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Advanced Rehabilitation Strategies for Critical Illness Recovery

Learn about the challenges and benefits of rehabilitation after critical illness at the Neurosciences University Hospital. Explore the early mobilization project, staff training, and successful outcomes for ICU survivors. Contact Stuart Fraser for more information.

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Advanced Rehabilitation Strategies for Critical Illness Recovery

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  1. Rocket science or RehabilitationStuart FraserTherapy manager - NeurosciencesUniversity Hospital Southampton NHS Foundation Trust

  2. Rehabilitation • ‘ To restore someone to health through training and therapy after illness’

  3. What are the challenges • Health care costs • Ageing population • Growing population • Private sector • Lifestyle • Public expectations • Rising Acuity • Communication • No: of organisations

  4. What are the challenges Healthcare costs Ageing population Growing population Private sector Lifestyle Public expectations Rising Acuity Communication! No: of organisations!

  5. Early Mobilisation Project

  6. Why EMP? • Survival following critical illness is often associated with a poor functional outcome Herridge et al 2011 NEJM: 364;1293-304 • The combined effects of reduced sedation and physical activity are safe, well tolerated Schweickert et al 2009 Lancet: 373:1874-82 • Early mobilisation is defined as occuring within the first 2-5 days of admission, but barriers to this are often reported • Hodgson et al 2013 Crit Care: 17:207

  7. What did we ask for? • Small investment • Staff • Equipment

  8. How did we do it? Inclusion • Acute medical patients • <72 hours I&V • Expected to remain I&V >24hours • Functionally independent prior to admission (+/- aid) Intervention • Strict sedation protocol- minimal sedation at all times • 2x 30 minute additional therapy sessions per day

  9. Clinical outcome data for ICU survivors enrolled in the QI project (Pre-QI data is included for comparison) Data are expressed as mean (standard deviation), unless otherwise indicated.

  10. What did we do next?

  11. Neurological Intensive Care

  12. Achievements 2012-2016

  13. In summary • Its not rocket science! • Investment / savings • Safe • Promotes therapists as being leaders in Rehabilitation • It’s the right thing to do

  14. Thank you Stuart.Fraser@uhs.nhs.uk

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