RESUMO
Historically, patients supported on extra corporeal membrane oxygenation were thought to be too unstable to engage in early mobility but are at increased risk for deconditioning from prolonged immobilization due to the nature of illness, numerous cannulas, equipment, and hemodynamic and respiratory instability along with heavy sedation/analgesia or paralysis. This article will discuss the specific considerations that should be employed to keep the patient and the staff safe while providing mobility to patients on extra corporeal membrane oxygenation.
Assuntos
Protocolos Clínicos/normas , Deambulação Precoce , Oxigenação por Membrana Extracorpórea/métodos , Movimentação e Reposicionamento de Pacientes/enfermagem , Movimentação e Reposicionamento de Pacientes/normas , Segurança do Paciente , Cuidados Críticos , Humanos , Unidades de Terapia Intensiva , Fenômenos Fisiológicos RespiratóriosRESUMO
A review of the literature revealed that there was a dearth of information regarding the financial impact of implementing a mobility program in an intensive care unit. The purpose of this article was to identify and quantify costs and cost-benefit from implementing a mobility protocol. Factors to be considered when implementing a mobility program in an intensive care unit are identified and discussed. The increased acuity and lengths of stay associated with this population and the unavoidable increase in the incidence of hospital-acquired pressure ulcers make it difficult to extrapolate the economic benefits of the mobility program at this time.
Assuntos
Protocolos Clínicos , Deambulação Precoce/economia , Unidades de Terapia Intensiva/economia , Centro Cirúrgico Hospitalar/organização & administração , Centros Médicos Acadêmicos , Análise Custo-Benefício , Unidades de Terapia Intensiva/organização & administração , Michigan , Centro Cirúrgico Hospitalar/economiaRESUMO
The purpose of an IME is to obtain an impartial, objective evaluation of an employees health condition. Based on the evaluation, the examiner is asked to render an opinion to answer questions set forth in written communication to the examiner. The opinion, which is grounded in the examiners professional education, experience, and judgment, becomes a legal instrument. Occupational health nurses must be cognizant of the ramifications of an IME and the communications surrounding this examination. In addition, many factors can affect the quality of an IME. Occupational health nurses should be aware of these factors when facilitating an IME to ensure the precise focus and overall quality of the evaluation.
