Telemetry Monitoring and Vital Signs

[ABNBUD#2]

Hey all,

I am new to this forum, but I figured I could get some help.

The policy and proceedure for the hospital I work in does not specify routine vital sign monitoring for patients on telemetry, only that the PT must be assessed and a set of vital signs recorded when the monitor tech calls with a monitored problem. The going school of thought is that it should be done Q4H. I have no problems with this except that many geriatric patients are ending up sleep deprived, confused, and down right buligerant after being here for a week or so. It seems that each nurse is developing their own view of this issue as well.

I am looking for scholarly information, experience, or precedence to prove either side of the arguement.

Thanks,

Your Airborne BUD

[Tweety, BSN, RN]

We monitor our Telemetry patients vital signs q4h. We are med-surg trauma and have 8 monitors.

What's interesting is that our Telemetry and PCU floors only do vitals q8h.

[queenjean]

Our official policy is q 4 hrs during day et at night at nurse's discretion. Meaning, depending upon their status, I might only take their vitals at 2200 et 0600, or I might take them at 0200 (or more often, of course, if need be). It is completely dependent upon the pt's status, what (s)he's been doing during the last 24 hrs, what their history is, what their tele has been running, medications they're on, etc.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Our telemetry unit has a policy of Q4hrs for the first 24h then Q shift unless otherwise specified by the Dr. (we don't use monitor techs,.our monitors are at the nsg station and each RN is responsible for monitoring)

[UM Review RN, ASN, RN]

Vs q4h on tele patients, q8h on med-surg.

If the patient is stable and BP's are not fluctuating, why not get a doctor order (while you're calling for something else, of course) to change the times of the vitals? Wouldn't that override the unit policy?

[ABNBUD#2]

Thanks all,

Some of the nurses seemed releived when they learned of the actual wording on the policy (of course these where the nurses that were assiging me to do routine VS at 2000 and 0400 in spite of the percieved policy).

This whole discussion was started when I pointed out that possibly the policy was worded to leave the routine vital signs monitoring up the the assigned nurse. A good way of allowing the nurse to adjust their care according the needs of the patient (more frequent or less frequent as needed). This lead to a standard-of-care-discussion where I and a few others were the minority.

Thanks again, this should help pass the time a bit tonight,

ABNBUD