This show accompanies the 'Critical Care Global Classroom' - fortnightly lectures delivered by leading global experts in Critical Care Nursing. Take a dive into the latest evidence-based best-practice, with leading researchers and speakers. The audio from each lecture will be released here shortly…
Paediatric sepsis remains one of the leading causes of preventable mortality for children. Global incidence exceeds 50% for the neonatal and paediatric population, with up to one third developing ongoing, sometimes lifelong sequelae. Early recognition and management is key to optimising outcomes, however can be difficult to recognise in the early stages. Paediatric sepsis is not isolated to the Emergency Department, but rather a journey that begins at home and encompasses the multidisciplinary team and families. This session will contextualise the many elements of paediatric sepsis and provide you with the tools to ensure your patient arrives at the emerald city. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Hemodynamic monitoring in a critical care setting is very important to the individualized care of the patient. Using heartrate and blood pressure is not enough to determine patients preload, afterload and contractility needs. Utilizing hemodynamics of some sort (non-invasive, less – invasive) can really better outcomes in the critical care patient. It is essential though if you are utilizing hemodynamic monitoring at the bedside that you understand what the numbers mean and how you can better implement care at the bedside. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Discuss strategies for the timely treatment of the septic patient based on the evidence Review the 2021 Guidelines for Sepsis and Septic Shock Understand the importance To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Contrast use of human-centred co-design in healthcare with other co-design approaches Describe common principles and methods for co-design Appraise factors expected to influence the success of human-centred co-design in a busy hospital setting Critique the relevance of human-centred co-design to knowledge translation and implementation science To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Contrast use of human-centred co-design in healthcare with other co-design approaches Describe common principles and methods for co-design Appraise factors expected to influence the success of human-centred co-design in a busy hospital setting Critique the relevance of human-centred co-design to knowledge translation and implementation science To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Contrast use of human-centred co-design in healthcare with other co-design approaches Describe common principles and methods for co-design Appraise factors expected to influence the success of human-centred co-design in a busy hospital setting Critique the relevance of human-centred co-design to knowledge translation and implementation science To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This presentation describes the patient care priorities when receiving a post-operative cardiac surgery from the operating room. Newer surgical approaches are listed followed by a description of outcome predications based on two scoring systems. The effects of cardiopulmonary bypass are described. Standards for routine care of the post-operative patients are presented. Complications are provided along with the recommendations for resuscitation should cardiac arrest occur. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This presentation provides an overview of critical care nurse transition. It summarizes theoretical perspectives that provide useful lenses to understand transition in nursing practice. A brief overview of synthesis studies on new nurse and new graduate nurse transition into critical care is provided. Additionally, a recent longitudinal study with a cohort of new graduate nurses hired into an IC is discussed. Recommendations that may be useful to consider for the recruitment and retention of nurses into critical care is also highlighted. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Discuss instruments that capture frailty and identify a vulnerable population Review the evidence of frailty and its impact on outcomes following critical illness Outline opportunities to improve care of individuals assessed as frail in the ICU To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
In this lecture, you will learn about best practice guidelines informing the management of pain in the critically ill adult. The updated definition of pain, its prevalence and challenges in the adult population in the intensive care unit (ICU) are described. A stepwise approach to pain assessment in the patient unable to self-report is presented and various valid pain assessment tools are introduced along with new developments. Pain management guiding principles based on a multimodal analgesia approach are also discussed. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Bloodstream infections (BSI) are the most deadly healthcare associated infections, and 35% of these are caused by intravenous (IV) therapy through various types of IV catheter [1] . Such ‘catheter-associated BSI (CABSI)' substantially increase risk of death, prolong ICU and hospital stay, and healthcare costs. Nurses are responsible for many aspects of catheter insertion, management, troubleshooting, and removal. To prevent CABSI, we must deny microorganisms entry into the blood via both the: (1) catheter insertion site, and (2) internal catheter lumen. This presentation reviews the concept of CABSI, core fundamentals of infection prevention, and reviews recent evidence from large randomised controlled trials. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
In this talk, I will discuss a paradigm shift in thinking about oral health and care in the intensive care unit (ICU) i.e. what goes wrong and how we should intervene. I will discuss the oral microbiome, dysbiosis, the chlorhexidine controversy, and expert/patient recommendations for the delivery of an oral care bundle including toothbrushing. I will emphasize recent evidence about de-adopting oral chlorhexidine use and implementing an oral care bundle. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This presentation describes the patient care priorities when receiving a post-operative cardiac surgery from the operating room. Newer surgical approaches are listed followed by a description of outcome predications based on two scoring systems. The effects of cardiopulmonary bypass are described. Standards for routine care of the post-operative patients are presented. Complications are provided along with the recommendations for resuscitation should cardiac arrest occur. