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Reply To: Cardiac Monitoring
MemberSeptember 7, 2013 at 2:52 pm
Mary Lynn Rae
Ann & Robert H. Lurie Children’s Hospital of Chicago
Sent: 09-05-2013 01:44 PM
From: Amanda Ebbert
Subject: Cardiac Monitoring
I am the Pediatric Nurse Educatorat the Penn State Hershey Children’s Hospital in Hershey PA. We moved into our brand new children’s hospital in February and are currently looking to move our unit to more of an IMC heme/onc unit. This will have our nurses doing cardiac monitoring which they currently do not do. I was wondering if anyone would be able to answer a few questions for us about how you run your unit and how you educate your staff.
1. How many beds are on your heme/onc unit? 24
2. What is your nurse to patient ratio? 2:1 for SCT and 3:1 for Hem/onc
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? Hem/Onc/SCT & Rheumatology
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? Based on patient assessment; SCT patients; drug regimens (i.e MoABs; IVIG; ATG).
6. What are the expectations of the nurses when they are cardiac monitoring? Are you willing to share your policy on cardiac monitoring? The monitors commiunicate with their phones so the policy is to respond to the alarms and asses the patient and monitor.
7. What kind of training is done/required before nurses can perform cardiac monitoring? Everyone received training on the bedside monitor. Rhythms are reviewed in PALS every 2 years.
8. Do patients transfer off your unit and to an IMC/ICU? PICU if necessary based on patient status.
9. If yes, for what reasons are patients transferred (respiratory status, cardiac status etc.)? Mostly respiratory.
10. What drips do you administer to patients on the heme/onc unit? Dopamine (will keep on unit if pt. is stabe and drip is not being titrated.
11. Do you have stem cell transplant patients on your unit? Yes
12. If yes, who administers the Stem Cells on your unit? APNs
13. What is the process for administering stem cells? Cells delivered; RN spikes and primes 0.9 set; baseline vitals; pre meds; administration; frequent VS.
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? APHON SCT class and Lurie SCT class for 20 total hours. APHON SCT test; Lurie SCT test; precepted time with a SCT RN.