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Explain the difference between a progressive care unit and intensive care unit

Question:

Dear Donna,

Can you explain the difference between a progressive care unit and an intensive care unit?

Explanation Needed

Dear Donna replies:

Dear Explanation Needed,

Intensive care units are typically for the most acutely ill patients, those who are unstable, in critical condition and needing very intensive nursing care and surveillance. In most ICUs, the nurse-to-patient ratio is 1-to-1 or 1-to-2 maximum.

The term “progressive care unit” (also called step-down unit, intermediate care unit, transitional care unit, or telemetry unit) may be used in varying ways in different facilities. But, often it is an intermediary step between ICU and a med/surg floor. These patients still need a high level of skilled nursing care and surveillance (although less so than in an ICU) but are more stable. The nurse-to-patient ratio would be higher than in an ICU, but lower than a med/surg unit — anywhere from 1-to-3 to 1-to-5. Some PCUs provide general care, while others are more focused, such as a cardiac care PCU.

When considering a position on either type of unit, or any unit for that matter, always ask for a tour of the unit and what the usual nurse-to-patient ratio is.

Best wishes,
Donna

 

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By | 2018-08-24T19:45:03+00:00 August 23rd, 2012|Categories: Blogs, Nursing careers and jobs|9 Comments

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9 Comments

  1. Avatar
    Elaine March 15, 2016 at 3:29 am - Reply

    My husband was admitted to a Progressive Care Unit. I could go on about our disappointment with this unit, but my main question is, should the nurses staffing this unit be certified to access a Smart Port? We have waited 2 days to find someone on this floor qualified to access his power port. They have to have a nurse come from the surgical floor to access his port. His IV has had to be moved twice and taped to his arm to stop the IV machine from stopping and sounding the alarm. Th

  2. Avatar
    Mark Stephens (KMMR Radio) October 13, 2016 at 5:52 pm - Reply

    In your experience (knowledge) is there a practical difference between an ICU and a PCU other than the “nurse to patient” ratio, and level of observation. In other words, is there equipment and/or procedures that are in the ICU which are not in the PCU? In other words, is the physical environment essentially the same?

    Thanks in advance,

    Mark Stephens
    (801) 613-1775

    • Heather Cygan
      Heather Cygan December 5, 2016 at 8:07 pm - Reply

      Hi Mark, There is a difference in nursing and physician care requirements of an ICU patient and that of a PCU (or intermediate care) patient. The Center for Medicare and Medicaid Services (CMS) defines critical illness or injury is one that acutely impairs one or more vital organ systems in such a way there is a high probability of imminent or life threatening deterioration in the patient’s condition. Patients on PCUs usually do not fit this definition—think imminent or life threatening deterioration. A critically ill patient is typically found in the ED and ICU. However, due to a change in the patient’s condition, they may need of be transferred to the ICU. It is also in the best interest of the hospital to transfer the patient to the appropriate care unit so that the hospital can bill for the increase in services provided for this critically ill patient, which would matches the increase intensity of nursing services such as surveillance. Understandably, a community hospital ICU might have very different equipment in their ICU compared to a large urban academic medical center ICU. Based on the location of a hospital and the typical patient population, equipment can vary in an ICU and PCU, but the key is the definition of critical illness and the intensity of nurse and physician services which is more than just level of observation needed to care for this type of patient.

  3. Avatar
    Mike December 2, 2016 at 10:50 pm - Reply

    Tupically a medical port is not permitted to be accessed by a nurse. This would require a doctors order to access and parameters/conditions.

    • Avatar
      Angela Reever March 28, 2017 at 1:48 am - Reply

      Yes thank you. As a PCU nurse I am qualified to access a port. I do need a doctors orders. The delay in time should of been explained to the family.

      • Avatar
        Ashley April 4, 2017 at 4:06 pm - Reply

        I am a PCU nurse that is port certified. I am able to access a port with a doctor’s order. On my unit, if I or another port certified nurse is not working and a port needs to be accessed then IV team has to be called in. Unfortunately there are only a few members on the IV team and they are responsible for the whole hospital. This is often the reason for the long delays in getting ports accessed.

        • Avatar
          Jp October 7, 2017 at 12:47 pm - Reply

          Which hospital do you work? Or state I mean.on my current work place every nurse should be able to and trained on orientation to access and deaccess ports.

  4. Avatar
    Jane Ambrose July 17, 2017 at 4:07 pm - Reply

    A good friend of mine is thinking about going to nursing school, so I’ve been wanting to research a little more about hospitals and nurse care. Before reading this I didn’t know that ICU’s are where the illest patients go to be closely monitored. It seems to me like it’s really important for those to be well functioning and staffed for the patients being treated there. This is great information to share with my friend! Thanks.

  5. Avatar
    Krystal December 17, 2017 at 11:24 pm - Reply

    I work in a PCU and we take a lot of 24 hr post-op CABG and heart/lung surgeries. We get the patients from the ICU when they are ready to transfer. We get a lot of BiPAP, CPAP, and DKAs on insulin drips. We also take Lasix drips and we can take patients that go up to 4 on Levophed. We have nitro drips, cardizem drips, among many others. We have been told by some travel nurses that our PCU is more like an ICU in a lot of places.

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