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The importance of the neurologic assessment for patients in the intensive care unit cannot be overstated. All patients are at risk for neurologic deterioration, whether from a primary neurologic process, or from metabolic complications associated with systemic organ failure. Notable change in the level of consciousness during serial neuro exams is the most sensitive indicator of neurologic decline. Nurses performing a thorough neurologic assessment will examine consciousness and cognition, language and speech, the cranial nerves, and movement and sensation. Although the neurologic assessment can be complicated, using a standardized approach allows the rapid identification of neurologic decline allowing for rapid intervention to prevent further neurologic deterioration. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Sternal Wound Infections (SWI) are one of the major complication post-surgical interventions that have a negative effect on LOS, health costs morbidity and mortality. This is why it's important that an early active surveillance program is put in place in all cardiothoracic surgical units. A task force must analyze cause of infections and put forth all the guidelines and recommendation on the prevention of SWI as well as having a clear knowledge on how to classify infections according to the CDC definitions .Our hospital experience has shown that standardization of processes is of fundamental importance, that active surveillance plays a key role in monitoring implemented measures and promote changes as well as keeping staff attention high. A multimodal and multidisciplinary approach is highly recommended. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: Describe the factors that contribute to loss of skin integrity for patients in the ICU Discuss appropriate pressure injury/ulcer staging and risk assessment Implement evidence-based strategies in the ICU to assist in improving patients' skin integrity To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
In this presentation, Dr Gillian Ray-Barruel reviews the evidence-based nursing actions for CVAD insertion, maintenance, and safe removal in the ICU patient, including potential complications that may occur. Recent evidence is also discussed to enable nurses to question their own local practice for infusion management. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Low-flow oxygen therapy devices are often the first choice when giving supplemental oxygen to critically ill patients. Ensuring the oxygen is administered in a timely and appropriate way, using the right device, is an important aspect of care. This presentation provides an overview of basic oxygen therapy principles, describes the indications for and care requirements of nasopharyngeal oxygen catheters, nasal prongs and simple face mask devices. Importantly, a practical algorithm for the management of mild-moderate hypoxaemia is provided, so that, where possible, the simplest, most effective form of therapy can be given. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The topic of neonatal resuscitation is vast and complicated. These 3 short lectures are aimed at providing a snapshot of 1. the normal birth process; 2. how this process can be interrupted and the impact on the newly born (especially the preterm neonate); and 3. a step by step review of resuscitation of the newborn at birth. Emphasis is given to the equipment required, new ideas in neonatology and the important steps when resuscitating the newly born compared to an adult or paediatric patient. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The topic of neonatal resuscitation is vast and complicated. These 3 short lectures are aimed at providing a snapshot of 1. the normal birth process; 2. how this process can be interrupted and the impact on the newly born (especially the preterm neonate); and 3. a step by step review of resuscitation of the newborn at birth. Emphasis is given to the equipment required, new ideas in neonatology and the important steps when resuscitating the newly born compared to an adult or paediatric patient. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The topic of neonatal resuscitation is vast and complicated. These 3 short lectures are aimed at providing a snapshot of 1. the normal birth process; 2. how this process can be interrupted and the impact on the newly born (especially the preterm neonate); and 3. a step by step review of resuscitation of the newborn at birth. Emphasis is given to the equipment required, new ideas in neonatology and the important steps when resuscitating the newly born compared to an adult or paediatric patient. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The purpose of this talk is to review suitable charting and prescription orders sheets for fluid balance and fluids use, and see new innovations in preventing positive fluid balance and for waste fluid management. Learning objectives for this talk: To review some key history for fluids used to provide CRRT in the ICU To understand prescribing CRRT and the precision necessary for fluid removal To appreciate errors and adversity associated with inadequate fluid balance To review the concepts of fluid removal and fluid regulation in the critically ill To link the above key objectives to lower resource settings and clinical care broadly To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: To have an overview of post-operative care of Liver Transplant patients To identify early post-operative complications in Liver Transplant patients To have an awareness of specific treatments based on aetiology for Post Liver Transplant patients To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Learning objectives for this talk: To have an overview of post-operative care of Liver Transplant patients To identify early post-operative complications in Liver Transplant patients To have an awareness of specific treatments based on aetiology for Post Liver Transplant patients To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
To manage the complexity of trauma resuscitation, a systematic team-based and process-focused approach are needed to rapidly identify and treat life-threatening injuries and minimize team errors. Critical care nurses are an integral part of the resuscitation team so this presentation will provide a trauma resuscitation update. Whilst the primary survey is the mainstay of initial trauma care there has been a change of approach when managing ‘circulation' with a focus on damage control resuscitation. Damage control resuscitation will be the main focus of the presentation. Other updates will also be highlighted including the management of the vulnerable geriatric population and surgical rib fixation. Finally, Relational Coordination and its importance in supporting team coordination and performance will be discussed. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
