This webcast is the third and final webcast from a unique series titled “Patient Safety During Bedside Procedures in the ICU," from the Society of Critical Care Medicine’s (SCCM) Project Dispatch Series, held in collaboration with the Surgical Section’s Patient Safety Committee. According to the FDA, hundreds of surgical fires occur in the United States each year. In this webcast, Soham Roy, MD, FACS, FAAP, discusses improving the surgical team’s ability to classify, assess, prevent, and manage the risk of fires. The implementation of tools and practices to reinforce this safety culture is also emphasized.
This session is part of the unique webcast series, Patient Safety During Bedside Procedures in the ICU. Preventable medical errors in our ICUs are associated with a culture that focuses on patient safety. In this webcast, Peter J. Papadakos MD, FCCM, FAARC, focuses on creating awareness of reducing noise and distractions in the ICU in order to create a safer environment for the patient and the procedural team. Additional information is provided on how electronic devices can spread infection and what can be done to prevent it. The implementation of tools and practice to reinforce this safety culture is the emphasis of this webcast.
This session is part of the unique webcast series, Patient Safety During Bedside Procedures in the ICU. When it comes to patient safety and successful outcomes, the value of checklists is becoming more apparent in the face of a crisis. During this session, Teodoro Forcht Dagi, MD, DMedSc, MPH, FAANS, FACS, FCCM, FRCSEd, discusses optimization of patient monitoring and the use of checklists for crisis responses during bedside procedures in the intensive care unit (ICU). The implementation of tools and practice to reinforce this safety culture is also emphasized.
Early Progressive Mobility in the ICU – AACN Clinical Scene Investigator Academy Project, is the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series, held in collaboration with the American Association of Critical-Care Nurses (AACN) and Project Dispatch, funded by the Agency for Healthcare Research and Quality.
Under the guidance of the AACN Clinical Scene Investigator (CSI) Academy, Duke Raleigh Hospital’s medical-surgical intensive care unit (ICU) implemented an early progressive mobility protocol. The goal was to decrease ICU lengths of stay and ventilator days, while increasing mobility and positive patient outcomes through reduced incidence of hospital-acquired infections (HAI) and complications. Since implementation, they have experienced a large number of successful outcomes and a strengthened ICU team, and have created a collaborative interprofessional culture in their unit. In this session, Cheryl L. Esbrook, OTR/L,BCPR, Katherine Geyer, BSN, RN, CCRN, CNIV, and Kristin Merritt, MSN, MBA/HCM, RN, NE-BC, CCRN, discuss the team’s approach to implementation, project planning, and protocol structure. They also highlight challenges, qualitative and quantitative outcomes, and meaningful patient stories.
Nurse-Driven Protocol for the Management of Alcohol and Polysubstance Abuse – AACN Clinical Scene Investigator Academy Project, is the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series, held in collaboration with the American Association of Critical-Care Nurses (AACN). In September 2013, the Maimonides Medical Center’s medical intensive care unit (ICU) implemented a nurse-driven protocol for the management of patients with severe alcohol and/or substance withdrawal. The project goals included alleviating nursing staff anxiety when caring for these patients, decreasing ICU lengths of stay, reducing the number of ventilator days, and decreasing falls.
In this session, Laurie Wilson, RN, MSN, and Christina Ycaza-Gutierrez, RN, BSN, CCRN, explore the team’s journey throughout the execution of the project and review how project implementation goals were achieved. Faculty also discuss other positive outcomes such as decreased overall hospital length of stay, decreased incidence of patient tracheostomies, the positive impact on the hospital’s financial budget, and the project’s ability to continue to surpass expected goals six months after its completion.
Family Engagement – AACN Clinical Scene Investigation Project
This webcast was held in collaboration with the American Association of Critical-Care Nurses (AACN). The AACN Clinical Scene Investigation (CSI) team at Massachusetts General Hospital (MGH) is composed of four nurses from the cardiac intensive care unit (ICU). This team administered an educational program on the ABCDEF bundle to an audience of ICU nurses at MGH. The final bundle element, family engagement and empowerment, was added to represent the value of family involvement in the overall patient plan. In this webcast, Erica Edwards, RN, MSN, CCRN, CMC, CHFN, and Alicia Sheehan, RN, BSN, provide the evidence for this addition, as well as illustrate how family engagement is implemented in the cardiac ICU.
Download webcast slides (Right-click and Save the file on your computer. PowerPoint Required)Understanding Brain Death: From Experts to Laypersons
Understanding Brain Death: From Experts to Laypersons, is a collaborative webcast from the Society of Critical Care Medicine’s (SCCM) Emergency Medicine section and Project Dispatch. During this session, Isaac Tawil, MD, FCCM, Chair of the Emergency Medicine section and Associate Professor of Emergency Medicine and Intensive Care at the University of New Mexico Health Sciences, and David Seder, MD, FCCM, Director of Neurocritical Care at Maine Medical Center, will explore the understanding of brain death by experts and the lay community, and provide insight on how interactions with patients and families can contribute to patient-centered outcomes.
