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ForwardSICU Fall Education Day
Target Audience
RN only
Learning Objectives
Participants will be able to:
1. describe two modifiable precipitating factors related to delirium.
2. state three interventions to manage delirium for the post-surgical patient in the ICU setting.
3. describe the post-intensive care syndrome (PICS)
4. describe the challenges patients and their families face after surviving critical illness.
5. describe at least 2 interventions or actions that can be taken to improve sepsis compliance.
6. describe at least 2 interventions or actions that can decrease patient mortality.
7. compare the Surviving Sepsis Campaign and CMS recommendations for antimicrobial administration.
8. describe the most common causative organisms by site of infection and antibiotic spectrums of activity.
9. review IV compatibility and prioritize antimicrobials according to most optimal order of administration.
Agenda and outline attached in application. Here is a copy of the outline.
I. Causes of delirium
A. Predisposing factors
B. Precipitating factors
II. Symptoms
A. Environmental
B. Cognitive
C. Behavioral
D. Emotional
III. Impact of delirium
IV. Preventing and/or tx delirium in ICU.
A. Adapting the environment: decreasing noise; maximizing sleep without interruption
B. Medications
1. Minimizing meds that contribute to delirium
2. Meds used to prevent or tx delirium
C. Nonpharmacological interventions
1. Assessment
2. Pain management
3. Spontaneous awakening trials
4. Spontaneous breathing trials
5. Mobility
6. Family engagement
7. Environmental interventions
V. Case Study
Post-Intensive Care Syndrome (PICS)
I. Post-intensive care syndrome (PICS) – what is it?
II. Effects of PICS
A. Unplanned early or late hospital readmission
B. New and/or worsening chronic illnesses
C. Post-ICU mortality
D. COVID-19 survivor considerations
III. Approaches to caring for patients with PICS
A. ICU aftercare
B. Goal-concordant care in ICU survivors
I. Scope of the problem – current deficits in implementation of the sepsis bundle
II. Using CALF as a reminder for the main parts of the sepsis bundle
A. C = Culture sent – need to be correct and timely
B. A = Antibiotics – be sure they are after the cultures
C. L = Lactate –timing, possible need for 2nd level
D. F = Fluids – when to give, how much to give
III. Biomarkers in sepsis
IV. More on use of fluids in sepsis
V. Nursing considerations for antibiotics for sepsis
I. Culture and source control
A. Common causative organisms
B. Common sites of infection
II. Antibiotic selection
A. CMS and other recommendations
B. Antibiotic spectrums of activity
III. Antibiotic administration
A. CMS guidelines for administration
B. Optimal order of administration of multiple antibiotics
C. Compatibility of antibiotics
IV. Duration of therapy
V. De-escalation of therapy
1. Brad Butcher, MD
Physician, and medical director of the Med/Surg ICU at UPMC Mercy
2. Tammy L. Eaton, MSN, FNP-BC, ACHPN
Nurse Practitioner in the UPMC Department of Critical Care Medicine
3. Nancy Miller, MSN, RN, ONC
Clinical Education Specialist and Advanced Practice Nurse in the areas of Pain and Behavioral Health in the UPMC Shadyside Department of Nursing Education and Research
4. Michael Trisler, PharmD, MPH, BCIDP
Infectious Disease Clinical Pharmacist at UPMC Shadyside
5. Rebecca Weiss, DNP, RN, NPS-BC, CEN CCRN-K
Programmatic Nurse Specialist for the UPMC Shadyside Department of Nursing Education and Research
In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Available Credit
- 4.00 ANCCUPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
- 4.00 Attendance