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An interview with an ICU Liberation Collaborative Leader and Participant.
The Joint Commission (TJC) is proposing the addition of new and revised requirements for hospital, critical access hospital, ambulatory care, home care, behavioral healthcare, and nursing care center accreditation programs.
The ICU Liberation Labs during the 49th Critical Care Congress featured information about the ICU Liberation Initiative – which aims to liberate patients from the harmful effects of pain, agitation/sedation, delirium, immobility, and sleep disruption that are common after ICU stays – and offered insights on the bundle’s implementation from ICU Liberation Collaborative members.
This Concise Critical Appraisal explores an article by Caputo et al published in Academic Emergency Medicine describing the use of early self-proning in awake, nonintubated patients in the emergency department (ED) during the COVID-19 pandemic.
This Concise Critical Appraisal offers a look into the results of the RECOVERY trial published in the New England Journal of Medicine, which demonstrated that dexamethasone improved mortality in hospitalized patients with COVID-19.
Todd Fraser, MD, speaks with John D. Santamaria, MBBS, MD, FRACP, FCICM, FCCP, about the article “Increasing the Number of Medical Emergency Calls Does Not Improve Hospital Mortality” (Santamaria J, et al. Crit Care Med. 2018;46:1063-1069). The podcast explores Dr. Santamaria’s recent study on the relationship between emergency calling rates and adjusted in-hospital mortality and the effect of increasing call rates on the workload of the teams. Dr. Santamaria is the director of intensive care at St. Vincent’s Hospital in Melbourne, Australia.
Dr. Todd Fraser, MD, speaks with Bruce A. Mueller, PharmD, FCCP, FASN, about his talk presented at the 47th Critical Care Congress in San Antonio, Texas, entitled “Artificial Kidney Meets Mechanical Lung: Comanaging the Patient with Renal and Respiratory Failure.” Dr. Mueller discusses the concepts of drug dosing during renal replacement therapy. Dr. Mueller is a Professor and Associate Dean at University of Michigan College of Pharmacy in Ann Arbor, Michigan. Released: 7/12/18
Ludwig Lin, MD, speaks with Brenda Pun, DNP, RN, ACNP, about the ICU Liberation ABCDEF Bundle Improvement Collaborative. Dr. Pun reflects upon Collaborative work, including origins and logistics of the project, team training and resource-sharing, and the importance of the interprofessional care model, as well as successes, challenges, and barriers to bundle implementation. Dr. Pun is the Project Clinical Manager at Vanderbilt University Medical Center in Nashville, Tennessee. She was a member of the ICU Liberation Moore Foundation Steering Committee and played an instrumental role in the development of the REDCap database that was used for quality improvement for the ICU Liberation Campaign. Dr. Pun served as a mentor and coach to her own team as well as others in the Collaborative. Her disclosures note that she is also an AACN speaker. Visit iculiberation.org for additional resources. Released 5/18/17
Todd Fraser, MD, speaks with Joseph L. Nates, MD, MBA, FCCM, about the article, “Intensive Care Unit Admission, Discharge, and Triage Guidelines: A Framework to Enhance Clinical Operations, Development of Institutional Policies, and Further Research,” published in Critical Care Medicine. Dr. Nates is Professor, Deputy Chair, and ICU Medical Director of the Department of Critical Care, Division of Anesthesiology and Critical Care, at The University of Texas MD Anderson Cancer Center in Houston, Texas. In this article, Dr. Nates and coauthors update SCCM’s guidelines for ICU admission, discharge, and triage, providing a framework for clinical practice, the development of institutional policies, and further research.
Todd Fraser, MD, speaks with Derek Wheeler, MD, about the article, “Critical Care Delivery: The Importance of Process of Care and ICU Structure to Improved Outcomes: An Update From the American College of Critical Care Medicine Task Force on Models of Critical Care,” published in Critical Care Medicine. Dr. Wheeler works as an Intensive Care Specialist at the Cincinnati Children’s Hospital Medical Center and serves as co-chair of the Society of Critical Care Medicine’s Task Force on Models of Care. In this guideline, Dr. Wheeler and coauthors make recommendations based on recent literature, which suggests that improvements in processes of care, ICU structure, and use of quality improvement science methodologies beneficially impact the outcomes of critically ill patients and reduce the associated costs of care.