Download webcast slides (Right-click and Save the file on your computer. PowerPoint Required)Comprehensive Patient-Centered Care in the ICU
In this presentation, Neil A. Halpern, MD, FCCM, Chief, Critical Care Medicine Service at Memorial Sloan-Kettering Cancer Center, describes how his unit developed a calming, healthy, safe, and healing ICU environment by ensuring shared decision making and frequent communications with patients and families through their ICU stay to end of life. He will discuss innovative programs linked to direct patient care, such as “Smart” alarm management, sniffing software for possible patients with ventilator-associated pneumonia, early mobility for ventilated patients, and integrative medicine consultation for bedside massage, music therapy and meditation. Dr. Halpern also reviewed the extensive accommodations made for patients and families, as well as how their program contemplates their entire ICU experience. Some unique features include large video displays with magnificent scenic views to provide oases of serenity to soothe patients, family members and visitors, volunteer greeters in the waiting room to help orient families and visitors to the ICU, food and coffee service, weekly multidisciplinary rounds and end-of-week conferences to discuss all patients focusing on the full spectrum of patient and family issues, communication skills training for ICU attendings, fellows, nurse practitioners, and physicians assistants through the Department of Psychiatry and Behavioral Sciences, child visits, and the use of a waiting room survey to assess how the environment helps patients, family members and visitors cope with a difficult situation.
Comprehensive Patient-Centered Care in the Pediatric ICU
In this presentation, Jason L. Adler, MD, MBA, discusses the implementation of patient- and family-centered care practices in the pediatric intensive care unit (PICU) at Joe DiMaggio Children’s Hospital (JDCH) in Hollywood, Florida, USA. He also speaks to the impact these practices have had on staff and the institution. Daily bedside multidisciplinary rounds were introduced in 2006 at JDCH. During these rounds, active participation in care is sought from all who are present. This includes parents, patients, physicians, nurses, respiratory therapists, pharmacists, social workers, and a family advocate/educator. The program at JDCH has grown dramatically over the years and continues to anticipate many needs of patients and their families. It is integral to how care is provided, and the impact it has had is significant and far reaching. Project Dispatch: Patient Centered Approach to Community Transition after Catastrophic Injury
One of the greatest challenges for patients and their families is the transition home and into the community after a catastrophic injury. These patients have intensive care needs and face a lifetime of risk for developing life-threatening medical problems. Can a patient- and family-centered approach to education, mentoring and support be effective in minimizing hospital readmissions for patients? The presenters have received a PCORI grant to examine just that question, along with sense of self efficacy and intensity of community participation for patients with spinal cord injury. The Shepherd Center is one of only two specialty hospitals that provide rehabilitation for patients with acute brain and spinal cord injuries. It has an excellent record of patient outcomes. Its discharge-to-home rate and rate of re-hospitalizations in the first 30 days after discharge are substantially better than national average. Patients report high levels of satisfaction with care received. In this webcast, Michael Jones, PhD, FACRM and Julie Gassaway, MS, RN, shares feedback received from people about how their rehabilitation experience could be improved and discuss their patient- and family-centered approach to education, peer counseling, discharge planning and support along with preliminary results from their research.
Project Dispatch: Tree of Life Memorial Event Meaningful for Families
Tragic, unexpected loss of a loved one is never easy for families, but they may honor their loved ones’ wishes to help others by giving the gift of life through organ donation. To honor these unselfish acts in the face of overwhelming grief, the University Hospital in San Antonio, Texas, USA, created the “Tree of Life“ Memorial Event, which serves as a living monument, recognizing the organ donor’s life and acknowledging the subsequent gift. The response to the family-centered annual ceremony confirmed for hospital staff the importance of the memorial in extending care and support to families.
In the webcast, The "Tree of Life" Memorial Event: Meaningful for Families, Charles Reed, PhD, RN, CNRN, discusses the development of a “Tree of Life” Memorial Event, including how the program has grown and become an integral part of the hospital’s commitment to patients, their families and the community.
Project Dispatch: Collaborating with Familes to Improve Patient Care and Transitions
Patient transfers out of the intensive care unit (ICU) are one of the most stressful times for patients and their families. Questions about what to expect and how to help the patient upon leaving the ICU are common concerns. Furthermore, patients are being transferred with higher acuities after shorter lengths of stay, adding to "relocation stress" and contributing to slower recovery and discharge from the hospital.
