Forcing My Dad Out of ICU with Tracheostomy, Can He Go Home Instead?

https://intensivecareathome.com/forcing-my-dad-out-of-icu-with-tracheostomy-can-he-go-home-instead/

Forcing My Dad Out of ICU with Tracheostomy, Can He Go Home Instead?

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Hi, it’s Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term, ventilated adults and children with tracheostomies, medically complex patients at home including Home TPN, Home IV potassium infusions, Home BIPAP (bilevel positive airway pressure), Home CPAP (continuous positive airway pressure) ventilation as well as IV antibiotics. We are also providing services for adults and children at home with tracheostomies that are not ventilator- dependent. We also provide port management, central line management, PICC (peripherally inserted central catheter) line management as well as Hickman’s line management, as well as palliative care.

Now, in today’s blog, I want to answer a question from one of our readers who says,

Hi Patrik,

They are forcing my dad out of ICU with the tracheostomy. Is this safe?

Well, that’s a great question and that is from Anne Marie. And Anne Marie, that is a great question and I argue it’s not safe. It’s sort of what hospitals do. It’s the one size fits all and we know that people are different and people don’t fit a one size fits all profile and hospitals have created pathways for people that often don’t work, and that have shown not to work.

So, if you are sick of being in hospital with your dad, you should be looking at Intensive Care at Home. I tell you why it’s not safe going from ICU to a hospital ward or a hospital floor. It’s quite frankly, on a hospital ward or on a hospital floor, he will end up in a bed and he won’t have the ICU nurse that he inevitably needs with the tracheostomy. He’ll end up on a nurse to patient ratio of 1:5, maybe 1:10, even, definitely 1:10 overnight. It’s probably going to be very unsafe very quickly.

And here is the evidence for why I am saying that, if you look on our website at intensivecareathome.com, you will find a section that the Mechanical Home Ventilation Guidelines, which are evidence-based. In the mechanical home ventilation guidelines, you will find that when patients go home with the tracheostomy, they need to have 1:1 nurse to patient ratio with critical care nurses 24 hours a day. And those critical care nurses need to have a minimum of two years’ critical care nursing experience.

And I can tell you that you won’t get that on the hospital ward or on the hospital floor with the tracheostomy therefore, it is like you said, they are forcing your dad out without providing evidence-based care. And the reality is that people have died because of no critical care nurse is looking after tracheostomy clients. And this is exactly what’s happening here.

Case in point, we have had clients at home with the tracheostomy and or ventilation, that needed 24-hour nursing care with critical care nurses with a minimum of two years, critical care nursing experience as documented and evidenced in the mechanical home ventilation guidelines and they died during times when critical care nurses were not present due to lack of funding.

So for example, we looked after clients at home that were only funded for critical care nurses overnight, but weren’t funded during the day and then family members or support workers, that with all respect might have worked in the supermarket last week. Now all of a sudden look after an ICU patient with the difference that they’re at home. And of course, that’s a disaster waiting to happen.

Continuation...
https://intensivecareathome.com/forcing-my-dad-out-of-icu-with-tracheostomy-can-he-go-home-instead/