Episode 186: The ICU Revolution at Mercy San Juan Medical Center Part 5 – Respiratory Therapy
What role do respiratory therapists play in creating Awake and Walking ICUs? How did Candace Wistrich, RRT, BSRT and Nelya Kapitula, RRT, BSRT lead their respiratory therapy department to move the revolution forward? They join us now to share their team’s journey! Episode Transcription Nelya Kapitula, RRT, BSRT 0:00 Candace and Nelya, thank you so
Episode 185: The ICU Revolution at Mercy San Juan Medical Center- Part 4 with the Trauma ICU RNs
How did education, training, leadership support, and deep compassion empower these experience trauma nurses to transform their ICU culture and practices? What successes have they had and how has keeping patients awake and mobile impacted their career fulfillment and team dynamics? Jessica Williams, BSN, RN, Adrienne Craig, BSN, RN, and Amber Brandt, BSN, RN share
Episode 184: The ICU Revolution at Mercy San Juan Medical Center- Part 3 with Luke Stratigates
Safe patient handling(SPH) is a fairly new and rapidly growing field. Mercy San Juan Medical Center is fortunate to have a strong SPH department and leadership. Luke Strategates, DPT shares with us the key role he plays in the ICU Revolution as the safe patient handling leader. Episode Transcription Kali Dayton 0:00 This is the
Episode 183: The ICU Revolution at Mercy San Juan Medical Center- Part 2 with Dr. Lawrence Bistrong
What happens when a medical director really sees the reality of “normal practices” and becomes a revolutionist? Dr. Bistrong shares his personal conversion and the key role he has playing in his team’s transformation. Episode Transcription Kali Dayton 0:00 This is the walking home from the ICU Podcast. I’m Kali Dayton, a nurse practitioner and
Episode 182: The ICU Revolution at Mercy San Juan Medical Center- Part 1 with Jeana Flakes
Standardized sedation and immobility are rooted in a gap in education. What is the power of a nurse educator in transforming knowledge, culture, and practice in the ICU? Jeana Flakes, MSN, RN shares how she helped lead the ICU Revolution as a nurse educator at Mercy San Juan Medical Center. Episode Transcription Kali Dayton 0:00
Episode 181: Physician Insights at CHEST
What do physicians understand of the ABCDEF bundle? What are their perceptions of early mobility? How are their teams practicing the ABCDEF bundle in their own units? What do physicians need to be able to lead an Awake and Walking ICU approach in their units? I interviewed physicians while attending the CHEST conference to find
Episode 180: Leading the ABCDEF Bundle in Bangledash
What happens when a visionary physician in a low-resource hospital in Bangledash leads his team to practice the ABCDEF bundle? How did this passionate team of ICU clinicians transform their care from automatic sedation and immobility to standardized mobility three times a day? How did they come to treat mobility as important and optional as
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Walking Home From The ICU Episode 179: The Legal Liability of Failing to Practice the ABCDEF Bundle
Fear of “liabilities” is often a barrier to keeping patients awake and mobile in the ICU. Yet, we know that the ABCDEF is evidence-based best practices. So what are the legal liabilities to a hospital, leadership, and bedside clinicians of current cultural practices? Maggie Ortiz, MSN, RN joins us now to share her expert perspective.
Walking Home From The ICU Episode 178: The Power of Nursing Leadership to Revolutionize the ICU
Although the ABCDEF bundle does not solely rest on the shoulders of nurses, their leadership is KEY. Andrea Silva, BSN, RN shares with his her journey to revolutionizing care in her ICU as an assistant nurse manager. Episode Transcription Kali Dayton 0:00 Kali, this is the walking home from the ICU Podcast. I’m Kali Dayton,
Walking Home From The ICU Episode 173: ICU Outcomes by Dose of Mobility
We know that for each additional 10 minutes of early mobility in the ICU, hospital length of stay decreases by 1.2 days. What else do we know about the relationship between dose of mobility and time on the ventilator? Sarina Fazio, PhD, RN, shares with us her exciting discoveries in her latest research. E Episode
Learn More > from Walking Home From The ICU Episode 173: ICU Outcomes by Dose of Mobility
Over the last few years I have become aware of the PICS (post-intensive care syndrome) condition and the very serious negative impact that it has on our ICU survivors. I have become much more aware of the potential negative impact of anxiety, depression, PTSD and cognitive dysfunction. Many patients whom we consider saves in the sense they leave the ICU alive have many issues that most people would consider far from a successful experience. Their lives are often dramatically changed in a very negative fashion.
I am a professor of medicine and have been an ICU director for over forty years. What I find very disturbing in my own experience and that of many other intensivists is that this outcome is generally considered acceptable; the patient survived and will get better with time. We have little access to these patients and almost zero information about their condition unless they are unfortunate enough to return to our ICUs. Very few of us have a PICS clinic where we would have a chance to better understand the challenges that some of our patients encounter, and there are very few systems in place to provide feedback to us as ICU clinicians. Therefore, we are blissfully ignorant of the many challenges that a substantial number of our survivors encounter. This is a major problem. The vast majority of ICU survivors and their families will experience cognitive, emotional and physical symptoms which often have devastating impacts on their lives. At this time, with PICS clinics being a rarity, there is no reasonable mechanism for intensivists to have a solid perspective on the frequency and severity of this condition.
How patients and their families are treated in the ICU often has a major impact on how the patient and families survive post discharge. It is generally agreed that most sedation infusions, particularly benzodiazepines, frequently have higher incidences of delirium and post-discharge dysfunction. There are a few hospitals in this country where sedative infusions are rarely used and the incidence of the complications described above are dramatically decreased. I have visited one of these hospitals and was amazed to see how effectively patients on maximum ventilator support can be managed, even walking without sedative infusions. In an effort to explore this treatment option in greater detail I have identified Kali Dayton. She is a nurse practitioner who has practiced in this Awake and Walking ICU for many years and is an amazing source of information on this topic. After extensive discussion with many colleagues, administration and many others, and reviewing the major potential benefits of the program for our patients, we have decided to introduce this program into our hospital.
Peter J. Murphy, MD, FCCP, MRCPI, BSc
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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