Cindy Bauer – Acute Care & ICU Rehab: Strategies for the Medically Complex Patient

Outline

PHYSIOLOGICAL CHANGES IN ACUTE CARE

• Effects of immobility on organ systems
  • Respiratory
  • Cardiac
  • Digestive
  • Musculoskeletal
  • Early and aggressive mobilization and intervention

ENSURING SAFE AND SUCCESSFUL TRANSFERS AND MOBILITY FOR ANY PATIENT

• Decision-making process
• Weight-bearing restriction mobilization
• Specific mobility restrictions
  • Pulmonary embolism
  • Deep vein thrombosis
• Mobilization management
  • Chest tubes
  • Arterial lines
  • IV management

ICU/IMC SPECIFIC MANAGEMENT

• Fecal management systems
• Various catheter types

ADVANCED TREATMENT INTERVENTIONS FOR IMPROVED OUTCOMES

• Orthopedic interventions
  • Orthopedically complex patient
  • Cutting-edge interventions
• Transitioning to same day ortho discharge
• Shorter length of stay with improved outcomes
  • Transfer considerations
• Alternative techniques for NWB
• Transfers for all WB restrictions
• Burn injury across the lifespan
  • Types and degree of burn injury
  • Burn management and surgical interventions
  • Current trends in therapeutic burn intervention
• Cardiac diagnoses
  • Cardiac surgery and appropriate therapeutic progression
  • Sternal precautions
  • Implementation of strength training
• Neurological emergencies and trends in intervention
  • tPA administration and impact on therapeutic intervention
  • Management of the severe stroke
  • Patients with brief neurological deficits
• Respiratory compromised patient
  • High-flow oxygen management
  • COPD
  • Fresh take on energy conservation techniques

INTERVENTIONS FOR PATIENTS WITH COGNITIVE/PSYCHIATRIC DIAGNOSES

• Addressing the behaviorally challenging patient
  • TBI
  • Dementia
  • Aggression
• Motivation of the chronically-refusing patient
• Major depression and its impact on therapeutic intervention

OUTCOME EXPECTATIONS AND GOAL CONSIDERATIONS

• Short-term vs. long-term goal implementation
• Timing of PT/OTR reassessments
• Predicting the future
  • Appropriate goal development

CREATING AN EFFECTIVE AND SUCCESSFUL DISCHARGE PLAN

• Importance of an interdisciplinary approach
• Pros/cons of sub-acute, home health, and other discharge destinations

CARING FOR THE CAREGIVER

• Client-centered practice and inclusion of the patient’s support system
• Managing the challenging family/caregiver

BILLING AND DOCUMENTATION

• Effective and successful documentation during acute and post-acute stay
• Documenting progression in patients with limited function
• Understanding G codes, payment, and billing

ACHIEVING PRODUCTIVITY

• History of productivity requirements and their necessity
• Current trends in productivity expectations