A multi-disciplinary approach to critical care for adults
Dale Needham, M.D. Intro to AMP-ICU
IMPROVING OUTCOMES
The AMP Adult ICU Early Rehabilitation program is an evidence-based, multi-disciplinary intervention that has been proven safe for ICU patients, even those requiring endotracheal tubes, continuous hemodialysis and femoral catheters. The program’s goal is to reduce deep sedation and get patients mobilized and engaged in functional activities. When early intervention is started within a few days of initiating mechanical ventilation, patients experience less hospital-acquired impairments, have shorter length of stay, and are more often discharged to their home rather than to a skilled nursing or rehabilitation facility. Follow @icurehab.Sign up for ICU Rehab monthly emails
AMP-ICU TOOLS AND RESOURCES
Physical Therapy and Occupational Therapy ICU Competencies ($495)
Competency materials utilized at Johns Hopkins Physical Medicine and Rehabilitation to train physical and occupational therapists in adult ICU rehabilitation
This 7-module competency presentation is designed to provide the core skills required to safely and professionally develop and perform a physical therapy and occupational therapy plan of care for the critically ill patient. Competency quiz and skills check-off are also included.
The 7 competency modules include:
Introduction to ICU Rehabilitation: Discusses the consequences of immobility and ICU-acquired weakness and the benefits of early activity and rehabilitation
Understanding ICU Equipment: Details common types of ICU equipment and how to utilize equipment to mobilize patients
Oxygen Delivery Systems: Reviews the basics of PaO2 vs. SaO2 and identifies common supplemental oxygen – low flow systems
Understanding Mechanical Ventilation: Identifies types of airways, common modes of ventilation, and possible complications associated with mechanical ventilation
ICU Lab Values: Discusses lab values relevant to ICU patients
ICU Delirium: Discusses how to define, assess, prevent and manage patients with delirium
Optimal Assessment and Treatment Planning: Discusses the development of an optimal treatment plan for patients in the ICU. Also included: Suggested Diagnoses and Disease Processes
$495 per hospital (1-4 Hospitals), $395 per hospital (5+ Hospitals)
Critical Care Physical Medicine and Rehabilitation Quality Assurance Toolkit ($49)
A collection of quality assurance forms, trackers and calculators used at Johns Hopkins. The toolkit is designed to efficiently monitor and evaluate physical rehabilitation and cognitive evaluations and interventions in the ICU, inclusive of physical therapy, occupational therapy intervention and delirium assessment.
Safety guidelines for physical therapy (PT) referrals
A system to track barriers to PT and OT implementation
A system to log PT and OT treatments and potential safety issues during a therapy session
A system to track data quality and training and quality assurance of assessors conducting sedation and delirium assessments, using the validated and recommended RASS and CAM-ICU instruments
Sedation, delirium and sleep (for physicians, nurses)
• ICU Sleep Checklist and 4 supporting studies
• Pocket Card: Sample sedation protocol for ICU patients
• Guidance for improving tolerance of endotracheal tube in awake patients
Mobility and rehabilitation guidelines and logbooks (for therapists, physicians, nurses)
• Pocket Card: Safety guidelines for PT/OT referrals
• Monitoring system for safety events & physiological changes
• Use of iPads and apps by occupational therapists in an ICU
• Patient Mobilization Attitudes & Beliefs Survey for the ICU
• Scoring instructions for Patient Mobilization Attitudes & Beliefs Survey
Finance/budgeting/administration (for ICU leaders, therapists, physicians, nurses)
• Customizable Excel financial analysis model to support ICU Rehabilitation, with a user’s guide
For 130 years, Johns Hopkins Hospital has led the way in both biomedical discovery and health care, establishing the standard by which others follow and build upon. This is one of many faculty-developed programs, protocols and services provided by Johns Hopkins HealthCare Solutions to improve health outcomes and reduce the cost of care.
Contact us to learn more about this solution and how it can benefit your organization.
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