Wake up and Breathe: A journey in quality improvement and unintended benefits
|
|
|
- Berenice Jones
- 5 years ago
- Views:
Transcription
1 Wake up and Breathe: A journey in quality improvement and unintended benefits Jeffrey Singh MD FRCPC MSc Toronto Western Hospital Interdepartmental Division of Critical Care University of Toronto
2 Disclosures I am the recipient of an unrestricted quality improvement grant from Hospira Delirium screening Sedative protocols Early mobility Honoraria from Snell Medical
3 Objectives Share a story of: Quality Improvement Humility in acknowledging there is a problem What we did What worked and didn t work
4 Toronto Western Hospital Part of UHN 236 beds 26 bed MSNICU 45% neuroscience Specialty Programs Neurosurgery / Spine Neurology / Stroke Ortho / Hand Bariatric Ophthalmology
5 The Tipping Point Attending Rounds Is this even a problem? (e.g. the patients are sick) We had no idea
6 Why We Need to Care About Delirium
7 Baseline : Awake Of all eligible patient-days with a sedative infusion: 29% had an average SAS for the day below 2 (e.g. comatose) 53% had an average SAS below target Only 27% of med-surg patients with coma and receiving infusions received a daily interruption of sedative infusions
8 Baseline : Breathing and Coordination Only 43% of ventilated patient-days had a spontaneous breathing trial
9 Baseline: Delirium Baseline delirium rates: 12% of all patient-days 27% of all admissions had at least one day of delirium But 49% of patient days were not assessed because patient was comatose
10 ABCDE Awake Breathing Coordination targeted sedation and daily awakening spontaneous breathing trials of SAT & SBT Delirium Screening Early Mobility
11 Timeline Delirium SAT SAT / SBT Coordination Early Mobilization Aug-Sept 2011 July 2012 July 2012 November 2012 Decision to address delirium first Education of ICU team and training in assessment tools
12 Quality Improvement Plan Goal: To have every eligible patient assessed for delirium every day To promote discussions on rounds about delirium and the ABCDE s of critical care Approached Hospira for support Summer student Data collection Educational materials
13 Intervention Interprofessional education on delirium Delirium assessment with validated assessment tool 2-day visit by world leaders in delirium from Vanderbilt University Bombarded with posters, announcements, lunches
14
15
16 Delirium Screening : 3 Months Fall 2011 Inconsistent performance Recorded CAM-ICU = 60% Agreement between trained observer and RN CAM-ICU Kappa 0.57 (95% CI ) Repeat education blitz February 2012 Kappa 0.77 (95% CI )
17 Delirium Screening : 6 Months CAM-ICU Screening (All observations) Baseline (N=626) 6 month Audit (N =270) Delirium Present N (%) 86 (14%) 60 (22%) Delirium Absent N (%) 254 (41%) 138 (51%) Unable to Assess N (% UTA) 286 (46%) 72 (27%) Proportion of Admissions With Any Delirium N (% UTA) 44 (30%) 38 (33%) Duration of Delirium, days Mean ± SD 2.0 ± ± 0.9
18 Delirium Screening : 12 months CAM-ICU (All observations) Baseline (N=626) 6 month Audit (N =270) 12 month Audit (N=778) Delirium Present N (%) 86 (14%) 60 (22%) 98 (10%) Delirium Absent N (%) 254 (41%) 138 (51%) 373 (43%) Unable to Assess N (% UTA) 286 (46%) 72 (27%) 307 (33%) Proportion of Admissions With Any Delirium N (% UTA) 44 (30%) 38 (33%) 37 (26%) Duration of Delirium, days Mean ± SD 2.0 ± ± ±1.4
19 Delirium Screening Unintended improvement in number of patients who could be assessed / decrease in coma rates Improvement in sedation practices Change in patient case-mix Analysis pending
20 A B and C Daily SAT Daily SBT Done concurrently (e.g. coordinated)
21
22 What We Learned Know your own unit Local culture Potential obstacles Identify champions Need to engage everyone Be persistent - momentum will build! Don t reinvent the wheel, but personalize
23 Key Lesson You must must must measure outcomes Otherwise you will have no idea what you are doing well, or what is working
24 Acknowledgements Eddy Fan Emma Mew Stefannie Vorona Jennifer Bell Elizabeth Wilcox Paulina Farias Mandy Ettinger And ALL the ICU nurses!
