Staffing Ratio for VAD Patients

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:prdnrs:

I'm curious as to how other facilities are staffing their VAD patients. We use the Abiomed AB5000. We have not done very many VADs, so we currently staff them 2:1. With our last one, we felt that the patient reached a point where she could have been staffed 1:1. I'm just wondering what criteria, if any are used to determine when a VAD patient can be changed from 2:1 to 1:1 staffing.

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Specializes in CTICU.

My hospital does about 60 VADs/yr. They are staffed 1:1 in ICU postoperatively, then often go to 1:2 when stable. They are 1:5 on the stepdown floor.

We do have a team of device engineers and techs who manage the devices, take readings and make adjustments though - which reduces the load and responsibility on the bedside nurse.

The AB5000 itself shouldn't need extra staffing, or 2:1 - the only thing you can change is the vacuum, and it rarely needs changing unless there are signs of hemolysis. Of course, you may need the extra nurse if the patient is bleeding/hemodynamically unstable postop.

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Specializes in ICU.

in my hospital its 1:1 coming out of the OR but if they are stable a few days out we will make them 1:2. ive had 2 vad patients at one time

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Specializes in Critical Care.

Honestly, we don't staff our fresh VAD's 2: 1 unless they are crashing which is very, very rare. Normally, they are one to one, especially the Abiomed's. With a risk of decannulation, our facility has deemed them to be 1:1. Our Heartmate's are usually 1: 1 fresh post-op, then later downgraded 1: 2. I could go into our other VAD's but not sure how much info you want. Hope this helps.

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Specializes in CTICU.

Do you mean the BVS5000?

There is no particular risk of decannulation with the AB5000 (well, no more than any other paracorporeal VAD).

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Specializes in Critical Care.

Actually I don't mean the BVS5000, I mean the AB5000. There is a risk if the cannulas aren't sutured in properly (we've gotten a few in from OSH's that were held in place with hemostats in the chest-I'm not kidding! ) so based upon some of the cases we've received, our service has elected to make them 1: 1 staffing.

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Specializes in CTICU.

Hmm.. scary.

We have people up and walking around doing rehab/PT etc with AB's. We do fix the cannulae with a Hollister patch/drain tube holder to the abdomen, plus add an abdominal binder.

(I recently heard of a hospital that lets patients with Centrimag pump ambulate - now that's scary! That's basically just sitting there like ecmo cannulae...)

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