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 Delirium: A Review E. Wesley Ely, MD, MPH Delirium and ICU Liberation: Vanderbilt University School of Medicine Impact on Survival and Survivorship 10:40 a.m.-10:50 a.m. BREAK 10:50 a.m.-11:50 a.m. Liberation from Mechanical Ventilation in Critically Ill Adults: 2017 ACCP/ATS Clinical Practice Guidelines 11:50 a.m.-12:10 p.m. Hospital Discussion: Question and Answers Timothy Girard, MS, MSCI University of Pittsburgh School of Medicine Facilitated by NYSPFP Staff Dr. Ely Dr. Girard Hospital participants 12:10 p.m.-1:00 p.m. LUNCH 2
Agenda Time Topic Speakers 1:00 p.m.-1:30 p.m. CAM-ICU Demonstration Dr. Ely and hospital participants 1:30 p.m.-2:15 p.m. Sedation Protocols: Improving the Management of Pain, Agitation, and Delirium (PAD) in the Intensive Care Unit: Translating Evidence Into Practice Christine Groth, PharmD University of Rochester Medical Center, Strong Memorial Hospital 2:15 p.m.-2:45 p.m. Early Progressive Mobility Syracuse (9/26) NYC (9/27) Marianne Munson, PT, DPT University of Rochester Medical Center, Strong Memorial Hospital Jodi Herbsman, PT, DPT NYU Langone Medical Center Ralph Carumba, MS, RN, CCRN NYU Langone Medical Center 3
Agenda Time Topic Speakers 2:45 p.m.--3:00 p.m. BREAK 3:00 p.m.-4:00 p.m. Panel Discussion & Close Syracuse (9/26) NYC (9/27) Facilitated by NYSPFP Staff and Drs. Ely and Girard Dr. Groth Dr. Munson Ida (Dolly) Simard, RN, BSN, CCRN Mohawk Valley Health System Facilitated by NYSPFP Staff and Drs. Ely and Girard Dr. Groth Dr. Herbsman Mr. Carumba Hospital participants Hospital participants 4
NYSPFP Approach to VAE/Delirium Reduction
VAE/Delirium Goal and Approach Goal: To reduce ventilator-associated events (VAE) by 20% and the incidence of iatrogenic delirium in critical care patients. Hospitals will focus on spreading interventions to reduce VAE and delirium throughout critical care units. NYSPFP will support hospitals in implementing evidence based strategies including: Implementation of the ABCDEF Bundle Implementing non-pharmacological interventions to prevent and manage delirium VAE: High Reliability in application of the VAP bundle Implementing emerging interventions aimed at reducing VAE 6
ABCDEF Bundle Components 7
PAD Assessment Tools 8
Overall VAE Rate 9
IVAC+ 10
IVAC Rate 11
Ventilator Utilization Ratio 12
NYSPFP Delirium Data Entry, Tools and Resources
NYSPFP Website: Tools and Resources www.nyspfp.org www.nyspfp.org/members/initiatives /InfectionPrevention/VAP/Tools.aspx Additional Resources: IPRO VAE Master Project Plan PAD Assessment Tools Critical Care Pain Observation Tool Behavioral Pain Scale Richmond Agitation-Sedation Scale Sedation Agitation Scale Complete CAM-ICU Training Manual Intensive Care Delirium Screening Checklist ABCDEF Bundle Action Planning Tool 14
Critical Care Team Education & Support Targeted education and tools for Critical Care Unit Staff: VAE/Delirium Prevention Daily Safety Checks Sepsis HIIN Tools: Critical Care Gap Analysis Critical Care Checklist Critical Care Data Collection Tool Project Manager Support 15
Summary of Handouts Speaker s Slides NYSPFP: ABCDEF Action Plan Non-pharmacological interventions gap analysis and action plan CAM ICU-Pocket Card Wake up and Breathe Protocol Bedside Checklist Sample Rounding Tools Sample Protocols from Presenters Useful Resource: Journal Article on how to assess critically ill patients mechanically ventilated patients for contra-indications to early mobility 16