25 In God we trust; all others must bring data W. Edwards Deming Slides? Questions?
KICU Spontaneous Awakening Trial (SAT) Questionnaire
KICU Spontaneous Awakening Trial (SAT) Questionnaire Please select your best answer(s): 1. What is your professional role? 1 Staff Nurse 2 Nurse Manager 3 Nurse Educator 4 Physician 5 Medical Director
ABCDEF Bundle Breakout
ABCDEF Bundle Breakout Andrew Masica, MD, MSCI VP, Chief Clinical Effectiveness Officer Baylor Scott & White Health andrew.masica@bswhealth.org Disclosures/Funding Support Grant R18-HS021459 from the Agency
Critical Care Strategic Clinical Network Provincial ICU Delirium Framework
Pain assessed and documentation using validated tool (CPOT and NRS) Assess and document q4h and prn 100% of patients assessed for pain and documented q4h A: Assess, Prevent & Manage Pain Self Reporting
Executive Sponsorship of Delirium Initiatives Lessons from ICU Liberation
Executive Sponsorship of Delirium Initiatives Lessons from ICU Liberation J. Matthew Aldrich, MD Co-Chair, SCCM ICU Liberation Committee Associate Professor Medical Director, Critical Care Medicine UCSF
ICU Liberation for the Pharmacist. A. Kendall Gross, PharmD, BCPS, BCCCP Critical Care Pharmacist UCSF Medical Center
ICU Liberation for the Pharmacist A. Kendall Gross, PharmD, BCPS, BCCCP Critical Care Pharmacist UCSF Medical Center Disclosure No conflicts of interest to disclose Objectives o Outline the elements of
Disclosure. Hospira Pharmaceuticals. Unrestricted research funding Honoraria for CME education administered via France Foundation
Disclosure Hospira Pharmaceuticals Unrestricted research funding Honoraria for CME education administered via France Foundation Economics in Sedation: Responsible Use of the ICU Budget John W. Devlin,
Status Epilepticus: Implications Outside the Neuro-ICU
Status Epilepticus: Implications Outside the Neuro-ICU Jeffrey M Singh MD Critical Care and Neurocritical Care Toronto Western Hospital October 31 st, 2014 Disclosures I (unfortunately) have no disclosures
Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe )
PROTOCOL Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe ) Page 1 of 6 Scope: Population: Outcome: Critical care clinicians and providers. All ICU patients intubated or mechanically
DELIRIUM IN ICU: Prevention and Management. Milind Baldi
DELIRIUM IN ICU: Prevention and Management Milind Baldi Contents Introduction Risk factors Assessment Prevention Management Introduction Delirium is a syndrome characterized by acute cerebral dysfunction
Ventilator-Associated Event Prevention: Innovations
Ventilator-Associated Event Prevention: Innovations Michael J. Apostolakos, MD Professor of Medicine Director, Adult Critical Care University of Rochester Mobility/Sedation in the ICU Old teaching: Keep
William Osler Health System
William Osler Health System Implementation of a Standardized approach to Delirium Assessment, Prevention & Management Cohort 1: Stephanie Jarvis, CNS, Seniors Health System Kuldeep Chahal, ELS, Hospital
Sleep in the ICU: helped by drugs? Yoanna Skrobik MD FRCP(c) MSc.
Sleep in the ICU: helped by drugs? Yoanna Skrobik MD FRCP(c) MSc. Conflicts of interest Member, SCCM Pain, Agitation and Delirium guidelines writing committee Vice-chair, SCCM Pain, Agitation, Delirium,
VENTILATOR ACQUIRED DELIRIUM CREATED BY JOSHUA VRONA COHP 450
VENTILATOR ACQUIRED DELIRIUM CREATED BY JOSHUA VRONA COHP 450 INTRODUCTION: Delirium is defined as An acute change in mental status or a fluctuating course, impaired attention, and disorganized thinking.