If you are looking to understand the basics in regards to nutrition support in the ICU and the provision of enteral nutrition this is the session for you. It will cover briefly the role and importance of nutrition in critically illness, the assessment of route of feeding and the evidence in relation to energy and protein requirements and how this relates to a nutrition prescription in clinical practice. This session will also highlight some key papers, which will provide a greater understand of critical care nutrition if you are interested in doing further reading on this topic. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
A summary of the ABCDEF bundle - what are the components, how is it implemented and what are the impacts? Learning objectives for this talk: Introduction of SCCM's ICU liberation bundle Understanding of post intensive care syndrome (PICS) Review of the benefits of ICU liberation bundle implementation To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Evidence supports those errors and poor quality are often the result of faulty system or processes versus individual behavior and are impacted by the work culture. Critical care nurses and the multidisciplinary unit team is in an excellent position to lead, participate and design the necessary changes required in their unit to meet the patient safety and quality. As nurses, the largest group of professionals within a unit environment, we must accept responsibility for the work cultures we create. Organizational structure and unit culture will shape clinical practice and determines whether we will be successful at creating a culture of safety. How do we create a value change and develop an environment that fosters professional growth and enthusiasm towards change, reduction of error and quality improvement? This session will focus on outlining the problem and discussing front-line strategies to enhance nurses feeling of personal power, teamwork, communication, and professional ownership in shaping a safe and quality focused culture. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The lecture on “Recognition of the Deteriorating Child” presents a systematic method for the clinical assessment of the paediatric patient. The systematic approach highlights the difference between paediatric and adult assessment due to the difference in paediatric physiology. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This presentation discusses the effect of muscle wasting on recovery in survivors of critical illness and presents the potential role that nutrition may play in attenuating this muscle loss. Literature on nutrition delivery and muscle mass or functional outcomes will be presented, and the potential implications on clinical practice discussed. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
As technology and medicine progresses so do our options for care. But how does doing ‘what we can' impact the ‘doing what is right'? How often do pressures related to the job cause us to act in ways that are inconsistent with our ethical values? How does that impact us and what can we do to minimise its effect? To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Principles, Hardware and Troubleshooting This talk discusses the following: Simple electric circuit: Pacemaker, connecting cables, pacing lead If 'pacing' light flashing but no spikes: It's a connection issue Fixed by restoring circuit: -Check connections -Replace bridging cable -Convert to unipolar -Replace lead To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This talk is about the most important aspects of resilience building in critical clinicians. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Sepsis affects over 30 million people worldwide every year with high morbidity and mortality. Knowledge of the best evidence-based practice for sepsis care is crucial for all healthcare professionals. The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock were recently updated in 2021 with 93 recommendations for practice in 6 categories. This talk will review the background of the Surviving Sepsis Campaign and their goal in decreasing sepsis mortality. Along with a brief discussion of the recent 2021 guideline methodology, the recommendations most directly relevant to nursing practice will be outlined. Additional resources to sepsis care will also be provided. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Ischemic cardiogenic shock is a highly fatal diagnosis, and patient outcomes are associated with early recognition and prioritized evidence-based management. This presentation will review the risk factors and pathophysiology, highlight the diagnostic approach, and discuss the prioritized management of adult patients with ischemic cardiogenic shock. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This talk gives a brief overview of potential PK/PD changes in a critically ill patient, assessing patients for pain and reviewing sedation. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The integration of palliative care into the care of people with serious illnesses and injuries has been associated with an array of improved outcomes for patients and their family members. Incorporating palliative care into the critical care context is a relatively nascent approach but one that has been shown to contribute to better outcomes for patients who require critical care. This presentation will review the evolving role of palliative care in the ICU. To watch the lecture, and learn more about the speaker, visit https://www.continulus.com
The nurse practitioner is an internationally recognised Advanced Practice Nurse role. Globally, NPs have been providing care in a range of specialities since the 1960s but the role is still uncommon in adult Intensive Care Units (ICU). This presentation discusses the nurse practitioner role, why the model works well in adult ICUs and a structured approach to determining the need, plan, implementation and evaluation of the role. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Critical illness can be a traumatic experience and impact the long-term outcomes of ICU survivors and their family caregivers. This talk focuses on the outcomes of family caregivers and provides clinical practice strategies to improve the family experience in the ICU and beyond. We also offer future directions for research, practice and policy. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This presentation aims to broaden understanding of the evidence base around staffing in ICU and what it means in practice. It touches on the broader safe staffing evidence base, the literature specific to ICU, including recent research. It looks at how evidence is measured, and some of the key tools and methods and briefly looks at surge planning, consequences for ICU nursing staff. Some important considerations and areas of focus for improvement are outlined for individual nurses and managers in charge of ICUs. