Should CVVHD be 1:1

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Should it be required that pts on CRTs be kept at a 1:1 ratio? I have a very unstable pt on CVVHD but also have to take on another pt cause my hospital doesn't require 1:1. I think it is ridic because my other patient gets super neglected while I'm constantly monitoring and managing this guy. We have a great suport system in my unit, but it all falls back on my nursing license. I can't seem to get my nurse manager to grasp on to my argument though... :cool:

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Specializes in CTICU.

Whether a patient should be 1:1 depends on their acuity, not their machines. If he is seriously unstable, then yes. If he's regular-ICU-unstable, maybe not. Not just because he has a filter though.

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Specializes in STICU; cross-trained in CCU, MICU, CVICU.

How do you mean your patient is unstable? BP/HR, pulmonary? CVVHD is NOT a 1:1 at my hospital, we try to make it a 1:1 if able however if the staffing does not allow then there is really nothing we can do about it. If the patient is unstable meaning....more than 1 vasopressor and just plain SICK!!!, then we will triple up another RN so that the CVVH can be 1:1....Just because a patient is on CVVHD should not dictate a 1:1 status.

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You are only responsible for the assignment you accept. If you feel that you are jeopardizing a patients care, you have the legal right to refuse the assignment on behalf of safety. Talk with your administrators in an open forum.

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Specializes in ICU.

It's 1:1 in my hospital

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Specializes in ICU.

Vents are 1:1 here, CRRT is 1:1.

95% of our patients are 1:1, even the people waiting to go to the ward.

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Specializes in CCU, ED.

Your patient's just have to have a vent to be a 1:1? Where do I apply?!

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Specializes in ICU.
Your patient's just have to have a vent to be a 1:1? Where do I apply?!

Me too!!!:nurse:

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I'm in a nicu with not much experience yet, but we had a baby on cvvh and he was 1:2 meaning 1 baby w/ 2 nurses, I think he was also very unstable, also ended up on ecmo I believe

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our filters are 1:1 but not vents. balloons are not 1:1 either. The only way a vent should be 1:1 is if the Doc won't give adequate sedation!!!!!:coollook:

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1:1 ratio for vents. There must be a line forming to the left to work in that unit. If you email me, I'll be honored to send you my resume. Show me where the Moca is kept.

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Specializes in Surgical ICU.

1:1 vent??? I need to work there. Its not atypical for me to get 2 vented patients,... but sometimes with the right sedation their easier anyway :p .

As for cvvhd,.. my unit tries to keep it 1:1 but that is not guaranteed. I don't believe they triple any nurses to get a 1:1 ratio. As long as the patient is not extremely critical then its usually not a problem. Its just hard at times when the filter clots and it takes 40minutes to start it up back again. there is either a delay in starting it back up or someone elses meds are late, etc.

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