NYSPFP HIIN: VAE/Delirium Prevention. Operationalizing Prevention Strategies in the ICU
NYSPFP HIIN: VAE/Delirium Prevention Operationalizing Prevention Strategies in the ICU 1 Agenda Time Topic Speakers 9:00 a.m.-9:10 a.m. Welcome & Introductions NYSPFP Staff 9:10 a.m.-10:40 am Why Prevent
Fighting the Fog A Collaborative Approach to Decreasing ICU Delirium
Fighting the Fog A Collaborative Approach to Decreasing ICU Delirium Kimberly Scherr NP Jennifer Barker RN Misericordia Hospital ICU Edmonton, AB CACCN Dynamics Sept 21, 2014 Delirium Delirium is an acute
ICU Delirium and sedation: understanding their role in long-term patient outcomes. Yoanna Skrobik MD FRCP(c)
ICU Delirium and sedation: understanding their role in long-term patient outcomes Yoanna Skrobik MD FRCP(c) Conflicts of interest Member, SCCM Pain, Agitation and Delirium guidelines writing committee
Canadian Practices for the Treatment of Delirium. Lisa Burry, BScPharm, PharmD
Canadian Practices for the Treatment of Delirium Lisa Burry, BScPharm, PharmD Disclosures & Acknowledgements Conflicts of interest: None Acknowledgements: our patients and the clinical staff that supported
ICU Delirium A Real Epidemic (or are we delirious)?
ICU Delirium A Real Epidemic (or are we delirious)? CCCF: Toronto October 2014 Jesse Hall MD University of Chicago Section of Pulmonary and Critical Care Medicine Faculty Disclosures Dr. Hall receives
Extubation Failure & Delay in Brain-Injured Patients
Extubation Failure & Delay in Brain-Injured Patients Niall D. Ferguson, MD, FRCPC, MSc Director, Critical Care Medicine University Health Network & Mount Sinai Hospital Associate Professor of Medicine
Doug Paul, D.O. FACOS Medical Director, Trauma Services Kettering Health Network
Doug Paul, D.O. FACOS Medical Director, Trauma Services Kettering Health Network A paradigm shift (or revolutionary science) is, a change in the basic assumptions, or paradigms, within the ruling theory
Managing Delirium: The best way to achieve clarity (of mind) Tim Walsh. Professor of Critical Care, Edinburgh University
Managing Delirium: The best way to achieve clarity (of mind) Tim Walsh Professor of Critical Care, Edinburgh University Lecture Plan: a route to clarity What is delirium? Why is delirium important? Step
Early Goal Directed Sedation In Critically Ill Patients
Early Goal Directed Sedation In Critically Ill Patients Yahya Shehabi, FCICM, FANZCA, EMBA Professor, Intensive Care Medicine Clinical School of Medicine, University New South Wales School of Epidemiology
Kendiss Olafson MD FRCPC MPH Section of Critical Care University of Manitoba
Kendiss Olafson MD FRCPC MPH Section of Critical Care University of Manitoba Outline Sedation in ICU Purpose/Goals Common Drugs Sedation delivery strategies Mobility in the ICU Weakness with critical illness
Can Goal Directed Sedation Improve Outcomes?
Can Goal Directed Sedation Improve Outcomes? Yahya SHEHABI, FANZCA, FCICM, EMBA Professor and Program Director Critical care Monash Health and Monash University - Melbourne School of Medicine, University
Management of the Hemiplegic Arm: Implementing a Best Practice Protocol
Background Information Appendix J Management of the Hemiplegic Arm: Implementing a Best Practice Protocol Dalia Abromaitis, OT Reg (Ont) Jennifer Curry, PT www.swostroke.ca Objectives Provide tools for
What are Appropriate End-points for Delirium Prevention/Treatment Studies
What are Appropriate End-points for Delirium Prevention/Treatment Studies Pratik Pandharipande, MD, MSCI Professor of Anesthesiology and Surgery Department of Anesthesiology Vanderbilt University School
9/28/2016. Sedation Strategies in the ICU. Outline. ICU sedation. Recent clinical practice guidelines Top 10 myths A practical approach
Sedation Strategies in the ICU UW Medicine EMS and Trauma Conference Seattle, Washington September 26 th, 2016 C. Terri Hough, MD MSc Associate Professor of Medicine Division of Pulmonary and Critical
Supplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Page VJ, Casarin A, Ely EW, et al. Evaluation
Sedation and delirium- drugs and clinical management
Sedation and delirium- drugs and clinical management Shannon S. Carson, MD Associate Professor and Chief Division of Pulmonary and Critical Care Medicine University of North Carolina Probability of transitioning
Do Specialized Units Improve Outcomes?