Michael Weinstein, MD, FACS, FCCP, speaks with E. Wesley Ely, MD, FCCM, at the 44th Critical Care Congress in Phoenix, Arizona. Dr. Ely, Professor of Medicine and Critical Care at Vanderbilt University Medical Center in Nashville, Tennessee, discusses the "Evolution of the ABCDEF Bundle" and the Society’s ICU Liberation initiative, which aims to help practitioners become more familiar with the Pain, Agitation and Delirium guidelines and assessment tools.
Michael Weinstein, MD, FACS, FCCP, speaks with Ira Cheifetz, MD, FCCM, Division Chief of Pediatric Critical Care at Duke University Medical Center. Dr. Cheifetz discusses “Early Mobility Implementation Strategies (Peds),” which he presented at the 43rd Critical Care Congress in San Francisco, California.
Michael Weinstein, MD, FACS, FCCP, speaks with Heidi J. Engel, PT, DPT of UCSF Medical Center, regarding her lecture on “Early Mobility Implementation Strategies,” which she presented during the 43rd Critical Care Congress in San Francisco, California.
Michael Weinstein, MD, FACS, FCCP, speaks with Jessica Spence, BMR(OT), BSc(Med) MD, a PGY3 Resident at McMaster University. Dr. Spence contributed the article “Variation in Diagnostic Testing in Intensive Care Units: A Comparison of Teaching and Non-Teaching Hospitals in a Regional System” to the January Critical Care Medicine journal. Dr. Spence discusses the importance of studying testing practice, factors influencing testing practice, influence of trainees on testing and strategies to improve the appropriateness of testing.
Margaret Parker, MD, FCCM, speaks Katri Typpo, MD, MPH, lead author of an article published in the September 2012 issue of Pediatric Critical Care Medicine, “Impact of Resident Duty Hour Limits on Safety in the ICU: A National Survey of Pediatric and Neonatal Intensivists.” The survey sought to better understand perceptions on how the current and future resident duty hour restrictions impact safety-related risk measures in the pediatric ICU. Typpo is an assistant professor of pediatrics at The University of Arizona in Tucson, Arizona.
Brian F. Joy, MD, a fellow in the Department of Pediatric Cardiology at Children’s Memorial Hospital in Chicago, Illinois, USA, discussed an article published in the May 2011 Pediatric Critical Care Medicine, titled “Standardized Multidisciplinary Protocol Improves Handover of Cardiac Surgery Patients to the Intensive Care Unit.” The article found that a formal, structured handover process for pediatric patients transitioning to the intensive care unit after cardiac surgery can reduce medical errors that occur during the admission process and improve teamwork among caregivers.
Kristine Lombardozzi, MD, FCCM, discusses her article published in the August Critical Connections titled, “Understanding the Evolution of Our National Healthcare Quality Improvement Process,” which outlines the origins and history of healthcare quality that brought us to where we are today. Lombardozzi is a surgical intensivist serving as director of the surgical and medical intensive care units at Spartanburg Regional Medical Center in Spartanburg, South Carolina, USA. She also is a member of the SCCM Advocacy Committee and has participated in quality and safety programs at her community-based teaching hospital.
William Meadow, MD, PhD, is the lead author of an article published in the March Critical Care Medicine titled, “Power and Limitations of Daily Prognostications of Death in the Medical ICU.” This article tests the accuracy of predictions of impending death for medical intensive care unit patients, offered daily by their professional medical caregivers. Meadow is a professor of pediatrics at the University of Chicago.
Peter Pronovost, MD, PhD, FCCM, discusses patient safety research and future efforts to reduce infections in the intensive care unit in this special 100th episode of the iCritical Care Podcasts. Dr. Pronovost is professor in the departments of anesthesiology and critical care medicine and surgery at The Johns Hopkins School of Medicine and a professor in the department of health policy and management at the Bloomberg School of Public Heath in Maryland. He also serves as director of the Quality and Safety Research Group at the Center for Innovations in Quality Patient Care Division of Adult Critical Care. Dr. Pronovost was selected to participate in the 100th iCritical Care Podcast because of his continued dedication to critical care, embodying the spirit of I AM SCCM.
Mitchell Levy, MD, FCCM, discusses his article, "Association between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit," published in the June 3, 2008, issue of Annals of Internal Medicine. Levy offers background about the study as well as his opinions about the controversial results.