After decades of research and effort, why is there a persistent struggle to truly practice the ABCDEF bundle? Are antiquated sedation practices because nurses are unwilling to change, or is it because they are unsupported and untrained in the risks and realities of sedation? Even when training is provided in the classroom, what do nurses
Walking Home From The ICU Episode 148: The History and True Mission of the ABCDEF Bundle
How did the ABCDEF bundle come to be and what is its true objective? What barriers are causing the ICU community to fall short of full compliance with the bundle and what is the future of the ABCDEF bundle? Michele Balas, PhD, RN shares with us her insights as one of the founders of the
Walking Home From The ICU Episode 146: Success Stories from ICU Revolutionists
Individuals and teams are transforming patient outcomes through the adaptation of the ABCDEF bundle. Hear a compilation of their inspiring successes in this episode! Episode Transcription The past few episodes have been heavy. Obviously we have to address the challenges we face and the damage being done to patients. Yet, we also need to focus
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Walking Home From The ICU Episode 143: The Impact of Delirium on Stroke Survivors
We know that stroke patients are at high risk of poor cognitive, physical, and psychological outcomes. How does delirium impact their outcomes and how can we better protect patients from additional brain injury from delirium? Episode Transcription Kali Dayton 0:00 Green. Rosa, welcome to the podcast. Can you introduce yourself to us? Rosa Hart, BSN,
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Walking Home From The ICU Episode 142: Treating Post-ICU PTSD
We know that critical illness, sedation, delirium, etc., can leave patients with deep psychological trauma. How can we help them recover? What resources are available to treat post-ICU PTSD? Dr. Brian Peach shares with us his exciting developments and research. Episode Transcription Kali Dayton 0:00 This week I flew out to meet with the executive
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Walking Home From The ICU Episode 139: The Power of RN “Soft-Skills” to Change Outcomes
It goes without saying that nurses are the gatekeepers of patient outcomes in the ICU. Do ICU nurses *really* aspire to care for unresponsive and atrophying bodies? How does the ABCDEF Bundle impact the nursing role, skillset, and job fulfillment? James Fletcher, BSN, RN seems to fit the mold of a nurse that would thrive
Walking Home From The ICU Episode 134: Are We Sedating Them to Death?
We know that deep sedation is an independent predictor of mortality. This guides most sedation orders to require a RASS of 0- (-2). Is that what is really happening at the bedside? What percentage of patients are actually lightly sedated to the RASS goal vs. deeply sedated? What is driving oversedation throughout the ICU community?
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Walking Home From The ICU Episode 118: Mobility Saves Lives During ECMO
During the worst of the COVID pandemic, how did this Baylor Scott and White The Heart Hospital- Plano CVICU decrease their COVID mortality rates by 30%? Jenelle Sheasby, MSN, RN, tells us about the transformation in their mobility practices. Episode Transcription Kali Dayton 0:35 Okay, I am really excited about this episode, we have been
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Walking Home From The ICU Episode 114: From the Eyes of a Travel Nurse
What was it like as a travel COVID ICU nurse to jump into an “Awake and Walking COVID ICU”? How does true mastery of the ABCDEF bundle impact RN workload, burnout, safety, and career fulfillment? Travel RN, Laurelai, shares with us her experiences and insights. Episode Transcription Kali Dayton 0:00 In episode 76 Travel nurse
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Walking Home From The ICU Episode 112: Unplanned Extubations
What does research reveal about how and why do unplanned extubations occur? How dangerous are unplanned extubations? We dive into it deep in this episode. Episode Transcription One of the common foundational reasons for giving sedation automatically after intubation is for an inherited sense of safety. Between being uneducated about the risks and repercussions of
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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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