Do Specialized Units Improve Outcomes? Gordon D. Rubenfeld, MD MSc Professor of Medicine, University of Toronto Chief, Program in Trauma, Emergency, and Critical Care Sunnybrook Health Sciences Centre
PREVENTING VENTILATORASSOCIATED EVENTS >>> >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> 2018 UPDATE
2018 UPDATE PREVENTING VENTILATORASSOCIATED EVENTS >>> PREVENTING VENTILATOR-ASSOCIATED EVENTS CHANGE PACKAGE ii >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> ACKNOWLEDGEMENTS The analyses upon
CRITICALLY APPRAISED PAPER (CAP)
CRITICALLY APPRAISED PAPER (CAP) Schweickert, W. D., Pohlman, M. C., Pohlman, A. S., Nigos, C., Pawlik, A. J., Esbrook, C. L., Kress, J.P. (2009). Early physical and occupational therapy in mechanically
NIH Public Access Author Manuscript Crit Care Med. Author manuscript; available in PMC 2015 December 01.
NIH Public Access Author Manuscript Published in final edited form as: Crit Care Med. 2014 December ; 42(12): e791 e795. doi:10.1097/ccm.0000000000000660. Effectiveness of Implementing a Wake up and Breathe
Rehabilitation within critical care
Rehabilitation within critical care Why consider Rehab on ITU? 110,000 people admitted to critical care units in England and Wales each year (ICNARC) 75% survive and are discharged home Long Term Effects
Improving the Management of Pain, Agitation, and Delirium (PAD) in the Intensive Care Unit: Translating Evidence Into Practice
Improving the Management of Pain, Agitation, and Delirium (PAD) in the Intensive Care Unit: Translating Evidence Into Practice Christine M. Groth, Pharm.D., BCCCP NYS Partnership for Patients September
MARIA KOBYLECKY RN, MScN, CNCC JEANENE LUCKHART BSc, Grad Dip PT CELINA ROGERS RRT SUZANNE WATTS BHSc PT
MARIA KOBYLECKY RN, MScN, CNCC JEANENE LUCKHART BSc, Grad Dip PT CELINA ROGERS RRT SUZANNE WATTS BHSc PT Objectives Understand some of the detrimental effects of critical illness, prolonged bed rest and
It Takes a Village. Patricia Mitchell, RN
It Takes a Village Patricia Mitchell, RN Assistant Research Director Department of Emergency Medicine Assistant Research Professor Boston University School of Medicine Objectives Leading a complex clinical
Respiratory Depression in the Early Postoperative Period. Toby N Weingarten, MD Mayo Clinic Professor Anesthesiology
Respiratory Depression in the Early Postoperative Period Toby N Weingarten, MD Mayo Clinic Professor Anesthesiology Conflicts of Interest Medtronic Chair of CEC Committee for PRODIGY Trial Merck Investigator
New approaches of sedation in critically ill patients.
