Creating a Strong Team Across Medical Specialties in an ICU Environment

Intensive care units (ICUs) are high-stakes environments where patients require round-the-clock care and monitoring. The success of this care depends mainly on the teamwork and collaboration of medical professionals from different specialties. This post will discuss creating a robust and cross-disciplinary team in an ICU setting.

Establish clear communication protocols: Clear and consistent communication is one of the essential elements of effective ICU teamwork. Establishing protocols for handoff reports, shift reports, and critical event notifications will help ensure that all team members are on the same page.

Encourage interdisciplinary rounds: Regular interdisciplinary rounds, where all care team members meet to discuss patients and plan care, are an excellent way to foster collaboration and improve patient outcomes. These rounds allow team members from different specialties to share their expertise and perspective.

Foster a culture of respect and collaboration: Encouraging a culture of respect and cooperation can help build trust and teamwork within the ICU. Team members should feel comfortable sharing their thoughts and ideas and be willing to listen and learn from each other.

Provide opportunities for education and training: Providing opportunities for continuing education and training can help build a strong, knowledgeable team. Encourage all members to attend conferences, workshops, and other educational events, and provide in-house training regularly

Preventing Infection in Toddlers with Tracheostomies

As a parent or caregiver of a toddler with a tracheostomy, it’s normal to have concerns about keeping your little one safeand healthy. One of the biggest concerns for children with tracheostomies is the risk of infection.

A tracheostomy is an opening in the neck that provides a direct airway to the trachea and lungs. Tracheostomies are often necessary for children with breathing difficulties. They also leave them vulnerable to bacterial and viral infections that can cause serious health problems.

However, there are steps you can take to minimize the risk of infection in your toddler with a tracheostomy. Here are some tips to keep in mind:

  1. Keep the tracheostomy site clean and dry. Regularly clean the skin around the tracheostomy and make sure it stays dry. Use a clean, damp cloth to wipe away secretions, and allow the area to air dry.
  2. Change the tracheostomy ties and dress regularly. Tracheostomy ties hold the tube in place, and the dressing protects the skin around the opening. Be sure to change these regularly as directed by your healthcare provider. At Nursing Evolutions, we attend to these every day.
  3. Avoid exposing your toddler to infections. Keep your toddler away from people who are sick andwash your hands frequently to prevent the spread of germs.
  4. Use sterile equipment. Always use sterile equipment when changing your toddler’s tracheostomy ties and dressing and cleaningthe tracheostomy site.
  5. Monitor for signs of infection. Look for any symptoms of infection, such as increased secretions, redness or swelling around the tracheostomy site, or a fever. If you notice any of these signs, contact your healthcare provider immediately.

In conclusion, preventing infection in toddlers with tracheostomies requires regular care and vigilance. Following these tips and working closely with your healthcare provider can help keep your toddler healthy and safe

Meet Mary, A Typical Nursing Evolutions Patient

Are you a nursing student or working to become a nursing student? Curious about pediatric critical care? Here is a case study of the type of patient you might serve in the future! What kinds of patients do we help? Here’s an example!

Case Study

Mary is an 11-month-old female patient who came to our services after an 11-month hospitalization. She was born 26 weeks premature and had bronchopulmonary dysplasia, severe gastroesophageal reflux, tracheal malacia, and developmental delay. Mary requires 16 hours of critical field care daily, seven days a week, with her parents providing care for the remaining hours.

She is on a Trilogy ventilator receiving Intermittent Mandatory Ventilation at 25 breaths per minute with a tidal volume of 90ccs. When awake, Mary takes additional breaths with a respiratory rate of 27 to 35 breaths per minute but does not take extra breaths while sleeping. She receives a set supplemental oxygen dose of 2 liters per minute with a SpO2 range of 95-97%.

Airway suctioning is necessary approximately every 10 minutes while awake and every 30 minutes while asleep. There are no plans for weaning from mechanical ventilation or decannulating the tracheostomy. Mary is on a strict NPO status due to her aspiration risk and severe GERD.

We’ve shared this snapshot of the comprehensive care and attention we give to every one of our precious patients.

Exciting news! You have appointments later today with some of the top healthcare specialists in the field, including the Pulmonary, Otolaryngology (ENT), Gastroenterologist (GI), Physical and Occupational Therapists, and Dietitian teams.

The medical team currently has no plans for “taste” trials for the patient. However, we will focus on the patient’s strength, balance, and mobility. The patient is fully innervated but has limited upper extremity movement, with lower extremity movement only occurring with stimulation. While the upper and lower extremities are relatively weak, the patient’s torso muscles are nearly flaccid, and neck musclesare notably weak. At this time, the patient cannot hold up their head or sit up without full support.

Despite this, the patient does follow movements and actions with their eyes. However, they may be unable to move their head to keep up with the effort if it exceeds what they can see with their eyes. The back of the patient’s head is also flat and bald.

We want to make the most of these appointments and gain as much valuable information as possible.Here are some questions to consider:

  • What information are you hoping to obtain from each Specialty Care Provider team?
  • What are your expectations and concerns for each appointment?
  • What is your advocacy plan for the patient with each of these SCP teams?

We also want to coordinate our efforts to address critical issues, such as:

  • Advancing from continuous G-and G-J-tube feedings
  • Progressive mobilization
  • The plan for supplemental oxygen administration
  • Reducing dependence on mechanical ventilation
  • The eventual plan for tracheostomy decannulation.

Welcome to Nursing Evolutions Pediatric Critical Care

Nursing Evolutions’ Pediatric Critical Care Houses provide advanced nursing care specialized in the medically fragile ventilator-dependent pediatric population. We serve patients from birth to five. Direct care is provided by Registered Nurses 24/7, along with support from Pediatric Care Technicians.

As a result, we can serve patients that could only otherwise be cared for at a hospital with Level 3 or 4 NICU/PICU capabilities. Nursing Evolutions’ care team and facility provide an alternative to extended hospitalization; once patients are weaned off ventilation and decannulated from their tracheostomy (if safely medically feasible), we aim to discharge patients to home.

We engage in continual high-level clinical education like any other specialty careprovider. Our focus on literature-based best practice and outcomes measurement significantly impacts the team’s ability to coordinate care and progress patients toward optimal health, function, and quality of life. Safe and effective patient progress leads to fewer infections, fewer unplanned hospitalizations, and lower healthcare costs.

Nursing Evolutions Pediatric Critical Care House is the hub of care coordination and patient information for each patient. Our services are clinically complex and labor-intensive. As a result, we can admit and safely progress patients whose only other option is hospitalization. Does this sound like a good fit for your baby? Your nursing career? Reach out and say hello!