Emerging Trends in Critical Care Nursing

1. EMERGING TRENDS IN ICU
MANAGEMENT.
PRESENTED BY:
PROF.VIJAYREDDY VANDALI
PHD SCHOLAR, M.SC(N).PGCDE,MIPHA,.
DEPT OF MEDICAL-SURGICAL NURSING
INDIA

2. INTRODUCTION
• Critical care is one of the most challenging and important
areas of healthcare. Nurses, doctors, and researchers are
constantly looking for new ways to improve patient care,
worker safety, and efficiency in critical care units like the ICU.
• In the past two decades, there has been tremendous growth of
intensive care medicine in India. However, there are scant data
on the organizational aspects, case mix and practice patterns in
Indian Intensive Care Units (ICUs). Most of the available
information comes from either single-center studies or studies
in specific groups of patients or conditions It is essential to
have data from several Indian ICUs to reflect the vast and
diverse spectrum of critical care illness, services, and
practices.

3. • In 1854, Florence Nightingale left for
the Crimean war, where triage was used to
separate seriously wounded soldiers from the
non-life-threatening conditions. Until recently,
it was reported that Nightingale reduced
mortality from 40% to 2% on the battlefield.

4. INDIAN SCENARIO
• The first ICU in India was actually a coronary
care unit, started in 1968 at the King Edward
VII Memorial Hospital, Mumbai, followed by
another one at the Breach Candy
Hospital. Since then, intensive care has grown
into a specialty in its own right.

5. Rapid growth
Today, the ICUs comprise up to 10% of all
hospital beds and consume as much as 25–
30% of hospital resources. In India, critical
care beds account for 5–8% of the total bed
strength in large public teaching hospitals

6. DEFINITION of ICU
• ICU: Intensive care unit. The intensive care
unit is a designated area of a hospital facility
that is dedicated to the care of patients who are
seriously ill.

7. There are many different conditions and situations
that can mean someone needs intensive care.
• A serious accident – such as a road accident, a severe
head injury, a serious fall or severe burns
• A serious short-term condition – such as a heart
attack or a stroke
• A serious infection – such as sepsis (blood poisoning)
or severe pneumonia
• Major surgery – this can either be a planned part of
your recovery, or an emergency measure if there are
complications

8. EQUIPMENT THAT MAY BE USED ON AN
ICU INCLUDES:
• Ventilator – a machine that helps with breathing; a tube is placed in the
mouth, nose, or through a small cut in the throat.
• Monitoring equipment – used to measure important bodily functions,
such as heart rate, blood pressure and the level of oxygen in the blood
• IV lines and pumps – tubes inserted into a vein (intravenously) to provide
fluids, nutrition and medication
• Feeding tubes – tubes placed in the nose, through a small cut made in the
tummy, or into a vein if a person is unable to eat normally
• Drains and catheters – drains are tubes used to remove any build-up of
blood or fluid from the body; catheters are thin tubes inserted into the
bladder to drain urine

11. TYPES OF ICUs
• Neonatal intensive care unit (NICU).
• Pediatric intensive care unit (PICU).
• Psychiatric intensive care unit (PICU).
• Coronary care unit (CCU):
• Neurological intensive care unit
• Intensive care unit(ICU).
• Post-anesthesia care unit (PACU):
• High dependency unit (HDU):
• Surgical intensive care unit (SICU) etc…

12. STAFFING
• Medical staffing, including a director, with
sufficient experience to provide for patient
care, administration, teaching, research, audit,
outreach….
• Nursing staff: Australian College of Critical
Care Nurses requires 1:1 for ventilated patients
and 1:2 for lower acuity patients. Nurse in
charge with post registration ICU qualification
• Allied health and ancillary staff

13. INTENSIVE CARE UNIT MODELS
• OPEN INTENSIVE CARE UNIT MODEL
This is an ICU in which patients are admitted under the
care of an internist, family physician, surgeon, or any
other primary attending physician, with the intensivists
being available to provide their expertise via elective
consultation. Intensivists may play a de facto primary
role in the management of some patients, but only
within the discretion of the admitting physician, and
have no overreaching authority over patient care.
•

14. CLOSED INTENSIVE CARE UNIT MODEL
• In a closed model ICU, all patients admitted to the ICU
are cared for by an intensivist-led team that is
responsible for making clinical decisions. The
admissions and discharges are controlled by an on-site
ICU physician in most closed ICU models. Because
most ICU patients have similar problems, regardless of
the reason for their critical illness, it is believed that
management by a team of specially qualified intensive
care physicians and nurses provides patients with better
care and is associated with improved outcomes with a
more efficient use of ICU resources.

15. EMERGING TRENDS IN ICU
1.Caring for a Child in Adult ICU
Although not as common in many hospitals, there are
circumstances where a child ends up in the adult ICU. In
these cases, the nursing staff has to make adjustments
from the protocols they commonly use to protocols that
are better suited for children.
• The two specific scenarios up for discussion are based
around a couple of the most common cases – a 12-year-
old head trauma child and a two-year-old child with
respiratory failure.

16. 2.Manual Hyperinflation
Manual hyperinflation is a useful maneuver that
nurses can apply to mimic a cough in the patient,
which mobilizes secretions for removal and clears the
airway. However, this technique comes with potential
side effects, and more research is required to
determine the benefits for critically ill intubated and
mechanically ventilated patients.

17. 3.Using Better Tools in the ICU
In addition to improving techniques, another growing trend is
the use of better tools in the ICU. New innovative
equipment improves safety for patients and practitioners, as
well as improving the quality of care patients receive.
As the leading stopcock provider in the US and Europe, Elcam
Medical continues to strive for better critical care by
creating better tools such as the Marvelous Stopcock.
Research shows that the Marvelous Stopcock improves
patient and worker safety with its unique design.
•

18. CURRENT TRENDS IN CRITICAL CARE
NURSING
• Continue your critical care nursing education
• Knowledge update regularly
• Adopt latest technology
• Critical care nurses will need to keep pace with
the latest information and develop skills to
manage new treatment methods and technologies.

19. FUTURE OF CRITICAL CARE NURSING :
Rapid advances in healthcare and technology have
contributed to keeping more people out of the hospital.
Many patients in today's critical care units would not have
survived in the past. It has been proposed that hospitals of
the future will be large critical care units, and other types of
care will be provided in alternative locations or at home.
Critical care nurses will need to keep pace with the latest
information and develop skills to manage new treatment
methods and technologies. As issues relating to patient care
become increasingly complex and new technologies and
treatments are introduced, critical care nurses will need to
become ever more knowledgeable.

20. • CONCLUSION : Critical Care Nursing has reached
an all time height in its advances in technology and in
caring based on scientific basis during the last two
decades. Critical Care Nurses provide care to restore
health, alleviate pain and suffering, preserve and
uphold the rights and dignity of the individuals.
Finally, the critical care nurses at all time must strive
for updating their knowledge continuously through all
the resources available to make themselves capable of
meeting diversified challenges which they come
across in their day-today practice.

21. THANK YOU