New approaches of sedation in critically ill patients. Jean Mantz, MD, PhD Professor and Chair, Department of Anesthesia and Critical Care F- Paris Val de Seine University Hospitals Univ Paris Diderot,
Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/ Management, and Early Exercise/Mobility Bundle*
Feature Articles Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/ Management, and Early Exercise/Mobility Bundle* Michele C. Balas, PhD, RN, APRN-NP, CCRN 1 ;
Sleep deprivation. Delirium
acknowledgements Colleagues at BRI Delirium project group- Sam Heaton SSN (light therapy), Bex Russell Acting sister (this is me), Louise Sherratt- SSN (music therapy), Lucy Alford (RN) diaries) CIS team
CAUTI Timeline. SEPT: *Implementation Phase 1 OCT: *Foley insertion competency for 4 th RNs and FP. Awarded CAUTI Grant to purchase catheter hooks
CAUTI Timeline Created CAUTI Computer Based Learning Module and Meditech Catheter care Intervention FEB: *Decision on which unit we would pilot *Created CAUTI Charter APRIL-MAY: *Began process for Foley
Fall T.I.P.S. Training
Fall T.I.P.S. Training Overview Fall TIPS Super User Training (this presentation) Review the types of patient falls Review the components of an evidence-based fall prevention program Universal fall precautions
Lumbar Facet Joint Injection
Lumbar Facet Joint Injection Issue 5: March 2016 Review date: February 2019 Page 2 When back pain originates from the facet joints, a specific type of injection may reduce inflammation and provide pain
Delirium Prevention: The State-of-the-Art & Implications to Improve Care in our State
Delirium Prevention: The State-of-the-Art & Implications to Improve Care in our State Jonny Macias, MD & Michael Malone, MD Aurora Health Care/ University of Wisconsin School of Medicine & Public Health
The Pain of a Fractured Neck of Femur. Ms Fiona Nielsen- Project Lead
The Pain of a Fractured Neck of Femur - Project Lead Our health service 75,000 in-patients 165,000 out-patients 900 beds 6,200 staff 70,000 emergency attendances #NOF Presentations 2010-2011- 262 2011-2012-
CHOPS. Care of the confused hospitalised Older person Study. Anthea Temple Project Officer Aged Health Network. February 2014
CHOPS Care of the confused hospitalised Older person Study February 2014 Anthea.temple@aci.health.nsw.gov.au Anthea Temple Project Officer Aged Health Network Population growth over 65yrs 13% of Australia
ICU LIBERATION: IMPLEMENTING THE ABCDEF BUNDLE AND IMPROVING THE LIVES OF ICU PATIENTS
ICU LIBERATION: IMPLEMENTING THE ABCDEF BUNDLE AND IMPROVING THE LIVES OF ICU PATIENTS J. MATTHEW ALDRICH, MD ASSOCIATE CLINICAL PROFESSOR OF ANESTHESIA AND PERIOPERATIVE CARE UNIVERSITY OF CALIFORNIA
Summary of Delirium Clinical Practice Guideline Recommendations Post Operative
Summary of Delirium Clinical Practice Guideline Recommendations Post Operative Intensive Care Unit Clinical Practice Guideline for Postoperative Clinical Practice Guidelines for the Delirium in Older Adults;
Sedation and Delirium Questions
Sedation and Delirium Questions TLC Curriculum William J. Ehlenbach, MD MSc Assistant Professor of Medicine Pulmonary & Critical Care Medicine Question 1 Deep sedation in ventilated critically patients
Implementation of a Delirium Screening Tool in a Pediatric Intensive Care Unit
Implementation of a Delirium Screening Tool in a Pediatric Intensive Care Unit BY: ABBY WACHHOLTZ, BSN, RN, PEDIATRIC ACUTE CARE DNP STUDENT Disclosures I have no disclosures. 1 Objectives 1. Recognize
EFFECT OF ABCDE BUNDLE IMPLEMENTATION DELIRIUM IN INTENSIVE CARE UNIT PATIENTS ON PREVALENCE OF. Delirium Assessment. 1.0 Hour
Delirium Assessment EFFECT OF ABCDE BUNDLE IMPLEMENTATION ON PREVALENCE OF DELIRIUM IN INTENSIVE CARE UNIT PATIENTS By Mandy Bounds, RN, MSN, CCRN, Stacey Kram, RN-BC, DNP, PCCN, CCRN, Karen Gabel Speroni,
Delirium in Critical Care. Recognition, Management, Research tasters. Dr Valerie Page Watford General Hospital
Delirium in Critical Care. Recognition, Management, Research tasters Dr Valerie Page Watford General Hospital What does it look like? Diagnosing delirium CAM-ICU CAM-ICU Feature 1: Acute onset of mental
Liberation from Mechanical Ventilation in Critically Ill Adults
Liberation from Mechanical Ventilation in Critically Ill Adults 2017 ACCP/ATS Clinical Practice Guidelines Timothy D. Girard, MD, MSCI Clinical Research, Investigation, and Systems Modeling of Acute Illness
BGS Spring The Dementia and Delirium CQUIN
The Dementia and Delirium CQUIN Dr Louise Allan Clinical Senior Lecturer in Geriatric Medicine Institute of Neuroscience Newcastle University Outline Why should it have happened? Why did it happen? How
University Health Network Scholarly List
University Health Network Scholarly List TORONTO GENERAL HOSPITAL Lorenzo Del Sorbo Lorenzo.Delsorbo@uhn.ca IDCCM Staff Job Description: Clinician Investigator 1. Basic science 2. Physiologic studies 1.
