my nursing. Thanks so much for your input!

[Penelope_Pitstop, BSN, RN]

You are not at all off...that is why the PRNs exist!

[Meriwhen, ASN, BSN, MSN, RN]

IMO you reassess a CIWA patient as frequently as you feel necessary. If you feel that means q1h, then do it q1h.

Personally, I think 4 hours is too long to let a CIWA patient go without checking on withdrawal...maybe if they're 2-3 days into w/d when they're more stable would I let 4 hours go by. I reassess my CIWAs q2h, more frequently as symptoms and PRNs warrant.

[Whispera, MSN, RN]

The reassess is AT LEAST every four hours. If you give meds, you definitely reassess soon. And, you reassess often if there's any change at all!

[CASTLEGATES]

I give meds, then reassess in one hour to determine my plans for the next several hours. Good question; better to ask than wonder )