Yuma Regional Medical Center on LinkedIn: YRMC has earned the 2024 Get With The Guidelines Stroke Gold Plus Award… (2024)

I read an article today on the American Heart Association website about an escape room designed to train nurses in stroke protocol and I think it's a brilliant idea!"The researchers developed the escape room in response to two key needs. Nurses at Tufts Medical Center Comprehensive Stroke Center gave feedback in recent years that they were looking for more interactive ways to meet their continuing education requirements through in-person formats. And those educational opportunities must be provided without requiring that nurses spend too much time away from their patients."I'm sharing a link to the article below and also thinking about how the idea of play as a way to learn could be applied to a sterile processing department.What if the game of Clue was crossed with the chain of infection? I could make a couple characters like Tanya Tuberculosis or Carlton C-Diff and assign teams of techs that character/microorganism. I could then "spread" that character through the department in some obvious and less obvious places along the 1 way work flow. Then give each team 10 minutes to trace that pyrogen's path through the department and at the end score each team based on if they found where the chain of infection broke down. It was Carlton, in the endo suite with a damaged channel brush! Based on how competitive our SPD Jeopardy game got, I think this would be so fun.What games do you think could be used to teach and build community in your sterile processing department?https://lnkd.in/gCzSsF3J#breakthechain #handhygiene #1wayflow #yeghealthcare

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Fantastic article by Atiya Dhala,Roberta Schwartz,Steve Klahn,Divina Tuazon,Farzan Sasangohar, PhD,Mario V Fusaro, MD, MS,Jefferson Alegria & Faisal Uddin ,sharing the journey of Virtual ICU ( e-ICU,Tele-ICUI) integration in one of most complex ICU"s -Cardiac and Cardiovascular ICU at Houston Methodist and Houston Methodist Center for Critical Care. Nocturnal Intensivist workload decreased by 50%, systematic reduction in code blue etc. Lots of learning for all.#telemedicine #virtualICU #virtualcare #cardiacsurgery#cardiacICU #telemedicine

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Nurses change the body position of critically ill patients as frequently as every two hours toprevent bed sores and other complications associated with immobility (pulmonary complications such as ARDS, VAP and bronchopnemonia). Turning from side to side may also help loosen and drain secretions accumulated within the lungs. A lateral rotation mattress with position holding function can help nurses achieve above daily care activities. What an ICU bed can't do, our mattress can.https://lnkd.in/gawPC7MR.

It is imperative that we determine if you are positive first. CAM is the gold standard however there are other validated tools too. Let the end user drive the tool selected or give them options.

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Thank you Greater Ohio Vascular Access Network GOVAN for shifting the paradigm! It was nice to present on the adult patient perspective of living with long-term vascular access devices alongside, Tara, who is a PICU nurse and a parent to her son with TPN, and Mickey Hawes, nurse, researcher, consultant, previous Home Infusion Company exec., and PICC patient. The presentation was titled, “The Story Behind the Line: The Journey You Don’t See.”Todd Heslep BSN, RN, Paramedic, VA-BC, President, and the Executive Team at GOVAN made sure a patient and family perspective was shared in a meaningful way at their network meeting by:1. Having us as the first speakers for the day. Doing so respects our time as the rest of the content is catered to clinicians and allows us to speak to audience members after having shared the bulk of our story so we do not have to repeat or experience any repeated trauma in resharing. Starting with the patient and family perspective can help set the desired tone and provides a good reminder of our why.2. Valuing our time and energy as individuals and as a group. 3. Giving us autonomy in our slides and our call to action to the audience. I also thought putting questions from the audience in the middle of the presentation changed up the style and pace nicely and allowed the audience to feel included and have their questions answered. Great questions were asked pushing us to a good panel discussion.It was a joy to present and be a voice alongside Tara and Mickey’s thoughtful and direct insights. We shared the education we received to care for our lines in the home that has been most useful and the hardest to implement, and tips on how to communicate with us as adults, children, and caregivers, in the hospital at different points of access and the resources we may or may not have in the home. We truly asked everyone to understand this is our life not our job and we want you to take ownership of care delivery WITH us. We must work as partners. Being in a more intimate audience I got to see more closely for the first time clinician reactions of shaking heads, jaw drops and big eyes, when they learn I have had 31 central lines, 26 CLABSIs, 15 yrs no infection, same line for >5 yrs, and too many sticks w/o ultrasound. This is my why. This is why I continue to educate and travel to present. I get similar reactions in the hospital as an adult, especially at non-subspecialty hospitals stating I am the problem instead of asking why I had infections and line placements, what has been and is currently working well, and how can we continue that for you in this hospitalization and moving forward beyond these 4 walls. No one else should go through what I have gone through. We all have to learn from mine and the larger patient and family community experience for the next generation, for my gutsy peers, and for my friends who I have not met yet. #vascularaccess #vascularhealth #centralvenouscatheter #rarediseases #isavemyline

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ICU Delirium: Part 9The CAM-ICU is the troponin, creatinine, ABG, etc. of the brain. A common gap I see when I train ICUs is that many ICU nurses are not trained and/or confident in doing a full CAM assessment. Some erroneous assumptions I’ve commonly noticed are: - If a patient follows commands, they’re “CAM Negative” - If a patient is intubated, you cannot perform a CAM assessment. - Delirium is detected when a patient is hyperactive and impulsive - If a patient can tell you where they are, they’re not delirious. Is it imperative that we treat delirium as “Acute Brain Failure”. We would never go days to weeks without checking the creatinine on a patient in the ICU. Yet patients can go days to weeks without a proper CAM assessment in the ICU. It is time to assess for and respond to acute brain failure as any other life-threatening organ failure in the ICU. #ICUdelirium #acutebrainfailure #ICU #criticalcare #abcdefbundle #CAMICU #delirium #earlymobility