Improving Delirium Management: Mapping Out One Unit s Journey. Geriatrics Institute June 27, 2013
Improving Delirium Management: Mapping Out One Unit s Journey Geriatrics Institute June 27, 2013 Rebecca Ramsden, NP Mary Ann Hamelin, CNS Susanne Loay, RN Objectives Background RNAO Best Practice Guideline
Why New Thinking is Needed for Older Adults across the Rehabilitation Continuum
Why New Thinking is Needed for Older Adults across the Rehabilitation Continuum Samir K. Sinha MD, DPhil, FRCPC Director of Geriatrics Mount Sinai and the University Health Network Hospitals Assistant
An Innovative Mobilization Framework for Delirium Management: How to Un-paralyze the Assessment and Implementation Process
An Innovative Mobilization Framework for Delirium Management: How to Un-paralyze the Assessment and Implementation Process Melissa Redlich PCM RNBN Christine Filipek CNE RNBN CNCC(C) Stephanie McLeod RNBN
CRITICALLY APPRAISED PAPER (CAP)
CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is early mobilization safe and more effective than usual care in promoting recovery and functional independence in clients in the intensive care unit (ICU)
HUSH (Help Us Support Healing)
HUSH (Help Us Support Healing) Why Sleep Hygiene? Patient and family complaints/concerns around sleep quality Healthcare provider s noting poor quality sleep in some patients Improved health outcomes for
Detailed Program. 8:00-8:30 Colony Ballroom and Foyer. Registration & Continental Breakfast. Opening Remarks 8:30-8:40
Detailed Program 8:00-8:30 and Foyer 8:30-8:40 8:40-9:20 Keynote Address Registration & Continental Breakfast Opening Remarks Malcolm Moffat, MHSc CHE Chair, GTA Rehab Network Best Practices Day Planning
Sedation Practice in Intensive Care Evaluation Early Goal Directed Sedation SPICE III
Sedation Practice in Intensive Care Evaluation Early Goal Directed Sedation SPICE III Yahya SHEHABI Professor Intensive Care Medicine Program Medical Director, Critical Care Monash University, Monash Health
Senior Friendly Hospital Care in the North West Local Health Integration Network Summary of Self-Assessment Responses.
Senior Friendly Hospital Care in the North West Local Health Integration Network Summary of Self-Assessment Responses February 2015 Overview In 2011, the Ontario Senior Friendly Hospital (SFH) Strategy
Capacity Analysis in a Specialized Service: Mapping the Future
Capacity Analysis in a Specialized Service: Mapping the Future Presenters: Judy Costello and Zsolt Hering Co-authors: Sabrina Bennett and Marnie Escaf @NHLC2018 #NHLC2018 PURPOSE Provide background on
A Questionnaire on Satisfaction of Family Members during Family Issues Meetings in the Intensive Care Unit
Quality Improvement A Questionnaire on Satisfaction of Family Members during Family Issues Meetings in the Intensive Care Unit Marnie Jakab, Sangeeta Mehta, Brittany Marinelli, Christina Nguyen, Andrea
Patient Safety - IV Opioid Use in Hospitalized Patients. October 2014
Patient Safety - IV Opioid Use in Hospitalized Patients October 2014 Objectives List reasons that necessitated development of risk assessment State a few risk factors or medical conditions from the IV
Delirium: Prevention with Melatonin
Delirium: Prevention with Melatonin Lisa Burry, PharmD Department of Pharmacy, Mount Sinai Hospital Leslie Dan Faculty of Pharmacy, University of Toronto Disclosures Centre for Collaborative Drug Research,
Sleep and Ageing. Siobhan Banks PhD. Body and Brain at Work, Centre for Sleep Research University of South Australia
Sleep and Ageing Siobhan Banks PhD Body and Brain at Work, Centre for Sleep Research University of South Australia Health and Active Ageing, 22 nd September 2015 Sleep and Aging How does sleep change as
Conducting Delirium Research
Optimizing Clinical Trials When Conducting Research Research funding: Disclosure NHLBI, NIA, AstraZeneca John W. Devlin, PharmD, FCCP, FCCM, Professor of Pharmacy, Northeastern University Scientific Staff,
VAP Prevention bundles
