Transporting Telemetry Patients off the unit

[CV CNS CCRN]

I am very interested in how different hospitals are handling the transporting of Tele patients off the unit for tests. Do you require a Tele RN to go with monitor and meds, just a monitor, no RN, no nurse, a transporter, a tele tech, no monitor, no meds, or what? There seem to be as many different ways and combinations of ways this is done, and it is quite variable from organization to organization. If you take them off telemetry, do you get a routine order on admission "may be off telemetry for tests" or is doe PRN each time they have to take a road trip? This is a hot topic in my organization, as I suspect it is in many. Please give me your practice. And although we would ALL prefer to see it be a credentialed RN doing the transporting, I am more interested is what is actually HAPPENING at your organizaitons. Thanks in advance. CV CNS CCRN

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

Patients go off the floor to radiology for as long as three hours at a time unaccompanied. But somehow the policy is that if the patient is being monitored and going to surgery, we have to put them on the portable monitor and escort them down two floors and walk them 50 feet into surgery holding. When the entire time the wireless telemetry is works just fine. Policy, you just gotta love it.

[mittels]

When we had to transport a pt off the floor for any reason then it was manditory that we get a specific order from the DR re tele on or off. If the tele could be taken off for any amount of time then a nurse did not need to go with that pt, but if the tele needed to stay on, then depending on were in the hospital this person was going and whether our tele reached that area such as an x-ray. This also goes for how sick they are.

[nursemaa]

Our ICU/CCU patients must remain on tele and be accompanied by an RN when leaving the unit. The patients on our Stepdown tele unit can go for tests, etc without tele and accompanied by transport staff (no RN).

[NiteNursee]

What is done where I work is if the patient's rhythm is stable, they may go in-house unmonitored, per policy. If they need to go out of the building for a test(ex.MRI) you need an order to send them without a ACLS RN

[kateRN]

We actually just changed out policy. We used to have to send everyone on tele all the time for every test. Now, there is a list of criteria that states when a patient must travel with a monitor, and as long as they do not meet any of the criteria, then it is up to "RN discretion" to decide whether of not they can go "off tele". A pt. must go on tele if they:

-have been admitted to our floor (intermediate cardiac stepdown) less than 24 hours

-have any kind of frequent ectopy

-are having chest pain, or any kind of distress (obviously)

-are currently on any drips (excluding saline or bloodthinners)

If they do have to travel on tele, our techs who are certified travel with them. The nurses on our floor would never have time to leave the rest of their patients to go down to xray for 45 minutes. Since there are still a lot of gray areas with "RN discretion", I just call the doc to get an order if I am uneasy.

[Bermuda]

I work on a tele unit and all patients monitored go with nurse/monitor all our nurses are ACLS certified and all RN's... we go with the patients and stay with the patients...it is our policy..of course...you just hope that while you were off the floor that your buddy watched your other 5 patients while you were off the floor..and if you have 2 patients to go at once then you have a recall until you can take them..how about that? All in a days work... :rotfl:

[Marnaby]

Where I work, patients are always taken off their telemetry monitor before they go off of the floor to a procedure. The only time a pt is accompanied by an RN is if they are on a drip like Nitro or Natrecor.

[Bermuda]

There was a time when our policy was a bit laxed....then we had 2 deaths 6 mos apart and that is when the big guys started enforcing it..if MD has ordered the tele unit it is a monitored unit and if monitored then monitored...and that does not mean to remove to leave the floor nurse goes with...end of story...if MD does not want monitor then go to the med-surg floor...because the whole game changes...we do vitals q2-4 hours constant monitoring..stips q2hours...(no monitor tech) nurses do their own (6pts too) and the med-surg q8 vitals so if MD says tele...then the protocol is just that..and by the way if they are stable enough to leave the floor without a nurse for a period of time then they don't need monitoring...let the MD order aholter monitor ..I guess it is different at each facility...ours is standard...and when the accident happened off the floor in nuclear med with the pt off monitor and NO nurse with the patient...guess who got the boot...nurse was 'let go" so see ...that is how some things work...watch your back...

[91WhiskeyM6]

Not only that, you have to tell the teletech to configure the tele computer for transport. Otherwise, when the patient's in the elavator, the tele computer will be alarming the whole time and it will start printing strips like crazy.

This is only if the box is going with the pt of course.