In Safe Patient Care
Opioid-induced respiratory depression (OIRD), a form of respiratory compromise, is one of the leading avoidable patient safety issue. Respiratory compromise, increases morbidity and mortality as well hospital inpatient costs. This presentation will discuss the results of a recent, multi-center study PRODIGY designed to identify people at high risk for OIRD. Results showed that more than 40% of patients on the general care floor experienced OIRD. The investigators will share an easy-to-use risk prediction tool they developed to identify patients at high risk that can lead to earlier interventions.
Enhanced recovery after surgery (ERAS) has demonstrated to improve outcomes. This webinar discusses the advantages of ERAS in managing surgical patients and identifies the various elements of enhanced recovery pathways. The role of processed EEG monitoring in intra-operative anesthetic management and the application of neuromonitoring in improving postoperative outcomes in patients undergoingtotal intravenous anesthesia will also be discussed.
In ICUs across the US, clinicians are working to ensure the ABCDF bundle is fully integrated into daily care. Over the last decade, concentrated effort has occurred to Awaken patients through use of sedation protocols, facilitating ventilator liberation through spontaneous Breathing trials, Coordination of complex interdisciplinary care, evaluating and managing Delirium in order to foster successful progressive Early mobilization with patient and Family engagement. Without successful bundling of the interventions, the ability to liberate a patient from the ventilator is significantly more challenging. Physicians, nurses and RTs working with an ICU patient have a unique as well as collaborative role in helping to achieve successful patient outcomes. This session will provide an overview of ABCDEF bundle to help demonstrate the impact these interventions have on increasing the readiness for a critically ill patient to be liberated from
Liberation from mechanical ventilation is not a “cut and dried” process. Clinicians need to be able to recognize patient’s rediness for ventilator separation and extubation. Spontaneous Breathing Trials (SBTs) are the accepted method of assessment, but not always predictive. In this webinar, there will be a discussion of the evidence for SBTs and of the role of automated weaning protocols.
While ventilation may be a life-saving tool for critically ill patients, it can also be an uncomfortable experience due to the invasiveness of the tubing, and mismatches (or “asynchronies”) between the patient’s demand for breath and the ventilator-delivered breathing pattern. In the past, clinicians addressed ventilator-patient asynchrony through heavy sedation. However, recent studies have highlighted the negative consequences of over-sedation for ventilatory patients, which include muscle atrophy from prolonged disuse and lengthened ventilation times. By evaluating for asynchrony, clinicians may be able to reduce the risk of oversedation. By using sedation more effectively, we can work together to potentially reduce ICU ventilation time.
Respiratory compromise (RC) is a critical postoperative complication that increases the likelihood of adverse outcomes and the cost of care. Several trials have confirmed that patient observation continues to underestimate the overall incidence of postoperative RC. This CE webinar will review the evidence and provide recommendations for the prevention of RC.
There is compelling evidence that continuous monitoring of the respiratory function has a significant impact on clinical outcomes and cost of care. Although ventilation and oxygenation are different physiologically, it is recommended that they be monitored togeher and continuously to prevent postoperative respiratory compromise.
Early Warning Scoring (EWS) systems provide a commonly understood way to recognize the degree of deterioration in a patient’s status, and can ensure that every patient is seen at the right time by the right person. The EWS is based on the collection of a combination of vital signs including heart rate, respiratory rate, oxygen saturation, blood pressure and body temperature. In this webinar, there will a discussion of the benefits, variations and strategies for overcoming barriers to successful implementation of EWS in hospitals.
Respiration rate monitoring is a new capability of the Nellcor™ pulse oximeter that allows respiratory rate to be monitored continuously through a single finger sensor. This webinar will explain the principles of respiratory rate monitoring using plethysmography, its advantages, and its limitations. Clinical scenarios in which Nellcor™ Respiration Rate technology has been validated and used successfully in detecting respiratory depression will be presented, including suggested workflows, monitor settings, and alarm management.
Total intravenous anesthesia (TIVA) offers advantages over inhalational anesthetics that may include reduced rates of post-operative nausea and vomiting, smoother emergence, and improved patient satisfaction. The BIS monitor allows the clinician to minimize drug cost and improve recovery parameters by allowing more precise titration of IV anesthetics such as propofol. However, the use of BIS technology for TIVA requires a more complete understanding of how processed EEG works. By learning to identify and troubleshoot common clinical issues like EMG artifact and patient movement in the presence of a low BIS number, practitioners can improve both patient outcome and their own confidence in BIS technology. Dr. Marsh will show how TIVA with BIS will help anesthesia clinicians increase value to hospitals, payers, and new healthcare partners like Accountable Care Organizations (ACOs).
The purpose of the webinar is to describe the methodology of measuring cerebral oxygenation saturation using the INVOS™ system and to demonstrate the clinical implementation and parameters for use of this monitoring technology in complicated and non-complicated cardiac surgical procedures. Finally, through published outcome evidence and case examples with interactive audience response technology, the benefits of INVOS in this patient population will be explained.