Episode 189: The ICU Revolution at Mercy San Juan Medical Center- Part 8 with Dr. Parimal Bharucha
What is the ethical and moral responsibility of a medical director to personally practice, lead, and support their ICU to keep patients as awake and mobile as possible? Dr. Parimal Bharucha shares with us the incredible revolution that has happened in his ICU. Episode Transcription Kali Dayton: [00:00:00] This is the walking home from the
Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch
“Let’s introduce the bundle gradually. We don’t want to overwhelm anyone. Let’s see what the team is willing to do. We can start with awakening and breathing trials, then tackle the rest once we have those down.” This kind of conversation has echoed through medical organizations and clinical leadership teams for years. It’s a logical
Learn More > from Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch
As an RN in the Medical-Surgical ICU at the hospital I work at, I began my interest in ICU Liberation through an Evidence-Based Practice project.
While I was initially grabbed by what the literature has to say about over-sedation and patient outcomes, it wasn’t until I discovered Kali’s Walking Home From The ICU podcast that a culture of sedationless ICU care sounded tangible. The group I worked with on the project was both inspired, devastated, and intrigued by the stories Kali illuminates on the podcast, and we were able to bring her to our hospital for a virtual Zoom Webinar, where she presented on the practices in the Awake and Walking ICU.
This webinar was an incredible way to draw attention toward this necessary culture shift as Kali shared stories of patients awake and mobile in the ICU despite the complexity of their illness. The webinar inspired our final draft for the new practice guideline on analgesia and sedation management in the ICU, and since then we have seen intubated COVID patients playing tic tac toe on the door with staff members on the other side, taking laps around the unit, performing their own oral care using a hand mirror, and most importantly, keeping their autonomy and integrity while fighting to leave the ICU to resume the life they had before coming in.
Nora Raher, BSN, RN, MSICU
Virginia, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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