Hey~ What's the Time Span between....

gwenith, BSN, RN · Jan 4, 2005

Julie - if you don't mind I will move this to the neuro forum so that it will not get lost and you will get specific feedback.

Answer is - it really depends. Post operatively we used to do 15 minutely for 1 hour and then half hourly for 2 and then hourly forever. However we also recovered patients and that requires continuous monitoring anyway.

jschut, BSN, RN · Jan 4, 2005

Nah, I don't mind you moving it...

I was wondering more along the avenue of someone hitting their head...

I work in LTC and all too often when a resident falls and bumps their head, no one knows the exact time to do neuro checks.

I want to know.

ktwlpn, LPN · Jan 4, 2005

Nah, I don't mind you moving it...
I was wondering more along the avenue of someone hitting their head...
I work in LTC and all too often when a resident falls and bumps their head, no one knows the exact time to do neuro checks.
I want to know.

Check your facility p and p-it's been different at every LTC I have worked in....Currently we do q 15mins x 4 and if stable we go to q4hrs x 48......But if I know the resident has really wacked their head and they are looking fishy-I stay with them for at least the first 15-and I make sure they are where they can be closely observed for that first few hours....There are bumps on the head and there are BUMPS on the head-you know?

webblarsk · Jan 5, 2005

I believe it depends on the facility. At the facility I worked at we did Neuro checks Q 15 minutes x2 hours, then Q30 min x2 hours, then Q1hr x2 hours, then every shift for 3 days. I always dreaded a fall with a head injury!

jschut, BSN, RN · Jan 5, 2005

I would IF I could FIND my faclities p&p manual.

Too many times I have seen the q15min x1hr, q 30min x4 hr and so on, and then, alot of those have been falsified since some nurse say, "Awwww...they are ok." or "I don't want to wake them up."

I just want to do the right thing and be a good nurse. Thanks for your help though.

talaxandra · Jan 5, 2005

Wow, that's way more intense than us (and we're a neuro ward!) - post-fall we do half-hourly for four hours, four hourly for twelve.

UM Review RN, ASN, RN · Jan 5, 2005

For a suspected stroke, we do neuro checks AND vitals q2h X24 hrs, then q4h X24 hrs, then q shift. If there's any deterioration, we do the NIHSS over again, call the doc, get the CT brain repeated, and start over again.

We have a whole page full of standing orders for stroke. Sometimes our stroke orders are used for patients who've fallen. In fact, we had someone with a subdural hematoma from a fall recently.

We use a frequent vitals sheet and a neuro checklist that speeds up the charting process greatly.

Hope that helps.

UM Review RN, ASN, RN · Jan 5, 2005

alot of those have been falsified since some nurse say, "Awwww...they are ok." or "I don't want to wake them up."
I just want to do the right thing and be a good nurse.

PS Julie, the good nurse teaches the patient what to expect. I'll say, "Because of the injury you've had, we're going to be waking you up every couple of hours, just to make sure that you can wake up. I'll ask you to wiggle your fingers and toes, and open your eyes for the flashlight. I'll want you to tell me if you have any numbness, tingling, or HA, or other symptoms that just don't feel right to you."

"If you have any increase in any of those symptoms and I'm not here, please use your call light to call me."

Most patients are not happy about being awakened all those times, but I always stress that it's because we care about them and want to treat them quickly if something's wrong. And truth to tell, it's hard to tell sometimes if someone is groggy from sleep or really having a hard time remembering how old they are, but at least we try.

Sorry if I'm so long-winded today. Guess it's bedtime. :chuckle

ktwlpn, LPN · Jan 6, 2005

I would IF I could FIND my faclities p&p manual.
.

Yowzer....someone there is not doing there job---every year during survey a few employees from several departments at our facility are asked questions regarding our various manuals....there whereabouts and their contents....

jschut, BSN, RN · Jan 6, 2005

Ahhh well... NOT to worry! (I hope!)

I start a new job at a new LTCF this Saturday! :chuckle