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Published byBernice Lee Hamilton Modified over 9 years ago
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Nursing Challenges in CRRT Margaret Farley RN
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CRRT Staffing Need to try and project how many children may require CRRT annually in your unit Develop and grow your team size with this number in mind- want to avoid either staff burn out or staff unable to access sufficient CRRT hours to support them in developing competence and confidence. Have two full day of study – mornings for theory and afternoons for Water Labs Governance requirement to monitor and document individuals acquisition of CRRT related skills using some form of competency chart Desirable to provide some individual 1:1 preceptorship for trainees in the clinical arena
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CRRT nurse role Early identification of children needing CRRT Rapid response aiming to initiate treatment within an hour of identifying the need for CRRT We currently have wet primed CRRT circuits prepared and ready to go 24/7 Where there are 2 or more children in PICU on CRRT have a dedicated CRRT nurse to support the bedside nurse in ensuring prescription is achieved reliably and accurately Support in ensuring patient ACT monitored closely to protect/prolong circuit integrity Education of the bedside nurses and the less experienced medics Monitoring and management of hardware and stock levels
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Staffing – Top Tips Aim to have a nurse lead for the CRRT service, when you have a named individual taking responsibility for service delivery and education things should run more smoothly – hopefully Keep treatment delivery SIMPLE to reduce the risk - You don’t need a wide range of haemofilter, pick two one large and one small -Keep your circuit sizes simple one large, one small -Look at the range of treatments you deliver to the average run of the mill patient SCUF/CVVH/CVVHD/CVVHDF - Really !! See the rule above and pick two. Currently we use CVVH and CVVHDF
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