Keeping a Client at Home and Out of ICU/ED Predictably After 30 ED Admissions Within 8 Months

https://intensivecareathome.com/keeping-a-client-at-home-and-out-of-icu-ed-predictably-after-30-ed-emergency-department-admissions-within-8-months/

Keeping a Client at Home and Out of ICU/ED Predictably After 30 ED Admissions Within 8 Months

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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 at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home. Otherwise, medically complex adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions, as well as home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management, and we also provide palliative care services at home.

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully for the Western Sydney Local Area Health District. Their in-touch program saving $2,000 per ED bypass service.

Basically, we send critical care nurses into the home for a client or into residential aged care and providing emergency department bypass services. They’re saving $2,000 and keeping a client at home, which is what the clients want.

Now today, I actually want to talk about a client that we’re currently looking after, just like in my introduction, I say we are predominantly specialized on long-term ventilation with tracheostomy at home requiring critical care nurses, 24 hours a day. We basically provide a genuine alternative to a long-term stay in intensive care and we’re providing an intensive care bed in the community.

Lately, we’ve been working with a client who’s not quite fitting our criteria, but I also want to show why critical care nurses, once again, keep patients out of the emergency department by even providing 24 hour a day nursing care. Once again, saving the healthcare system $2,000 per bed day and potentially even more by providing 24-hour nursing care at home with critical care nurses.

So, here’s the case, a man in his 50s with an acquired brain injury after a motor vehicle accident has had about 20 to 30 emergency department admissions between August 2024 going back as far as November 2023. So, the time of this recording here is around the 11th of October 2024.

So, the client had numerous emergency department admissions often ending in lengthy hospital admissions, not in ICU but on medical ward, and the majority of the hospital admissions were triggered by hyponatremia, which means low sodium, which is a sign of too much water on board, fluid overloaded, and also the setting of aspiration pneumonia, and the setting of seizures with a known history of epilepsy.

Furthermore, this particular client also has a PEG (Percutaneous Endoscopic Gastrostomy) tube, and the client is known to pull out his PEG tube every so often because he can’t control it, and that’s also why he ended up very often in ED.

Now, this client has been looked after by 24-hour support workers and they’re doing a marvelous job trying to keep him home but they’re simply not skilled enough to keep him home predictably.

Continue reading at: https://intensivecareathome.com/keeping-a-client-at-home-and-out-of-icu-ed-predictably-after-30-ed-emergency-department-admissions-within-8-months/