How often do you assess your patients?

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Just a poll - and I do mean ICU pt assessments. I've been places where it was q2, some where it was q4, some where it was once a shift and then q2-q4 "unchanged" check boxes. Currently my facility's policy is q4 head to toe, with no option for "unchanged." I was at a facility that explained "JCAHO doesn't stipulate how often assessments have to be done, just that they are done head-to-toe once a shift and any changes in condition are accurately documented..the rest is up to the facility." Not sure as to the accuracy of that, but just wondering what different policies there were out there, and which ones perhaps you favor more..more frequent or less frequent...charting-wise, that is.

Specializes in SRNA.

full head-to-toe Q4.

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Specializes in ICU/Critical Care.

we do vitals every hour. Full head to toe assessments are every four hours.

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Specializes in ER, ICU, Cardiac, Med-Surg.

Complete assessment Q4H with focused assessments Q1 to Q2. i.e. Neuro checks Q1 on acute neuro pts. Pts with resp problems/vented lung sounds Q2.

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Specializes in MICU, neuro, orthotrauma.

general

full assessment q2.

vitals q1

oral care q4 (oral/ett suction q2, though)

acute strokes are neuro checks

q15 min x 2 hours

q30 min x 6 hours

q1 hr x 16 hours.

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Specializes in ICU.

At our unit we do the usual assessment with charting at the beginning of the shift and PRN. If there are special circumstances (aka neuro, suicide) then Q15 territory.

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Sorry to bring up such an old discussion, but does anyone have any evidence to support any of these standards? I'm working on a research project for school on the frequency of complete head-to-toe nursing assessments in the ICU and I can't find any evidence. Obviously it makes sense to complete an assessment when there is a change (although common sense really only has you do a focused assessment of what's wrong) or when an intervention has been completed (again, only the system involved in the intervention) but what about "routine" assessments? Our hospital stipulates that a complete assessment be done every 4 hours but I know there are places that require every 2, every 6, every 8, etc. How are these numbers arrived at? Is it simply "expert" consensus? If so, is there somewhere this consensus is published? I've searched CINAHL, PubMed, Google Scholar, etc and can't find anything. Help?

Thanks,

Bryan

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Specializes in SRNA.

Q4 where I work.

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