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Nurse FAQs
Follow the links below to navigate directly to specific questions.
- How can the sickest patients in the hospital be cared for virtually?
- Who does procedures/emergency procedures if they are needed?
- What about patient privacy?
- How does the Advanced ICU Care program affect the way bedside nurses take care of their patients?
- Who staffs Advanced ICU Care's monitoring facility?
- As a bedside nurse, who do I call first if I have a problem?
- How do x-rays get to the eICU facility?
- How much time does it take for nurses to document in eCareManager®?
- Will the Advanced ICU Care program affect nursing-to-patient ratios?
- How do attending physicians coordinate with the eICU team?
- What has been the feedback from the ICU nurses?
- How is the house staff supported by this program?
How can the sickest patients in the hospital be cared for virtually?
Virtual care of intensive care unit (ICU) patients using virtual eICU® technology adheres to the highest standards for quality care. ICU patients are cared for quite effectively in this manner. Clinical decisions in the ICU are often based on a large and continuous stream of data (physiologic, laboratory, radiographic, etc) and these data can be communicated electronically in real time. Informed caregivers can then perform the cognitive decision-making remotely. Virtual management of ICU patients has been evaluated in two clinical studies, both demonstrating a 25 percent to 30 percent reduction in
hospital mortality for ICU patients.1
1Rosenfeld et al: ICU Telemedicine - An Alternate Paradigm for providing Continuous Intensive Care. Critical Care Medicine.2000;28;3925-3931. Breslow et al: The Effect of a multi-Site ICU Telemedicine Program on Clinical and Economic Outcomes: An Alternative Paradigm for Intensivist Staffing " accepted for publication in Critical Care Medicine.
Who does procedures/emergency procedures if they are needed?
All hospitals have processes in place to deal with common emergency procedures. These include dedicated in-house personnel (physician assistants, critical care nurse practitioners, house physicians, hospitalists, anesthesiology personnel, and emergency department physicians) or specialty physicians on call from home (cardiologist for pacemaker, etc.). These processes remain in place, except that the call for the procedure would likely be initiated by the eICU intensivist, after discussion with the attending physician. If surgical evaluation is required, the virtual eICU® intensivist contacts the surgeon requested by the attending physician. AICU Care's intensivists coordinate these activities, maintaining the nurse at the bedside.
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What about patient privacy?
Patient information is secure and confidential. The technology provides the highest level of electronic data security and meets the latest security and privacy recommendations of the federal government (HIPAA). While there is a camera, speaker and microphone in each room, this communication system is only activated by request from the bedside nurse or during prescribed "virtual rounds." It is readily apparent when the camera is activated (it moves from pointing at the wall to pointing at the patient's bed) and an audio signal is used to alert the nurse who may be in the patient's room. There is no capability for recording video or audio and patient privacy is respected when virtual rounds are required.
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How does the Advanced ICU Careprogram affect the way bedside nurses take care of their patients?
The Advanced ICU Care program helps nurses provide better patient care and reduces situations of fear and conflict. Nurses have a specialist available with immediate access to them, their patients and their charts and records. Nurses no longer need to find the right doctor on call, wake them up, or wait for them to return a page. With the program, nurses can reach the eICU doctor immediately.
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Who staffs Advanced ICU's monitoring facility?
The Advanced ICU Care Monitoring Center is staffed by on-site board-certified intensivist physicians (all part of a single specialty practice), critical care nurses, and health care assistants. Our critical care nurses have an average of 20 years of critical care experience. Our intensivists are fellowship-trained and board-certified.
As a bedside nurse, who should I call first if I have a problem?
Bedside nurses should call the monitoring center and the AICU Care physician will call the attending of record or the appropriate consultant to discuss any issues. This effectively gives the bedside nurse "one stop shopping" and removes the confusion of who to call, the fear of calling, or the interrogation that can follow. If house staff is covering the patient and they are assigned in the unit, nurses should call them first. If they are not in the unit and the situation is emergent, nurses should call the AICU Care Monitoring Center first and then try to reach the house staff.
How do x-rays get to Advanced ICU Care's clinicians?
If Advanced ICU Care's physician needs to view a patient's x-ray and a PACS system is not available, nurses may be asked to scan the x-ray to the AICU Care Monitoring facility. This requires just one push of a button and the technology does the rest.
How much time does it take for nurses to document in eCareManager®?
eCareManager™ is designed to have little or no impact on nursing workflow. Nurses may be asked to update the patient care plan (one to two minutes per patient), but much of this information is also used to create the nursing sign-out report, which will print in the ICU at change of shift. This sign-out report provides a more accurate and efficient exchange of information to the next shift nurse.
Will the Advanced ICU Care program affect nursing-to-patient ratios?
The Advanced ICU Care program is not designed to replace anyone and in fact it adds a layer of care. Data has shown that reducing nursing-to-patient ratios has negatively impacted patient care. Advanced ICU Care's goal is to help health care systems manage costs through quality improvements, not personnel reductions.
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How do attending physicians coordinate with the Advanced ICU Care team?
Hospital medical staff members choose the level of interaction they want from Advanced ICU Care's intensivists and nurses from two selections below:
FULL INVOLVEMENT The Advanced ICU Care intensivist responds to changes in patient's condition, treats and notifies the attending physician of major changes. | MINIMUM INVOLVEMENT The Advanced ICU Care intensivist only intervenes for life-threatening emergencies and best practices, but contacts the attending physician for all other medical conditions.
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| ICU Best Practices Compliance is baseline for all ICU patients DVT Prophylaxis Stress Ulcer Prophylaxis as indicated Ventilator Associated Pneumonia Prevention Bundle Head of bed assessment Sedation vacation Spontaneous breathing trials Beta blockers in ACS, when not contraindicated Low Tidal Volume Ventilation for ALI Glucose control Sepsis Management Bundle | ||||
What has been the feedback from the ICU nurses?
ICU Nurses at Parkview Noble in Fort Wayne, Ind. shared the following comments. "Parkview Health has a program called 'Recognition of Excellence.' It is designed to recognize anyone in the system for displaying excellent patient care, teamwork, flexibility, and going above and beyond. We girls at Parkview Noble's CCU would like to let all of you know that if you were employees, we would recognize you daily for all your assistance. You are a blessing to have "at our backs" and our patients have benefitted greatly."
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How is the house staff supported by this program?
Advanced ICU Care's intensivists are readily available to provide guidance and consultation to the house staff. The system is designed to support the house staff in learning and implementing best practices for critically ill patients.
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