Vital signs? How often do you take them on your LTC unit?

[night owl]

I was wondering if we're the only place in the whole world that takes VS on every resident every day. One hall has them taken on days, another hall on eves and the 3rd on nights. Now if they are sick, it's whenever the Doc wants them (ie) q shift, bid. If they happen to c/o something I take them for the record. But OD if they aren't even sick? They're VS can change in the matter of seconds, so what's the point? They wouldn't take them OD if they were home, and this IS their home!

I can see that maybe after a few days, you might see someones BP increase and therefore could be a warning sign of something to come. When we tell the PA-C, (who thinks she's GOD...another thread of discussion) she ignores our opinions because afterall, "we're only dumb nurses" So how about you all? Do you take all residents VS OD?

[adrienurse, LPN]

On admission, PRN and every 3 months minimum. Every three months seems a little long (I'd prefer at least monthly to get a really good baseline), but these people are medically stable.

[Youda]

It would depend on the resident population. If Medicare, you have to do VS this often. If unstable, you have to, too. Although the ideal is usually pretty far from reality in most LTCs, any res. with a recent change in condition, change in meds, etc., should have daily VS. Remember that just because it's their "home" the elderly really are not a very stable population medically. Another thing to consider is why. Is this part of a plan of correction because the facility got tagged about not taking them or monitoring the res. closely enough? Guess I'd need more information before really giving an opinion on this one.

[duckie]

We take them weekly and PRN with change of condition.

[longtermcarern]

We take them q shift x5 days for new admits, bp's wkly for anyone on cardiac meds, monthly for all others.

[rebelwaclause, ASN, RN]

Wow...I never knew this. It explains why when I worked on the ambulance when on scene at a LTC, I'd get a blank face when I asked for the most current VS. Never knew Q3days is a norm.

On med-surg in the hospital its q4 or routine (q8).

[Nursenan0]

We take them q shift for 72 hours on new admissions, daily for cardiac meds and monthly unless a change of condition occurs

Nursenan

[shygirl]

If they are medicare, we take them q shift for 2 weeks. Otherwise prn. If we are charting on them for whatever reason, then q shift until notes are put back. Then its 2x month. We have some meds that require BP before med is given with a bp hold or a pulse hold.

Shygirl

[night owl]

We have the q shift x3 days with new admits, prn for change of condition, and bp or AP prior to giving certain meds, but I'm talkin EVERY day, sick or stable. The CNAs are supposed to take them, but they wait for us to finish our meds then ask us for the b/p's & pulses and fill in the blanks for the rest if they bother at all. Nice...but what's the point in every day if they're in stable condition? Makes no sense to me.

Oh and Rebel. If they are sick enough to call for an ambulance, shouldn't they have taken VS prior to you getting there?

[Talino]

Frequency of VS check is apropos to the resident's condition. Good practice is common sense -- if it's imperative to identify or monitor a resident's medical condition or response to a drug regimen, then do it.

Same goes true w/ Medicare residents. If their in for Rehab, not for skilled nursing from an acute illness, golly, stick that thermometer back in it's cradle.

A stable resident may require VS once a month during a monthly physician visit ONLY if the physician asks for it.

Routine VS checks is a facility practice, not a regulation. If you check VS frequently without a sensible rationale, you may be intruding on a quality of life issue. If the resident does not need it, let him enjoy his peace. :kiss

[tinkertoys]

Our protocol is V/S Q shift x 72 hours for new admissions. After that, everyone gets a full set of V/S weekly. If a patient is ill or on alert for some reason, V/S q shift for at least 72H. Temp q shift if on antibiotics, AP and BP if appropriate for meds. We would never dream of calling a MD without first getting V/S If possible, we try not to disrupt their sleep, activities, etc., but sometimes it's necessary in order to give the care our patients deserve. Our patients are mostly skilled care. Maybe regs for patients who are physically stable and on very few meds are different...I don't know...

[tattooednursie, LVN]

In my facility we do every resident once a week. But daily we do certain residents 3 times a day, once per shift. If one of the residnets has a fall, or something else serious happens to them, the vital signs are taken all the time all day and all night.