Nurse Patient Ratios in an 8 bed CVICU

GilaRRT · Jul 22, 2007

What is the RN to patient ratio?

suzanne4, RN · Jul 23, 2007

IABP patients should always be 1:1.

Pressors that are being continuously titrated and requiring q 15 minute vital signs should be 1:1, especially with higher doses of the pressors.

CVVHD and VADs should also be 1:1.

What type of staffing are you using per shift?

GilaRRT · Jul 23, 2007

I agree with the prior post. Anything not to this standard, run far far away from that hospital. Both Nurses and patients.

kat9114 · Jul 23, 2007

We staff our CVICU with 1:1 for the first 4-6hours post-op, if stable they then could be 2:1. Patients with multiple titrating pressors we try to keep 1:1. VADs are 1:2 post-op for the first 4-8h then always 1:1 until stable. IABP with titrating pressors are 1:1, CVVHD are always 1:1 unless we are desperate. We manage all types of open heart procedures and our patients tend to be of the high risk group.

BBFRN, BSN, PhD · Jul 23, 2007

My unit is staffed as above. We do remove chest tubes, sheaths, PA caths, etc.

lee1 · Jul 25, 2007

I am a Pateint Care Coordinator in a busy 8 bed CVICU. We average 4 cases per day. Our acuity tends to be high. I would like to know how others staff their units. We are currently battling with higher hours of care than our administrators would like to see. We feel our staffing actually could be better, that we are not overstaffed. I'm curious to ratios including those with IABP, CVVHD, VADs and multiple pressors. Nurses in my unit are set up to be very autonomous and we utilize only 1 patient care tech and 1 unit clerk. We pull our own central lines, sheaths and PA caths. We are being asked to potentially include chest tube removal as part of our responsibilities. Any info anyone can share would be helpful.

I would check with state standards for hospitals to begin with. I live in NJ and there ARE state standards------post open heart is always 1:1 and should be adjusted for acuity. Then there are the AACN guidelines. Who is helping your nurses do all the turning and lifting, the 1 tech???? What other responsibilities does that tech have that would prevent them from helping the RN with bedside care? Do you use ceiling lift equipment, etc. etc. Are your nurses doing all documentation in the computer or still on paper, etc. etc. What takes them away from direct pt care.

pickledpepperRN · Jul 25, 2007

We staff our CVICU with 1:1 for the first 4-6hours post-op, if stable they then could be 2:1. Patients with multiple titrating pressors we try to keep 1:1. VADs are 1:2 post-op for the first 4-8h then always 1:1 until stable. IABP with titrating pressors are 1:1, CVVHD are always 1:1 unless we are desperate. We manage all types of open heart procedures and our patients tend to be of the high risk group.

Ours is a mixed cardiac unit with chest pain R/O MI and post op patients. We staff the same. Our IABP patients who also need CVVHD or CRRT are 2:1 with an RN and either another RN or an LVN to assist. The LVNs float from telemetry and know their stuff.

We have a clerk until 11:00 pm. Then one or two CNAs and when our total is > 10 patients or when many are physically heavy we get two or three. Our charge RN has no direct care assignment. With > 5 RNs needed we also get a resource nurse for breal relief. We give report and leave for 1/2 hour.

The RN assigned to the patient in collaboration with the charge nurse determines the acuity and thus staffing needs for each patient. Family and/or patient needs can make a patient 1:1. An example could be a patient or family interfering with care needs.