Free Download: CVICU Report Sheet
When I was a bedside CVICU nurse, I prided myself on my personalized report sheet. I did tailor it to fit the unit where I worked as a nurse, but I cannot express how much it helped me get through my day and give sign out to the oncoming nurse. The following was my morning routine as a bedside nurse and included is a free download to my report sheet. Best of luck to you in your careers!
NOTE: This is done simultaneously with a thorough head to toes assessment. Steps for a head to toe assessment are not included in this post. The purpose of this is to include parts of a morning routine that are often missed ❤️
1) Breeze past both patient’s rooms and glance and the patients and monitors - make sure everything looks “okay” - if patients are restrained, I make sure the restraints are tied properly ✨
2) Take bedside report ✨
3) Quick check of orders, meds and last chest X-ray, trend pertinent labs ✨
4) Go into the the room of the most critical patient first ✨
5) Check drip concentrations, confirm weight programmed into the IV pump matches the patient, confirm infusion rates, and patient name on IV bags ✨
6) Check monitor alarm parameters ✨
7) Check IV access on patient (I.E. Where will I be able to push code drugs if necessary?) ✨
8) Check for ambu bag on wall, trach supplies, suction set up ✨
9) Check ET tube size, length, and vent settings, including peak pressure ✨
10) Check settings on any device and insertion sites: CRRT, IABP, LVAD, ECMO, PA cat etc.- level and zero all transducers, note waveforms)✨
11) Note feeding tube length and securement, check residuals and placement if warranted ✨
12) Note date on central line dressing and all dressings ✨
13) Complete urinary catheter care and make sure there are no dependent loops of kinks in tubing ✨
14) Make sure all chest tubes, cords, IV tubing, drains are operating properly (either hooked to suction or not, whatever is ordered, canisters aren’t full, tubing isn’t under patient, etc.) ✨
15) Note patients skin, particularly bottoms of heels and behind the ears. Prop heels on pillows, change draw sheet and chucks pad, note sacral region for breakdown, turn patient ✨
16) TALK to the patient -make sure their call light is in place and TV is on chosen channel - or I put on music for my vented patients ✨
17) Complete CAM-ICU delirium scale ✨
18) Throw away old supplies, Cavi wipe surfaces, move any chairs, tables, etc. out of the way that might be blocking a path to the patient or cluttering room ✨
19) Repeat with next patient ✨