Continuing Education at Michener/UHN ’s Post

ICU Delirium: Part 1 I have noticed that much of the ICU community seems to see #ICUdelirium as transient confusion that is a hassle to deal with and can be sedated away. There is a lack of urgency. There seems to be an unawareness that: - #Delirium is life-threatening acute brain failure. - Delirium doubles the risk of dying in the hospital. - For every 1 day of delirium there is a 10% increased risk of death. - Delirium triples the risk of dying 6 months after hospital discharge - The risk of death for delirium survivors is still elevated 1 year after discharge. Delirium occurs in up to 81% of #ICU patients. If we are not practicing the #ABCDEFbundle, then we are not giving patients the best chance to survive and thrive. Follow along to continue this series on delirium. Citations will be in the comments. #criticalcaremedicine #evidencebasedpractices #criticalcare #nurses #icunurses #respiratorytherapists #intensivist #acutecarenursepractitioner #app #medicalresearch

Early Mobility: Part 5 The second a patient develops critical illness, the hourglass is flipped. How we manage patients greatly impacts how quickly this "sand" drops. Sedation and immobility drastically increases and expedites the loss of independence, cognitive function, chances of survival, etc. Keeping patients awake and mobile decreases and combats the loss of patients' futures. For example, we know that walking patients within 48 hours after intubation improves cognitive function by 20% 1 year after discharge. Does your ICU team have this knowledge and perspective? How would this perspective impact how your ICU teams’ approach in caring for patients on mechanical ventilation? Comment below! #ABCDEFbundle #ICUsurvivor #AwakeandwalkingICU #ICUliberation #ICUrehab #ICUdelirium #Earlymobility #ICU #criticalcaremedicine #ventilator #PICS #PostICUsyndrome #nurses #nursesoflinkedin #physicaltherapist #occupationaltherapist #respiratorytherapy #respiratorytherapist #RRT

I have seen the impact of ICU delirium both as a nurse and a family member. There needs to be more support, and it can be done. Better outcomes are just a horizon away. Let’s start thinking that way. #ICUdelirium #criticalcaremedicine #evidencebasedpractices #nurses #medicalresearch

HOT TOPIC... You can't make it to your appointment anymore... Please let your GP Practice know as soon as you can... As you'll be aware they are often very busy and appointments are in high demand... What you might not be aware is that they often have lots of patients who do not show up to pre-booked appointments and don't let them know. These "Did Not Attends" (DNAs) unfortunately result in wasted appointments which could have been taken by other patients. Although we appreciate that on some occasions this might be due to unavoidable circumstances, however, if you can just let them know, as soon as you can, if you can no longer attend then this will help practice teams with high demands and ultimately help to improve your services and potentially create more availability for other patients. 💚💙 #freethespace #dnas #gpappointment #NHS #cumbria #northcumbria #primarycarenetworks #primarycare #primarycareservices #nurses #doctors #doctorsofinstagram #doctorsoftiktok #doctorslife #Receptionist #pharmacists #moderngeneralpractice #generalpractice #nhsstaff #Carepathways #carenavigation #NHSCareers #gpsurgery #generalpracticeteams #patients #patientcare #patientappointments

Dive into a challenging scenario: a 45-year-old male, intubated post-olanzapine overdose, faces ongoing agitation during ED to ICU transport. With a pending chest X-ray and immediate ICU transfer, ventilation complexities arise.   Engage with this case, explore the issues and predict outcomes.   Answers will be revealed at the end of the week! #CriticalCare #CaseStudy #VentilationChallenges #ACCCN #BrushUp #Nursing #Healthcare

Yes, COMPLICATIONS, COMPROMISES, INJURIES, & FAILURES - CCIF(s)! Vein Access Technologies has been TELLING this story for 28 years!!!!! And VAT has the SOLUTION to all of these CCIF(s) - the STEM-based VATmethod - involving new technique, new tools, NEW CONCEPTS. P...L...E...A...S...E visit VATmethod.com You (and your patient) have nothing to lose - except a bad venipuncture and a bad infusion. Here's the flip side: Good venipuncture and good infusion do occur. Right? Well, what's the difference between the two? How do you make all venipuncture and all infusions - good? VAT has the science-based answers to those questions - it is NOT a person's OPINION on how it should be done. It is FACT.

Continuing from last week's session, we dive into a real case: a 34-year-old man in the ED with breathlessness and nausea. Diagnosis: traumatic pseudoaneurysm. Swift surgical intervention was key.   Test your knowledge - how would you interpret the chest X-ray in this critical scenario? Share your insights! Let's learn together in the world of critical care.   #ACCCN #BrushUp #Healthcare #CriticalCare #Nurses

Structured Models: One Solution to Improve Communication in Health Care 🗣️ Structured models are one way that clinicians can navigate accountable conversations with empathy, respect, and a commitment to patient-centered care. In the context of accountable conversations in health care, a structured model is a systematic and organized approach for communicating information, addressing issues, and facilitating discussions. One well-known example of a structured model is situation, background, assessment, and recommendation (SBAR). Here is an example of how SBAR might look like in the clinical setting: • Situation: “Dr S, this is Kelli, the postanesthesia care unit RN caring for Mr X, your 45- year- old patient who underwent a left lower lobectomy this morning.” • Background: “I wanted to let you know that his chest tube drainage exceeded 100 mL in the past 30 minutes.” • Assessment: “IV fluids are running, and two units of packed red blood cells are available in the blood bank. His vital signs are stable with no drop in blood pressure or rise in heart rate.” • Recommendation: “I recommend an order for a complete blood count. If you agree, I’ll notify you if his hemoglobin level decreases by more than 1 g.” Do you practice communicating with SBAR or other structured models? What tips can you offer? In a feature article in the September issue of the AORN Journal, Cheri Clancy, and Paige Clancy, provide an overview of how to navigate accountable conversations and the importance of structured communication models. https://lnkd.in/gNCmgQiP #AORNJournal #Nursing #Nurses #ORNurse #NurseLife

Good perspective on ICU delirium and sedation practices.

The ABCDEF Bundle: Part 12 There is a spectrum of compliance with the ABCDEF Bundle. I see many teams still automatically start sedation on all intubated patients which ends up being deep sedation (despite documentation of light sedation). There may be some SAT/SBT once ventilator settings are minimal and extubation is being considered. Other teams automatically sedate patients but perform quick daily SAT/SBTs. Some teams automatically sedate patients but truly do keep patients responsive to voice and take quick breaks for SATs every day. Few teams only start sedation if there is an indication for sedation, but are still working on optimizing early mobility. Then there are the Awake and Walking ICUs that have full compliance with the ABCDEF bundle. These are teams that: -Only give sedation if there is an indication for sedation. -When there is an indication for sedation, the safest sedative is given at the lowest dose for the shortest duration possible. -Patients are performing their highest level of mobility unless there is a contraindication. -There is open family visitation and families are part of the ICU team. -Every patient possible has access to communication- even/especially while intubated. Where is your team at with compliance with the ABCDEF? Comment below! #ABCDEFbundle #awakeandwalkingicu #iculiberation #sedation #earlymobility #medicallyinducedcoma #evidencebasedmedicine #icu #criticalcaremedicine #intensivist #ventilator #healthcarecosts #icunurses #nurses #physicaltherapists #occupationaltherapists #respiratorytherapists #multidisciplinaryteam