I am interested in trying to find out if anyone works for a hospital that has a policy on whether your critical care patients are done in the dialysis unit or are they done bedside in the unit? I am specifically looking for a written policy. If anyone has such a thing I would appreciate the input. A physician that I work with is interrested in possibly trying to draft one for the hospital I work out and needs help! Thanks

Being a family member of a diaysis patient, when he was in the hospital, they dialyzed him in ICU, as well as on the step down unit, did not send out......

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Originally posted by advocating:
Being a family member of a diaysis patient, when he was in the hospital, they dialyzed him in ICU, as well as on the step down unit, did not send out......

I also worked where the hospitalized patient was brought up to a room in the ICU. We got most of our orders via telephone as the docs were in Buffalo and we were in Niagara Falls. The patient was completely assessed ,labs, weight,access,i&o etc. prior to calling in the report. Sounds like your Docs are already in house and that makes it nice. I am now in Massena NY and we look forward to offering inpatient tx's as soon as we can get a local nephrologist. We just opened an 8 station HD unit, truely a beautiful ,homelike atmosphere.I soon hope to be writing policies for inpatient HD as well.

ICU patients should remain in the ICU for dialysis treatments. If a patient can be moved out of the ICU for HD, they really do not belong in ICU to begin with and should be moved out of an acute bed.

If the Hospital insists that patients be moved for HD, the renal nurses will need the same skill set as an ICU nurse, such as ACLS, advanced education for critical care patients, experience with all types of medication drips, swan lines, etc. and same staffing levels.

Good luck

I work in a hospital dialysis unit. We have icu, ccu pts brought to us. Myself and one other nurse are critical care nurses. We manage the vents, drips etc.

I work for a hospitial acute dialysis unit. There are nurses and technicians that dialyze patients that come from various floors. Those that are too unstable to come to the unit are done bedside by the acute dialysis team. P.S.Kim in Wilmington N.C. this is how we do it in Maryland.

I work in a hospital as an acute care dialysis nurse .. if a patient is in ICU or CCU vented and or have alot of pressors hanging ,than they are done at the bed side ..one to one .. stable patients from a medical floor will go to the dialysis unit, we have policy's / guild lines for what types of patients we will except in the dialysis room.. hope this will help you

I'm also a RN in an acute HD unit. We contract with 2 hospitals. One of the hospitals allows us to bring ICU pt's to our in house HD unit if and only if we have a verbal order to do so from the pt's nephrologist. We often get post-op, post-code, or otherwise very sick pt's. Our nephrologists trust our judgement on whether or not a pt is stable enough to come to our unit and often will ask how we feel about the situation.
Some people will say that if a pt is stable enough to go to dialysis then they need to get out of ICU. However, these people must not work in units such as the one I work in. We monitor our pt's just as ICU. (heart monitor, O2 sat., BP on q15-30min, and maintain continuous pt contact).
Creating a protocol is difficult because you will have so many variables. I suggest you work into your protocol that it is ultimately up to the pt's physician on whether or not the pt can leave the ICU for their HD tx. It's ridiculous for hospitals to expect or demand that ALL ICU pts be done 1:1.