Kirsten Davin – 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

Ensure 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 tends 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
• 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

Create 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
• Manage the challenging family/caregiver

Billing And Documentation

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

Achieve Productivity

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