Cardiac Step-down Unit

Services/Responsibilities

The Cardiac Step-down Unit is a medical/surgical unit that cares for the acutely ill cardiac patient. The common diagnosis includes: angina, acute MI, CHF ,  and open-heart surgery .

Technology

All Cardiac Step-down beds are monitored via wireless remote telemetry packs. Monitor Techs continuously watch the monitors and report changes to the nursing staff. All beds have the capability of doing invasive monitoring such as arterial monitoring. Computerized charting is utilized by staff via a mobile computer system called a “Johnny”. Medications and supplies are readily available via an Omnicell.

Staffing

CSU has 30 beds with an average daily census of 25 patients. The average length of stay for medical patients is approximately two days and for surgical patients is four days. Since there is a rapid turnover of patients on a day-to-day basis, a modified team nursing approach is utilized on CSU. A team of two nurses cares for a group of 8-10 patients. The nurses divide the patients between themselves based on acuity and patient needs. Staffing ratios range from 3:1 to 5:1. Both RN's and MT/UC's are staffed around the clock. Being an open unit, CSU is able to float staff to other units and gather staff from other units based on census. All CSU staff is expected to take turns at floating and at being on call/low census.

Training/Education

Monthly educational offerings are posted for information and continuing education. All CSU nurses are expected to attend the acute care classes and successfully complete the dysrhythmia course offered at OMHS. ACLS is required within one year of hire. Frequently, cardiac in-services are held to provide on-going education in the dynamic world of cardiology and critical care. Nurses without a cardiac background generally require 8 weeks precepted floor orientation.

Continuous Quality Improvement

CSU participates in all the hospital sponsored process improvement teams. Staff members actively participate in many process improvement initiatives/teams such as: CHF taskforce, FMEA team, Pharmacy and Supply team, etc. CSU functions as a member of the code blue team when the Coronary Care Unit is at minimal staffing due to census.