How many daily one-to-one assignments does your unit have on average?

[gscott]

I am a process engineer looking at how to better capture the volume of one-to-one patients in the ICU, MICU, SICU units in the health system where I work. Which patients and how many there are that need a one-to-one (RN to Patient) assignment is often lost on the unit's daily sheet and not reflected in the financial records, etc. How does your unit track this volume of patients and how many does your unit carry on average per day? Thank you so much - I have learned so much from all of you - it's the only place I can get a real nurse's perspective.:wink2:

[sicushells, RN]

I honestly couldn't tell you how many we have on average. We go through busy/sicker cycles, and then things seem to calm down for a few weeks, and then the acuity gets high again.

I would suggest going to the head nurse/ manager for this information. I have a hard time believing that the unit isn't tracking staffing ratios somewhere (based on my very limited experience). If the manager doesn't have the info handy, s/he should be able to give you more direction as to where that information is stored.

Good luck!

[gscott]

Yes, we do track patient load and assignments but often in our ICU's, patients may be a 1:1 for a few hours then off then back on (Level 1 Trauma Center) and it drastically changes the nurse staffing needs. They currently write down on the Charge nurses daily sheet who is a 1:1 but it's not totally accurate and if the information isn't extracted from those sheets manually, no one can see it - hence staffing plans look like they went awry when they didn't. Thanks for the feedback though - much appreciated.

[RNFELICITY]

CVVHD for us is always a 1:1 and that is about it. If a really sick pt comes in that requires a 1:1 for just a few hours, we do not really consider that a 1:1 because the nurse will pick back up her other pt when things settle down.

[stressgal, RN]

Post PCI patients are 1:1 for the first hour, IABP patients 1:1 as long as they are on the pump. Other patients are often 1:1 for a short time at admission, then we may pick up another patient. I think you really need teamwork to manage patient care through an ICU.

[jbp0529]

We usually single fresh open heart patients for at least a few hours (another RN babysits your other patient, if you have one), but longer if they come out unstable or on a balloon pump. Otherwise, if its an uncomplicated surgery, or relatively stable pt, then the nurse may have the fresh heart plus another patient that is less busy. At my facility (a 25 bed CVICU), that averages 6-8 heart surgeries a day, it can be quite challenging, as far as staffing goes, to completely single each and every fresh heart surgery...there just isnt the staff to do it without tripling or quadrupling the assignments of the other nurses. Not to mention, the budget would be out of control.

However, balloon pumps are always kept 1:1, as well as CVVHD's.

Our daily assignment sheet does keep track of the 1:1's, though.