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ECMO IN THE EMERGENCY DEPARTMENT?!Extracorporeal membrane oxygenation [ECMO] is a type of life support that facilitates oxygenation, perfusion and ventilation in patients suffering from severe cardiac or pulmonary dysfunction. How exactly does this work?🩸A venous cannula is placed in the vein (usually femoral) taking the deoxygenated blood from the right atrium. The blood is then directed through a machine that oxygenates it through a gas exchange membrane and eliminates the carbon dioxide. The revitalized and warmed blood is subsequently pumped back into the body through an arterial cannula (usually femoral) and into the proximal aorta.🩸ECMO is most often used in the ICU and operating room. In recent years, it has been integrated into the emergency department for patients arriving in cardiac arrest. This specific type of ECMO is called extracorporeal cardiopulmonary resuscitation [ECPR].How does this process take place in the ED?🩸Prehospital EMS notifies the ED of an incoming cardiac arrest patient who meets criteria to be placed on ECMO. A ‘Code ECMO’ is paged overhead and the team of MDs, RNs and other ancillary staff assemble.🩸Then controlled chaos ensues. Two physicians attempt to obtain access of the venous and arterial lines all the while CPR is pumping, intubation is happening and medications are being given. It is in its entirety, a team effort.🩸Once lines have been established and confirmed, the machine is turned on and the patient is declared to ‘be on pump’. The patient is then transferred to and cared for in the ICU.🩸The idea behind ECPR is to get the patient on ECMO as quickly as possible, enhancing their chances of survival. In my most recent case, our team initiated ECMO within 13 minutes of the patient's arrival to the emergency department.FUN FACT: At the hospital where I practice, our emergency physicians have been successfully using ECPR as a salvage tool for more than a decade.In fact in 2010, one of our actively-practicing emergency physicians, Joe Bellezzo, MD, was the first emergency physician in the world to successfully use ECPR to save a patient.Do you do ECPR at your facility? What are your favorite ECMO stories?#legalnurseconsultant #emergencyroomnurse #criticalcarenurse #traumanurse #ECMO #nursesonlinkedin

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Congratulations to the authors of the recently released article in the Methodist DeBakey Cardiovascular Journal entitled: "Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort"This clinical article discusses the successful integration of a Virtual Intensive Care Unit (vICU) with cardiac and cardiovascular intensive care units (ICUs) at Houston Methodist Hospitals. The shortage of critical care specialists and nurses, exacerbated by the COVID-19 pandemic, led to the adoption of tele-critical care, but complex and high-acuity ICUs faced challenges in utilizing these resources. The vICU program aimed to improve ICU staffing efficiency while providing continuous access to in-person and virtual intensivists and critical care nurses.The article outlines a roadmap for planning, launching, and integrating vICU services within cardiac and cardiovascular ICUs. Key factors for success included recruiting specialized vICU staff, gaining buy-in from bedside clinicians, and improving workflow protocols and communications. The integration of vICU resulted in reduced night-call requirements for in-person intensivists, increased work satisfaction, and a significant reduction in Code Blue events. As providers became more comfortable with advanced technology, the Cardiac ICU Cohort improved methods to predict and track patient trends in the ICUs.Congratulations to Equum Medical Chief Innovation Officer Mario V Fusaro, MD, MS for his contributions and participation in this research work and publication in support of broader thought leadership in critical care telehealth.https://lnkd.in/eX9fVSwQ#criticalcare #telecriticalcare #cardiacicu #staffing #burnout

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It's a hot one this week! 🌶 ☀ Let's cool off......with a little Target Temperature Management (TTM). ❄ If a patient does not follow commands after a cardiac arrest, the AHA recommends cooling the patient to 32-36 degrees Celsius for at least 24 hours. ❔ Why ❔ ➡ Preserve brain function ➡ Reduce MortalityTTM should be initiated ASAP. Once the gel pads are applied, they DO NOT come off for 72 hours. The goal is to cool the patient for 24 hours, gently rewarm for 24 hours, and then maintain normothermia for 24 hours.Any interruption is TTM will undue the therapy and can be detrimental for the patient ⚡ After the 72 hour mark, the pads can be removed as long as the patient DOES NOT have a fever. If they have a fever, keep the pads on to maintain normothermia. A rapid increase 📈 in temperature can cause fluid and electrolyte shifts, leading to arrythmias ❤️ and cerebral edema 🧠 Labs 💉 must be carefully monitored during this time to ensure electrolyte shifts are managed appropriately. If the patient is shivering ☃, place a warming blanket on top of the patient (sounds counter-intuitive, I know) and administer medication to stop the shivering. Shivering warms the body up quickly, which we DO NOT want.Facilities providing TTM should have specific policies in place. This can be immensely helpful if reviewing a TTM case or caring for a post-arrest patient. Next week, I'm going to dive more into the critical electrolytes & new changing research around TTM. It gets a little WILD so stay tuned!What's your experience with TTM?🔽 🔽 ----------------------------------------------------------------------------------Need help reviewing a post-arrest case? Wondering if the patient should've received TTM? Contact me belowHannah Welk, BSN, RN, CCRN, LNC🌹 Red Rose Legal Nurse Consulting🌹 welkhannah@redroselnc.com🌹 (717) 940-3717

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