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- Title
Let's Get Moving! The N-SPADESS Initiative and Progressive Mobility in the Critical Care Patient.
- Authors
Cashman, Cindy; Nathan, Jeyanthy; Howland, Michelle; Blakeley, Leesa
- Abstract
Purpose/goals: A patient's ability to recover from an ICU stay is often inhibited by post intensive care syndrome (PICS), which encompasses cognitive, physical, and psychological impairments. An initiative developed within our organization's adult Intensive Care Unit to limit the severity of these sequelae is N-SPADESS (nutrition, sedation, pain, agitation, delirium, early mobility, sleep, supports). This initiative’s purpose is to manage these essential factors through an interdisciplinary approach, thereby reducing ICU and hospital length of stay, and overall cost and, ultimately, improve patient outcomes. Session description: There are many advances that are continually being made within critical care. As patients continue to survive critical illnesses, they are being faced with challenges in the recovery process such as increased length of stay and severe debilitation, ultimately affecting their quality of life and functional status. Early progressive mobilization, combined with a multidisciplinary team approach to optimize nutrition, sedation, pain, agitation, delirium, and sleep in the critically ill patient are imperative to improved patient outcomes. The N-SPADESS bundle is a newly developed initiative within our intensive care setting to facilitate collaboration of the multi-disciplinary team to challenge the effects of post intensive care syndrome in ICU patients. The N-SPADESS bundle also includes nurse driven analgesia and sedation orders that allow the patient to better communicate with the healthcare team. Consequently, our patient population can participate in and advocate for their healthcare. By using assessment tools that have already been developed based on recommended guidelines, we can synchronously decrease mechanical ventilation days, ICU length of stay, ICU delirium, and improve overall ICU patient outcomes. Learning outcomes: 1. Understand the concepts of N-SPADESS in relation to limiting the long-term consequences of critical illness and PICS. 2. Assess the benefit of analgesia vs. sedation via a nursedriven protocol and use tools to assess management of pain, delirium, and sedation (CPOT, CAM-ICU, RASS). 3. Assess a patient's stability and readiness for mobility by applying above tools in conjunction with hemodynamic/ ventilator stability.
- Subjects
CRITICALLY ill; HEALTH care teams; INTENSIVE care nursing; INTENSIVE care units; PATIENTS; POSTERS; BODY movement; EARLY ambulation (Rehabilitation)
- Publication
Canadian Journal of Critical Care Nursing, 2017, Vol 28, Issue 2, p54
- ISSN
2368-8653
- Publication type
Article