I have been attempting to determine what other hospitals comprehensive stroke care units RN to patient ratio is. I started this process off by compiling a list of comprehensive stroke care units (there are nearly 200 in the US, if not more--the list is lacking a few hospitals) and calling the hospital switchboard, asking to be transferred to either HR or RN recruiter for their comprehensive stroke unit. Clearly, I could just call the unit and ask who ever picks up the phone what their ratio is. The problem is that the hospital operator does not know off the top of their head which unit is comprehensive stroke certified AND--working on a comprehensive stroke unit myself--I don't want to clog up the lines on that unit when I'm not a family member of a patient or staff.
So, now I'm here. If any of you work on a unit that is comprehensive stroke certified, please reply with your DAY shift and NIGHT shift RN to patient ratio along with the HOSPITAL, CITY and STATE you work in.
I work on a Neuro Step Down Unit, in PA. Our ratio on the unit is 3:1. But when we are short staffed, we can get pushed to 4, and this happens quite frequently.
I work on a supposed neuro/surgical medical floor, level 1 stroke center, but the acuity is really more of step down. We still have a 5:1 nurse-patient ratio. The actual step down unit is 3:1 I think? Or 4:1. And the ICUs are 1:1 but sometimes they have to double up. Same for days and night. Missouri.
We are comprehensive stroke here in Los Angeles, CA. I work on a stroke tele floor at 4:1. Day shift!
Stroke/tele floor in the chicago area... We aim for 4:1 days and 5:1 nights for RN's - I've seen it at 5:1 days and 6:1 nights though.
Cna is usually 10/11:1 and occasionally (2 nights a week usually) we have to deal with 1 cna for the entire floor (24:1) which means that the rn's are then responsible for their own vitals and accuchecks. A third cna is only called in when the floor is full (24) and only for day shift.
There are Comprehensive Stroke Certified (CSC) facilities, but not individual units. There are CSC facilities that have dedicated stroke or neuro units, but there are no standardized criteria or staffing ratios since their patient mixes will still vary.
Among other things, CSC means the facility has the ability to provide neuro intensive unit care, although this can be in within a general ICU not necessarily a neuro specific ICU, and lower acuity care by staff trained in stroke care. The nursing care needs of post-stroke patients can vary widely, so you're probably unlikely to find a single nurse to patient ratio that applies to all post-stroke patients.
In Canada, a comprehensive stroke centre would be doing stuff like giving tPa, thrombectomies/embolectomies, along with providing stroke care for those outside the window. Patients that are given tPa/thrombectomies are admitted to a hyperacute stroke unit where they are at worst 2:1 with neuro checks to be done every hour at the minimum (a step down unit). Otherwise stroke patients are 4:1 on days and 6:1 on nights.
California has a mandatory set staffing ratio. In our neuroscience ICU (which is a comprehensive stroke center) the ratio is never more than a 2:1. If the patient is unstable or has to many tasks (e.g:. cerebral microdialysis, CRRT), they are 1:1 care . Our Neuro step down is a 4:1 ratio.
Last edit by Delia37 on Aug 3
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