How does your facility handle training for CRRT? Who is responsible for the set up, take off and hourly balances? Do you ever change the rates? Do you have parameters?
Who provides the training? Are all staff trained for CRRT?
Right now what we are doing isn't working. We want to approach management with some ideas of how other facilities handle the training and ongoing competencies. Currently our PICU nurse gets about 10 mins of review with the previous shift's nurse on how to fill in the paperwork. The dialysis services have been contracted out and the experienced dialysis nurses have moved on to other things. I'm one of those who moved on only to make the move to PICU. The new dialysis staff freely admit to being new grads and are not inspiring a great deal of confidence.
Mar 16, '07
Hi, I know its been months since your question but I felt like a response is in order. It seem most hospitals have very poor education regarding CRRT. At our hosp. Get 4 hours training with the machine (set up, trouble shoot etc.) Thinking about adding theory, calcualtions, crtitical thinking etc... This is being done by nurses who know the most and trying to pass on there knowledge with support of the unit supervisor.
Mar 17, '07
We go to an 8 hour introductory class before being certified to work the machine. After that, at some point, there's another 8 hour advanced class to be taken. When we have a kiddo on CRRT, there's one nurse for the patient and one for the machine. The nurse in charge of the machine takes care of all the calculations, setup, troubleshooting etc. We have a seperate flowsheet for that nurse to fill out. The kid's nurse gets totals for I/O from the CRRT nurse for the usual PICU flowsheet.
I'm not sure about changing rates etc, because I haven't taken the class yet. (Wanted to last time it was offered but a "traveller" got the last spot. I hate scabs.)
Staffing is always done with an eye to CRRT trained nurses, but there isn't always one on. If we have a kid heading that way (honestly, we don't do it all that often) we'll make calls to have trained RNs who will be available to come in if the need arises.
May 1, '07
Our PICU is combined with an adult SICU. We do Adults before children. Orientation is a 8hour beginner class with a dialysis nurse and then 8hours of being precepted on a patient with CRRT. Down the road there is a 4hour advanced CRRT class. We also have a competency.
Our most experienced nurses take care of our children on CRRT. Often the children are 2:1's if they are real sick.
The dialysis sets up and the PICU nurse does all the hourly needs. Our nephrologist writes orders for the net loss and the bath and other dialysis orders. If need be we take off during the night, we are all trained to rinse back and disconnect.
Last edit by Clg03280 on May 2, '07
Feb 1, '10
Please, do you have a simple to the point flowsheet you use with CRRT? Thank you!
Feb 1, '10
We use electronic charting with integrated flow sheets. I think I might have a copy of our old paper flow sheet kicking around at home. I'll have a look.
Feb 2, '10
Thank you for responding so quickly! I understand that many hospitals are using electronic charting but many are still not up to speed on this.
Feb 2, '10
I'm a nephrology APN and our CRRTs needs are addressed by acute care dialysis nurses from a contracted company - in our case, Fresenius.
Feb 2, '10
Thank you for your reply!