Goal is to improve patient outcomes
MORGANTOWN, W.Va. – Among the 6 million adults admitted annually to intensive care units across the United States, 60 to 80 percent will have some form of functional or physical disability afterwards. In a recent study, 48 percent of adults had not returned to work within a year of their critical illness. A new initiative at WVU Medicine Ruby Memorial Hospital is aimed at reversing that trend.
Ruby Memorial Hospital was chosen to be among 69 adult ICUs across the United States to participate in the ICU Liberation – ABCDEF Bundle Improvement Collaborative sponsored by the Society of Critical Care Medicine.
“Critical illness is an immense burden for families during the hospitalization. The physical, psychosocial or cognitive, and financial effect on survivors and families may be long-lasting and devastating,” Alison Wilson, M.D., director of the WVU Trauma and Critical Care Institute and Skewes Family Chair for Trauma in the WVU School of Medicine, said. “The ICU Liberation Initiative endeavors to prevent and reduce this burden.”
The individual elements, which are proven in multiple studies to have a much greater positive impact when implemented as a bundled initiative, include:
- A – Assess, prevent, and manage pain
- B – Both spontaneous awakening trials and spontaneous breathing trials to reduce the time patients spend on mechanical ventilation. Respiratory therapists are utilizing new protocols to reduce the length of time patients remain on mechanical ventilation.
- C – Choice of analgesia and sedation to construct a safe and effective medication regimen for the management of pain and agitation in critically ill adults
- D – Delirium: Understand delirium risk factors and find tools for its assessment, treatment, and prevention. Delirium occurs in 50 to 80 percent of adults who need ventilators to breathe and is associated with long-term effects similar to traumatic brain injury or Alzheimer’s disease.
- E – Early mobility and exercise: Physical and occupational therapists are coordinating with nurses to exercise patients earlier and with greater frequency.
- F – Family engagement and empowerment in patient care can help recovery. Experts in supportive care medicine in concert with chaplains are developing new avenues to engage and empower patients and their families in the critical care process.
“This project is of profound importance for critically ill patients and their families as well as the professionals caring for them at Ruby Memorial Hospital. The Bundle Initiatives are based upon quality evidence and common sense. The degree of interprofessional cooperation is essential and has been inspiring for successful implementation and is yielding positive changes for our patients and families,” Gregory Schaefer, D.O., associate director for surgical critical care at WVU Medicine Ruby Memorial Hospital and associate professor of surgery in the WVU School of Medicine, said. “The leadership of the WVU Trauma and Critical Care Institute has been instrumental in facilitating our participation in this initiative. We greatly anticipate the short and long-term benefits that will manifest from these changes.”
On Monday, April 11, physicians, nurses, administrators, and staff at WVU Medicine Ruby Memorial signed a pledge of commitment to liberating ICU patients.
“It is amazing to see the great teamwork and collaboration between the various healthcare providers in support of the ICU Liberation initiative. By implementing each piece of the bundle, our patients will experience high quality care in a unified and coordinated manner,” Jerry Yoho, R.N., M.S.N., director of trauma and critical care services at Ruby Memorial, said. “During a very critical and stressful time, this level of care is going to have a profound impact on our patient and family experience here at WVU Medicine Ruby Memorial Hospital.”
Photo caption: On Monday, April 11, physicians, nurses, administrators, and staff at WVU Medicine Ruby Memorial signed a pledge of commitment to liberating ICU patients as part of the ICU Liberation – ABCDEF Bundle Improvement Collaborative sponsored by the Society of Critical Care Medicine.