VAP Prevention bundles Dr. Shafiq A.Alimad MD Head of medical department at USTH YICID workshop, 15-12-2014 Care Bundles What are they & why use them? What are Care Bundles? Types of Care Bundles available
Critical Care Pharmacological Management of Delirium
Critical Care Pharmacological Management of Delirium Policy Title: in the Critical Care Unit Executive Summary: This policy provides guidance Pharmacological Management of delirium in the Critical Care
Delirium: How We Can Make a Difference. Denise Kresevic RN, PhD, APN January 2017
Delirium: How We Can Make a Difference Denise Kresevic RN, PhD, APN January 2017 Disclosure Dr. Kresevic has no actual or potential conflict of interest in relation to this presentation Any views or opinions
Jie Chen Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University
Jie Chen Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University Crit Care Med. 2004;32(4):955 62. BMJ. 2015;350:h2538. Background Delirium, defined as acute brain
The Impact of Patient-Ventilator. Karen J Bosma, MD, FRCPC Critical Care Medicine and Respirology
Achieving Restful Ventilation: The Impact of Patient-Ventilator Interaction on Sleep Karen J Bosma, MD, FRCPC Critical Care Medicine and Respirology Disclosure Statement I have received a research grant
8:30 9:30 9:30 10:15. Learning Objectives 1. Understand the different mechanisms through which hearing loss could affect
TIME PROGRAM TITLE 7:30 8:20 Registration and Continental Breakfast 8:20 8:30 Opening Remarks Four Birds with One Stone: Reparative, Neuroplastic, Cardiorespiratory and Metabolic Benefits of Aerobic Exercise
The Way UP: How Four Cross-Cutting Strategies Can Reduce Harm Across the Board
The Way UP: How Four Cross-Cutting Strategies Can Reduce Harm Across the Board 1 Today s Agenda 11:30 11:35: Welcome & Introductions Nikki Medalen & Jean Roland, Quality Health Associates of North Dakota
Confusion Assessment Method for the ICU (CAM-ICU)
Confusion Assessment Method for the ICU (CAM-ICU) The Complete Training Manual Revised Edition: August 31, 2016 This is a training manual for physicians, nurses and other healthcare professionals who wish
Stepping up to the challenge of falls at Basildon Hospital
WELCOME TO THIS SIGN UP TO SAFETY WEBINAR Stepping up to the challenge of falls at Basildon Hospital All participants lines are muted to reduce background noise Stepping Up to the challenge of falls Anne
CUSP 4 MVP-VAP Patient Care Bundle
Spontaneous Awakening and Spontaneous Breathing Trials, Literature Synopsis CUSP 4 MVP-VAP Patient Care Bundle Spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT) reduce the length
Start Walking: Improving Outcomes through Use of an Early Progressive Mobility Program. Theresa Murray MSN,RN, CCRN,CCNS Samantha Lichti BSN, RN
Start Walking: Improving Outcomes through Use of an Early Progressive Mobility Program Theresa Murray MSN,RN, CCRN,CCNS Samantha Lichti BSN, RN Challenge, Journey, Evolution Everest is 29, 035 ft. 5 ½
Difficulties in establishing Neurocritical Care Units Dr.Omar Ayoub Consultant & Assistant Professor of Neurology Stroke, Neurocritical Care RTP
Difficulties in establishing Neurocritical Care Units Dr.Omar Ayoub Consultant & Assistant Professor of Neurology Stroke, Neurocritical Care RTP Neurology at KAUH Evolution of ICUs ICUs started as specialized
Test your Knowledge: Recognizing Delirium
The Ottawa Hospital Name: Unit: Profession: RN RPN PT OT SW Other Note: Each question has only one correct answer. 1. If a patient is identified as being at high risk for developing delirium, his/her mental
1. Screening to identify SBT candidates
Karen E. A. Burns MD, FRCPC, MSc (Epid) Associate Professor, Clinician Scientist St. Michael s Hospital, Toronto, Canada burnsk@smh.ca Review evidence supporting: 1. Screening to identify SBT candidates
Universal Screening for Palliative Needs
P A L L I A T I V E C A R E NO PATIENT LEFT BEHIND Universal Screening for Palliative Needs BY MARY HICKS, RN, MSN, APRN AND ELIZABETH DISTEFANO, RN, BSN How can health care providers be confident their
