Reply To: Cardiac Monitoring

  • Tara Arevalo

    September 5, 2013 at 8:11 pm



    1.            How many beds are on your heme/onc unit?  17 on hem/onc/bmt combined unit.  10 of those hem/onc


    2.            What is your nurse to patient ratio? 3:1 hem/onc and 2:1 bmt


    3.            What types of patients do you care for on the heme/onc unit? Are all of the patients on the heme/onc service or do you have other service lines as well? we are overflow for clean surgical patients, but our priority is to hem/onc/bmt patients


    4.            Do your nurses perform cardiac monitoring for your patients? yes


    5.            If yes, what types of patients get cardiac monitored and for what reasons? bmt’s during the transfusion of cells.  certain chemo/bio agents such as campath and atgam require monitoring.  very ill patients, such as, those with TLS or risk for TLS.


    6.            What are the expectations of the nurses when they are cardiac monitoring? Are you willing to share your policy on cardiac monitoring? trained in PALS and BLS and Pediatric Learned Rhythms.  


    7.            What kind of training is done/required before nurses can perform cardiac monitoring?  We use a program called “Pediatric Learned Rhythms” that the hospital purchases through health stream.  We also have a policy.  The patients are centrally monitored.  We also have a competency form on this.  


    8.            Do patients transfer off your unit and to an IMC/ICU? only straight to ICU since we are monitored we are considered an IMC


    9.            If yes, for what reasons are patients transferred (respiratory status, cardiac status etc.)?  both.  or if we have high risk for TLS like a new dx with 300,000 WBC.  also apheresis patients that need sedation will go to ICU.  We sent a patient today who had a mediastinal mass and fluid around heart to have his effusion drained in the ICU.  


    10.          What drips do you administer  to patients on the heme/onc unit?  only “drip” we do is dopamine to a max dose of 5.


    11.          Do you have stem cell transplant patients on your unit? yes

    12.          If yes, who administers the Stem Cells on your unit? Staff RN


    13.          What is the process for administering stem cells?  very detailed…if you’d like the form we use for this I can send it to you directly, just let me know.

    14.          What kind of training do you provide to nurses prior to deeming them competent to care for SCT patients? Would you be willing to share your nursing policies/education on caring for SCT patients and administering stem cells?   Willing to share.  See one, do one, teach one.  It is very similar to a blood transfusion.  The patients are 1:1 and the charge nurse is a resource.  Also the physicians are always present and they are familiar with the process.  I can send you our competency form that we use for training check off.

    Tara Arevalo, RN
    Clinical Nurse Educator
    Methodist Children’s Hospital 
    San Antonio, TX