In the webcast, Collaborating with Families to Improve Patient Care and Transitions, the latest offering from the Society of Critical Care Medicine's (SCCM) Project Dispatch series, Andrea Meaburn, RN, MSN, ANP-BC, CCRN, will share how the medical ICU at the Medical University of South Carolina created a comprehensive transfer brochure, the way in which the brochure supported patients and families, and how the brochure fits into their broader patient-centered care approach. Ms. Meaburn's presentation will be followed by
Project Dispatch: Impact of Pet Music Therapy
Music and animals have a distinct ability to improve a patient's mood and outlook. Anxiety among patients in the intensive care unit (ICU) is often understandably heightened. Patients are confronted with unfamiliar surroundings and intrusive procedures, including being on mechanical ventilation. Music and pet therapy are two integrative approaches that may alleviate such anxiety and reduce sedation frequency and intensity. In the latest webcast, from the Society of Critical Care Medicine's (SCCM) Project Dispatch series, The Impact of Pet and Music Therapy on the Critically Ill, expert faculty will share their unique experiences with integrative therapies for patients and families in the ICU. Linda Chlan, PhD, RN, FAAN, reviews the results of her randomized clinical trial published in the Journal of the American Medical Association, "Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support." Erika Gonzalez, MSN, RN, CCRN, discusses her critical care unit's implementation of music and pet therapy.
Project Dispatch: Sharing Patient-Centered Strategies to Improve Care at the Bedside
The Project Dispatch session at the 43rd Critical Care Congress addressed strategies for integrating patient-centered outcomes research into clinical practices and highlights several initiatives that serve as examples of how to apply this research in clinical practice. Find presentations titled: Development of a Pilot Family and Nurse Presence on Rounds Audit Tool, and Next Steps to Promoting Patient- and Family-Centered Care as a Standard of Care in the ICU.
Using the FS-ICU instrument to Improve Family Satisfaction
As both a research and quality improvement initiative, the Neuroscience ICU at Yale-New Haven Hospital (YNHH NICU) is using the FS-ICU, an extensively validated survey instrument for assessing family satisfaction with general care and shared decision-making, to collect continuous data from all families of patients whose length of stay exceed 72 hours. Team members are also mailing FS-ICU surveys to all families of patients who pass away or who are made comfort measures in the unit. In this presentation, David Hwang, MD, Assistant Professor of Neurology in the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine, and other faculty members discuss what prompted the YNHH NICU to begin this effort, what has been learned so far, and what new projects the data has generated. They will also discuss the logistics of using the FS-ICU instrument and cost-effective strategies for continuous data-gathering on family satisfaction.
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SCCM Pod-232: Assessing Family Satisfaction using the FS-ICU Instrument in a Neuroscience Intensive Care Unit
Michael Weinstein, MD, FACS, FCCP, speaks with David Hwang, MD, Assistant Professor of Neurology in the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine and a neurointensivist at the Yale-New Haven Hospital. Dr. Hwang will be hosting a webcast in 2014 featuring the FS-ICU tool, a well validated survey instrument utilized to assess family satisfaction with ICU care and shared decision-making. He will discuss the data collected from his Neuro ICU as well as his unit’s experience and why they became interested in family satisfaction research. This podcast made possible through a grant from the Agency for Healthcare Research and Quality in support of Project Dispatch -- Disseminating Patient-Centered Outcomes Research to Healthcare Professionals. This project was supported by grant number R18HS21940 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
SCCM Pod-231: Family Presence: Evidence vs. Emotion
Margaret Parker, MD, FCCM speaks with Cathie Guzzetta, RN, PhD, HNC, FAAN, Director of Holistic Nursing Consultants at Children’s National Medical Center in Washington, DC. Dr. Guzzetta has been mentoring nurses and physicians in conducting family presence research and developing family presence programs since the mid-1990s. She will discuss Family Presence during CPR and invasive procedures. This podcast made possible through a grant from the Agency for Healthcare Research and Quality in support of Project Dispatch -- Disseminating Patient-Centered Outcomes Research to Healthcare Professionals. This project was supported by grant number R18HS21940 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Released: 11/27/13
Improving End-of-Life Care through Better Clinician-Patient Communications
J. Randall Curtis, MD, MPH, reviews the importance of his PCORI-funded study that focuses on ensuring patients receive the care they desire through improved patient-clinician communication. Dr. Curtis discusses why his team selected this topic, the structure of the study, and the measures used including frequency and quality of communication; agreement between the care patients desire and that they receive; and symptoms of anxiety and depression among patients and family members.
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Improving Psychological Distress Among Critical Illness Survivors and Their Informal Caregivers
Nearly 800,000 Americans receive mechanical ventilation for acute respiratory failure in the ICU each year. In this webcast from the Project Dispatch series, Christopher Ethan Cox, MD, MPH, and his team explore a Patient-Centered Outcomes Research Institute-funded study and explain which of two treatments is more effective in reducing psychological distress and improving quality of life.
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