Course Handouts & Post Test
STROKE/COMA: DISEASE TRAJECTORY AND HOSPICE ELIGIBILITY Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Hospice Education Network Course Handouts & Post Test To download presentation
Updates in Geriatrics. Christopher R. Carpenter, MD, FACEP, AGSF October 24, 2018
Updates in Geriatrics Christopher R. Carpenter, MD, FACEP, AGSF October 24, 2018 Disclosure of Relationships Deputy Editor-in-Chief Academic Emergency Medicine Editorial Board ACP Journal Club Journal
Conference Program. 8:00 8:30 Registration & Continental Breakfast
8:00 8:30 Registration & Continental Breakfast 8:30 8:40 Opening Remarks Malcolm Moffat, MHSc CHE Chair, GTA Rehab Network Best Practices Day Planning Task Group Executive Vice President, Sunnybrook Health
Hypoglycemia Reduction STARTER PACK WEBINAR #1
Hypoglycemia Reduction STARTER PACK WEBINAR #1 Why is it important to reduce hypoglycemia? Why Hypoglycemia Reduction? Key Statistics Overall 29% reduction in ADEs since 2010 Hypoglycemia still occurs
Case Review of Inpatient Rehabilitation Hospital Patients Not Suited for Intensive Therapy
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF INSPECTOR GENERAL Case Review of Inpatient Rehabilitation Hospital Patients Not Suited for Intensive Therapy OEI-06-16-00360 DECEMBER 2016 SUZANNE MURRIN
Dr Alireza Yarahmadi and Dr Arvind Perathur Mercy Medical Center - Winter Retreat Des Moines February 2012
Dr Alireza Yarahmadi and Dr Arvind Perathur Mercy Medical Center - Winter Retreat Des Moines February 2012 Why screen of OSA prior to surgery? What factors increase the risk? When due to anticipate problems?
Changing Demographics in Death After Devastating Brain Injury
Changing Demographics in Death After Devastating Brain Injury Andreas H. Kramer MD MSc FRCPC Departments of Critical Care Medicine & Clinical Neurosciences Foothills Medical Center, University of Calgary
The audit is managed by the Royal College of Psychiatrists in partnership with:
Background The National Audit of Dementia (NAD) care in general hospitals is commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England and the Welsh Government, as part of
Post-Arrest Care: Beyond Hypothermia
Post-Arrest Care: Beyond Hypothermia Damon Scales MD PhD Department of Critical Care Medicine Sunnybrook Health Sciences Centre University of Toronto Disclosures CIHR Physicians Services Incorporated Main
Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium
Online Data Supplement Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility (ABCDE) Bundle Authors-Michele C. Balas, Eduard
Sedation of the Critically Ill Patient
Buffalo theory of sedation It s a well known fact that a herd of buffalo can only move as fast as the slowest buffalo. And when the herd is hunted, it s the slowest and weakest ones at the back that are
Delirium in Critically Ill Mechanically Ventilated Patients Enrolled in the SLEAP Multicenter Randomized Trial
Delirium in Critically Ill Mechanically Ventilated Patients Enrolled in the SLEAP Multicenter Randomized Trial Geeta Mehta MD, FRCPC And The SLEAP Investigators For the Canadian Critical Care Trials Group
Online Data Supplement Perceptions and Practices Regarding Sleep in the ICU: A Survey of 1,223 Critical Care Providers
Online Data Supplement Perceptions and Practices Regarding Sleep in the ICU: A Survey of 1,223 Critical Care Providers Biren B. Kamdar, MD, MBA, MHS, Melissa P. Knauert, MD, PhD, Shirley F. Jones, MD,
Mental Health in STH Mike Richmond, Medical Director Mark Cobb, Clinical Director of Professional Services Debate & Note
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE E TO BE HELD ON 27 FEBRUARY 2012 Subject: Supporting Director: Author: Status 1 Mental
Enhancing Patient Care: Implementing Advance Care Planning (ACP) Initiative In Singapore General Hospital (SGH)
Enhancing Patient Care: Implementing Advance Care Planning (ACP) Initiative In Singapore General Hospital (SGH) Esaias Poh Liang Jie, Programme Executive Darlene Hong Yun Quan, Programme Coordinator 21