ICU RNs running CRRT?

[liz0105]

Hi everyone,

I'm curious to know if any ICU RN's out there are currently practicing in an ICU where they are called upon to do CRRT at the bedside. Currently, all HD/CRRT/SLED are done by HD RNs in our hospital, but there is an initiative to train ICU RNs to do CRRT (only). We have been told that the ratio for this assignment would be 1:1...

Just curious to know anyone's experience with this. Thanks in advance!

[Chisca, RN]

We have been told that the ratio for this assignment would be 1:1...

Try and get that in writing because they will change their minds. Also try and involve the medical director of Nephrology as he/she will support the necessity of 1:1 staffing. There is no such thing as a stable CRRT patient. If they were stable they would receive a regular HD treatment.

[cc2005]

In my MICU, RN's run CRRT and dialysis nurses come up and run HD. Staffing is usually 1:1 unless we have 3+ patients on CRRT.

[notimetoday]

I have heard most hospitals keep CRRT 1:1 but unfortunately mine does not. As others have mentioned, the nurses run CRRT and HD nurses come to the ICU to do HD. We are 2:1, with our CRRT patients.

[gonzo1, ASN, RN]

The RNs do CRRT in our ICU. Usually 1:1 patient.

[xxlilkacixx]

I'm new to the ICU and did my first sled today, it was so fun! We also scuf and do CRRT ratio 1:1

[meanmaryjean, DNP, RN]

We also do CRRT in our PICU- the HD nurses set up the machine, but it's all PICU RNs after that.

[sockov, ADN, ASN, BSN, CNA, LVN]

It all depends on staffing and acuity of the patient. CRRT has been grouped with another patient or been 1:1 depending how sick they are and staffing.

[ICU.RN]

We do crrts on the Msicu/Micu unit where I work. The hd comes and sets up, but we manage it, troubleshoot, rinse back and pull down th circuit when it clots, then we call the HD nurse to put up a new circuit.

[JSBSN]

CRRT's in my hospital are 1:1 unless they aren't that sick (not vented or not on many pressors). HD nurses come to bedside when ever the kidney clots off/is due to be changed. Its such an easy thing (we use NxStage) but the dialysis company that our hospital contracts with make$ a killing each time they come to do that 45 minute process. Its terrible sometimes because in the middle of the night I've had patients wait for up to 6+ hours for the on-call dialysis nurse to get there and get the CRRT running again. I've worked at a facility (not in the ICU though) that keeps there CRRT patients as normal staffing (2 patients per nurse) AND they have to do all the setting up/etc themselves. It really just depends on where you work. The NxStage systems are so easy to run that its become much less labor intensive.

[beckster_01, BSN, RN]

Dialysis RNs set up, but we run the machines after that. It really isn't that bad once you get the hang of it, and we have them frequently enough that most of the nurses are accustomed to it. We keep 2:1 ratio, but if the patient that is paired with the CVVH is pretty sick then we might split. And obviously we would split the assignment if both patients were on it, but I haven't seen that happen yet.

[XYRNMN]

In my Twin Cities area ICU the pt and the machine both get a nurse, so, 2 RN's in the room - this is for as long as it is felt that it's necessary, then if the pt is stable (in ICU terms) then it's a 1:1.

Never will the CRRT nurse have another pt.

[sockov, ADN, ASN, BSN, CNA, LVN]

I work at a Level 1 trauma center. The ICU nurses run the CRRT, but the HD nurses set it up. Most times the patient is grouped with another assignment, depending how sick the CRRT patient is, but we try to make them 1:1 if staffing allows and unit acuity.