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Gastrointestinal dysfunction occurs in up to 60% of intensive care patients and almost 20% suffer from three or more gastrointestinal symptoms. Persistent GDF in this setting results in the enteral feed delivery of less than half of the estimated caloric requirement in these patients putting them at risk of hospital-acquired acute malnutrition and adverse complications including organ failure. The role of the gut in the genesis of organ failure has been recognised for decades. Gut injury occurs in many intensive care patients, where splanchnic vasoconstriction is present to maintain perfusion of heart, lungs, kidney, liver and brain. The intestine is extremely sensitive to ischaemia, and this results in hyperinflammatory response secondary to gut hypoperfusion leading to mucosal atrophy, increase in intestinal permeability, bacterial overgrowth and translocation. This prioritisation of blood flow away from the gut has consequences. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
It has been widely reported that research takes on average 17 years to be incorporated into routine clinical practice. Sadly, only about half of that research reaches widespread clinical usage. Shortening the interval would increase the translation rate of scientific advancements into health care improvements. This presentation will review the pipeline for research translation to improve health, differentiate implementation science from other implementation activities, identify different approaches for implementation in critical care, and lastly, to identify competencies and strategies to enhance knowledge translation. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This podcast will explain the serious problem of intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in the critically ill patient. At least 50% of critically ill patients have it. It has been identified as a cause of morbidity and mortality for our patients. Much has been written as to the medical and surgical treatment of this issue. This presentation will identify specific independent nursing interventions that can be done to diminish the effects of IAH and ACS. This talk is based on the international guidelines of the Abdominal Compartment Society (WSACS.org). To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
This podcast will provide the participant with an overview of clinical ethics principles, how to apply those principles and information important in caring for a patient at end of life. We will discuss a clinical ethics model that assists in gathering information so that clinicians can help patients and their family to make fully informed decisions regarding treatment. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Vasoactive medications, including inotropes and vasopressors, are used in the treatment of various shock states. Understanding the hemodynamic impact of shock on cardiac output, preload and afterload is important to identify the role of vasoactive medications. Through adrenergic and non-adrenergic mechanisms, inotropes increase myocardial contractility while vasopressors cause vasoconstriction of vascular smooth muscle. Studies evaluating vasopressors in shock have identified norepinephrine as a first-line therapy, especially in patients with septic shock. Vasoactive medication selection should be driven by the patient's presentation to achieve the desired hemodynamic effects while minimizing adverse effects. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
The presentation focuses on critical care nurse competence. Competence as a concept is defined in general and in critical care nursing specifically. The importance of examining competence from both patients' and nurses' perspectives is highlighted. Some examples of competency standards and frameworks, and their utilisation in clinical practice are presented. The role of experiential learning and future trends in competence development are discussed. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Sepsis impacts over 1.7 million Americans each year resulting in over 270,000 deaths (a death every 2 minutes). According to a Centers for Disease Control and Prevention (CDC) study, as many as 87% of sepsis cases begin outside of the hospital, so early identification and treatment in the post-acute setting is key to reducing morbidity and mortality in this population. Healthcare personnel in skilled nursing facilities play a significant role in early identification and treatment of sepsis. This presentation will overview sepsis, its pathophysiology, signs and symptoms and treatment within the context of skilled nursing and long term care (LTC). It will outline an early identification and treatment process for sepsis and how to incorporate it into usual work processes including communication strategies to providers that focus on action. Strategies for patient and family education will also be reviewed. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com
Critically ill patients experience poor quality sleep including frequent awakenings and little restorative sleep. This talk outlines the specific characteristics of sleep during critical illness. Practical strategies and interventions to ameliorate the effect of the environment and ICU treatments are suggested.
As preceptors integrate neuroleadership principles of Dr. David Rock's SCARF framework, intentional storytelling, and crisis resource management concepts into communication with students and fellow co-workers, learning culture is enhanced. As preceptors engage in this style of communication and support, they can improve retention and recruitment, promote psychological safety with students and fellow staff, and create an environment people want to work in. Practical examples for how to do this are provided to guide preceptor development. This ultimately translates into better working environments for staff and patients and families benefit in their outcomes and experience.
This presentation will briefly highlight some of the problems with the current ICU environment, and the impact this has on patients and staff. Some potential future design and technological improvements that are likely to be available in the near future for ICU staff to help improve patient care and support staff in delivering best care will be briefly discussed.
This lecture describes the problem of Post Intensive Care Syndrome (PICS), and how early rehabilitation in the ICU can begin to address this. Part 2 of this talk will focus on how to create a culture of rehabilitation in our ICUs, and real examples of translating the theory into practice will be presented to encourage interactive discussion.
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