Does your unit do it's own CRRT?

I work in a general ICU. we take care of every critically ill patients(med/surg/neuro/etc) in our hospital (except post CABG). we do our own crrt and yes it should be 1:1 ratio. I love doing it, aside from the fact that it is fun, i only have to take 1 patient. lol.

We also do it, and i love it. I enjoy doing CRRT...it keeps you busy, and the pt is usually interesting as well. In Canada though, we are always 1:1. Once a week we take turns having 2 pt's that are less sick. Sometime we run Highflow Prisma which requires 2 nurses. One for the machine and 1 for the nurse. In my opinion, its just easier to to crrt yourself, and not have to bother another nurse, or the dialysis unit to come set up.

In the units I've worked, the nurses do their own crrt only if they've been certified or have taken a special class for it. Most like it, b/c it's a 1:1 and it keeps you busy all day.

In the units I've worked, the nurses do their own crrt only if they've been certified or have taken a special class for it. Most like it, b/c it's a 1:1 and it keeps you busy all day.

We do our own CRRT, from package to plate. No HD nurse input. I've heard of units where the HD nurses set up the system and if it poops out the treatment is discontinued until the HD nurses can set it up again.

Not so here. We do the set-up and trouble shoot all problems.

I like it, frankly.

We manage our CRRT machines, but the dialysis nurse sets it up and changes the filter if it clots. Pros: you can manage metabolic acidosis/alkalosis changes using the machine. It gets you moving. Cons: can't think of any! Actually, the prisma's alarm when it senses a slight change in fluid weight. So, if you (or pt family) bumps it even slightly, it starts beeping.We also staff 1:1 if a pt is on CRRT, and they are usually on 1 or more pressors.

We also do our own, and patients are a 1:1. Only staff that have completed the CRRT training/in house certification can do it, though. After class training is completed, staff have to orient with another experienced

RN for 2 shifts worth of CRRT to be sure they are competent. Lengthy process, but you are paid a bit more if you go thru it all (a few cents on the dollar, but it all adds up and is better than nadda!).

I work in a general ICU. we take care of every critically ill patients(med/surg/neuro/etc) in our hospital (except post CABG). we do our own crrt and yes it should be 1:1 ratio. I love doing it, aside from the fact that it is fun, i only have to take 1 patient. lol.

I need to work where you all work. On unit where I work, it is supposed to be 1:1 if pt is on CRRT. It hardly works out that way. We set up our own machines and troubleshoot ourselves. We operate the Prisma and PrismaFlex machines.

The benefits/pros: As a new grad, you gain a very marketable nursing skill. Rarely are my pts only on CRRT. Usually there are numberous gtts involved so you also become skilled at titrating many different pressors. You will sharpen your hemodynamic assessment skills and your time management skills.

The cons: Rarely are my pts only on CRRT, there re numberous gtts involved/titrating pressors and I usually have another pt.

I have found that operating the CRRT machine and caring for those pts helped me become more marketable; all around more desireable employee.

We do our own CRRT from setup on. It can be frustrating at times, but I generally love it. We had a 4 hour class so we could learn all the pathophys and hemodynamics involved with renal failure and the ICU and when CRRT should be used,etc. It's a 1:1 assignment, even if they have other devices. I've had patients on CRRT, have a heartmate II LVAD, and a centrimag RVAD.

Definitely keeps you busy, but I enjoy it.

we will mostly do CRRT 1:1 but there have definitely been times I've had a CRRT patient and another patient. I've even had an LVAD Ventrassist patient and a Thoratec BIVAD patient at one time before. its not common but it does happen. what makes me angry is my unit is the only unit in the hospital that will pair a CVVH patient and another patient. they do it now cause they know it can be done, which sucks.

AAhh the days of being singled with CRRT. That is the IDEAL scenario, but these days staffing is so bad. If the patient is a 'stable' CRRT patient, we get 2 patients. LOL

And yes, we have to take a class and do yearly competencies for the certification.

It's cool to learn and do, but it can be VERY cumbersome. It's ONE busy assignment, so be prepared.

hey all,

the sicu i work in is considering learning to do our own crrt. currently, a micu nurse comes over and does it for us so we still have a two patient assignment... if we start doing our own crrt the crrt patients will be 1:1. for those of you that do your own crrt what are the pros and cons?

thanks for your feedback!:heartbeat

we do our own and use the gambro prismaflex. our pts are 1:1. the documentation and keeping all the bags going is labor intensive as well as if you have a pt that you have to adjust how much your pushing and pulling off based on their tolerance. you definitely will have a busy shift. we go thru phases with how many we have on crrt at any one time. our unit is a 17 bed unit, so if we have 2-3 on crrt at the same time, staffing gets harder. we still use dialysis nurses for regular hemodialysis, they just bring the machine with them but we have our own prismaflex machines that we share between cvicu/ccu/icu. i would say we have pts on crrt monthly but it may end up being that we only had one pt that whole month just in our unit...not including icu. the pro is that it is a 1:1 (and will hopefully always be), you have to make sure you document well to keep the acuity high and justify the 1:1 nursing care needed. you pretty much camp out in the room with the pt or very near by to ensure you catch it if they start to not tolerate. you have to make sure the catheter does not clot off. you also have to think ahead of what you need, make sure you have it and keep good contact with pharmacy to get the fluids you need when you need them-we have most of ours in a designated cart outside the room but have to order calcium gluconate...etc.... its organization, keen watch over the pt., good documentation, think ahead, protect the cath site and make sure you get all the other pt care and meds given. bottom line....you earn every penny you make that shift!!!!!!!!!!!!!