Asunto(s)
Cuidados Críticos , Servicios Médicos de Urgencia , Asignación de Recursos para la Atención de Salud , Fuerza Laboral en Salud , Hospitalización , Neurología , Pandemias , COVID-19 , Enfermería de Cuidados Críticos , Atención a la Salud , Humanos , Enfermeras Practicantes , Enfermeras y Enfermeros , Transferencia de Pacientes , Admisión y Programación de Personal , Farmacéuticos , Asistentes Médicos , Médicos , SARS-CoV-2 , TriajeRESUMEN
The neurologic patient presenting to the emergency department is especially complex, with the goal of care being to prevent secondary injury while maximizing oxygenation and perfusion to the brain. To maximize the outcomes for the neurologic patient, the interprofessional team in the ED must be vigilant to ensure that patient transitions occur smoothly. Proactive measures are taken as soon as possible to prevent secondary injury and not delay access to care or services. This article provides an overview of strategies used to assist the ED care team in managing a smooth transition to the next level of care.
Asunto(s)
Encefalopatías/terapia , Servicios Médicos de Urgencia/normas , Servicio de Urgencia en Hospital/normas , Hospitalización , Enfermedades del Sistema Nervioso/terapia , Guías de Práctica Clínica como Asunto , Cuidado de Transición/normas , HumanosAsunto(s)
Isquemia Encefálica/terapia , Warfarina/uso terapéutico , Isquemia Encefálica/diagnóstico , Hemorragia Cerebral/inducido químicamente , Contraindicaciones , Servicio de Urgencia en Hospital , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Persona de Mediana Edad , Activador de Tejido Plasminógeno/uso terapéuticoRESUMEN
OBJECTIVE: Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. RESEARCH METHODOLOGY: Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. SETTING: This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. MAIN OUTCOME MEASURES: Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. RESULTS: Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. CONCLUSION: Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit.