Full Course Description

Walking Home From the ICU: Regaining Alertness, Orientation, and Mobility

Dr. Dayton, host of the Walking Home from the ICU podcast, provides essential evidence-based recommendations for modernizing mobility practices in the ICU. Discover contemporary approaches to enhance functional outcomes in a complex patient population. Plus, you’ll learn proven interventions to re-stimulate functional – cognition, alertness, orientation, and motor planning.

Program Information

Objectives

Integrate the research on short and long-term outcomes of ICU patients during and after prolonged sedation and immobility.
Develop tools to critically think through the risk and repercussions of sedation and immobility and customize the ABCDEF bundle for each patient.
Exemplify advanced competence to help ICU teams provide evidence-based sedation and mobility practices to their patients.

Outline

History of the Awake and Walking ICU

Brief overview of the history
Patient story/testimonial

Understanding the ABCDEF Bundle

How should it be implemented?
Addressing optimal practices for sedation and mobility
Championing a shared care model
Improving departmental resource utilization
Proven leadership strategies

Modern Evidence-Based Practices in the ICU

Preventing and managing delirium
Preventing and overcoming ICU acquired weakness
Improved outcomes management

Understanding causative conditions such as …

Post-ICU PTSD
Post-ICU dementia
Reconnecting normal – brain activity, cognitive functioning, orientation, sleep, and rem cycles

Reimaging early mobility in the ICU

The inter-organ connection between muscle function and other vital systems
Effect of muscular atrophy on functional performance (i.e., postural control to sit EPB)
- Examples in the CVICU, Neuro, Trauma, ECMO, etc.
Research supporting safety, practicability, and effectiveness of early mobility
Documentation to support patient mobility accomplishments
Championing a multidisciplinary approach

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists

Copyright : 07/18/2023

Innovative Rehab Strategies: Redefining Functional Goals in Acute Care

Working in the ICU setting requires a constantly evolving skillset. When handling trauma and multi-organ involvement – be prepared to make appropriate and safe clinical decisions on the spot.

This session will introduce you to the latest techniques for promoting recovery and regaining function in critically ill patients. PLUS, you’ll learn new treatment approaches to enhance activities of independent daily living (ADLs) such as – dressing, grooming, toileting, AD use, and more.

Program Information

Objectives

State the critical elements of analysis and assessment in mobilizing medically fragile patients.
Develop an appropriate plan of care for patients who present with a critically ill cardiac, neurological and/or respiratory diagnosis.
Demonstrate competency to initiate and progress therapeutic interventions for common diagnoses in the Acute Care setting to improve outcomes and functional independence with occupational tasks such as dressing, grooming, and toileting.

Outline

Introduction to Acute Care

The importance of early and aggressive mobilization and intervention
Effects of immobility on organ systems (respiratory, cardiac, digestive, musculoskeletal systems)

Goal Overview – Big Picture of goals across the spectrum

Advanced Transfers and Mobility – Ensuring Safe and Successful Transfers and Mobility for Any Patient

Decision making process and specific mobility considerations
- Patients with PE (pulmonary embolism), DVT (deep vein thrombosis), etc.
Mobility with multiple lines, wire, tubs (including chest tubes, art lines, IV management, etc.)

Lines, Wires, Tubes and ICU/IMC Management

Management of lines, wire and tubes during intervention and mobility
Vitals interpretation: What does it all mean? HR, BP, PsO2, RR and more!
Addressing the medically fragile patient

Common Diagnosis in the Acute Care Arena – Advanced Rehab Strategies for Improved Outcomes

Orthopedic Intervention Across the Spectrum
- Managing the orthopedically complex patient
- Cutting edge interventions and looking into the future!
- Transfer considerations for the acute care ortho patient
Cardiac Diagnoses
- Cardiac surgery and the progression of therapeutic intervention
- Sternal precautions and the implementation of strength training with surgical cardiac patient
Neurological Emergencies and Trends in Intervention
- tPA administration and its impact on therapeutic intervention
- Management of the severe stroke
- Considerations for the patient with brief neurological deficits
- Thinking outside the box! New methods to achieving improved therapeutic outcomes
The Respiratory Compromised Patient
- Managing a patient with high-flow oxygen during therapeutic intervention
- Consideration for the COPD patient
- A fresh take on energy conservation techniques
Closing, Question and Answer

Copyright : 07/18/2023

Connecting Brain to Body: Early Functional Rehab for Neurological Trauma

Patients who have experienced a stroke, brain injury, or related neurologic event are in a sensitive position in the acute stage of recovery and healing. Doing too much can produce life altering implications, and doing too little can delay recovery and create further barriers in achieving functional independence. Getting the balance right is critical. Join Dr. Benjamin White and discover the latest evidence on early mobilization following a neurological event. Review important Clinical Practice Guidelines and safety considerations when working with this patient population. Unlock effective interventions to enhance neuroplasticity, gait training, balance, coordination, and much more!

Program Information

Objectives

Demonstrate proficiency in managing safety and adequate intensity post stroke in the Intensive Care Unit.
Foster an environment breeding neuroplasticity and early mobilization post stroke within the Intensive Care Unit.
Employ treatment interventions to optimize balance and coordination, reduce fall risk, and enhance return to functional independence and activities of daily living.

Outline

Early Mobilization

Stroke
- Hemorrhagic
- Ischemic
- Early Mobilization Clinical Practice Guidelines
Early Mobility and Intensive Care
- Gait, balance and coordination training
- Range of motion and managing spasticity
Enhancing Functional Independence
- Evidence-based Medicine
- Safety considerations
  - Line Management
  - Vitals
  - Exercise and positional changes on cerebral hemodynamics
Integrating Neuroplasticity
- Clinical assessment and screening
- Dual task training to improve: visual-spatial functioning, proprioception and fatigue
- Implementation and treatment interventions
Neurological Impairments
- Neglect
- Pushing
- Fear
- Anxiety
- Emotional Resistance

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/18/2023

Polypharmacy & Delirium: Impaired Mobility for the Geriatric Patient

Investigate the influence of polypharmacy on the geriatric critically ill patient population. Understand the causative effects on – balance, cognition, fall risks, functional independence, and safety. Explore the impact of drug-to-drug interactions on early mobility, prognosis, and mortality. Reframe your clinical approach to bedside education for patients’ family members, and caregivers. Further evaluate integral components including the body system, delirium, metabolic function, and co-morbidities.

Program Information

Objectives

Analyzing the impact of polypharmacy, drug to drug interactions, and the gap of bedside education on early mobility after critical illness.
Investigate reasons leading to acute delirium and demonstrate reversible causes to integrate in care plans for improved patient outcomes.
Demonstrate an effective interdisciplinary team framework through communication, care plan development, achievable goal planning, and collaborative needs assessments.

Outline

Medical Reconciliation
Recognizing the importance of early identification and deprescribing >

Mobility Impairment
- Assessing Risk versus Benefit when reviewing a patient’s med list
- Determining Achievable Goals
- Reviewing Comorbid Risk Stratification
Reviewing the Most Common Reason for Acute Delirium
Understanding reversible causes for the acute delirious state with specific attention to the ICU climate and role of the ICU team
- Metabolic causes
- Body system review
- Interdisciplinary team Communication
- Integration of Outpatient and Inpatient Needs Assessment
Positive Outcomes
- Creating successful patient care plans
- Continuous evaluations of patient progress

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapy Assistants
Speech Language Pathologists

Copyright : 07/19/2023

Reimagining Speech, Swallowing, and Mobility in Critical Care Settings

Covid presented clear examples of the complications in caring for ventilator supported patients. Acute Care and ICU settings are continually challenged to expedite the stabilization and rehabilitation progression of critically ill patients with acute and chronic tracheostomy/ventilator dependence.

As medical care becomes progressively sophisticated, so should our rehab approach. Join this course and rapidly familiarize yourself with evidence-based diagnostics and rehab interventions surrounding … the restoration of communication and treating related dysphagia following tracheotomization, defining the foundation of establishing an early mobility program, and understanding key factors for the entire team to successfully progress towards extubation/decannulation.

Learn cutting edge skills the entire medical team can utilize to advance rehab outcomes with this complex patient population.

Program Information

Objectives

Outline steps to assess both vent and nonvent dependent patients for speaking valve utilization.
Distinguish three mechanical vent settings for which a speaking valve can be safely used in the tracheotomized patient while recognizing contraindications for placement.
Prepare/Establish the foundation for early mobilization with vented patients including therapy roles, team responsibilities, and rehab strategies for maximizing both patient safety/cotreating opportunities.

Outline

Mechanical ventilation and the application of speaking values

Physiology of utilization, anatomical review
Population and timing
Warning and Precautions
Assessment and placement on vented and non-vented patients
Special considerations when placing valve
- Timing/populations valves are utilized
- Trouble shooting difficult placement

Respiratory intervention related dysphagia

Effect of extubation and tracheostomy upon swallowing physiology
Determining options for informal vs formal assessments of the tracheotomized patient
Rehabilitative effect of speaking valve upon swallowing

Team approach to early mobilization and optimizing patient outcomes

Physical inactivity and mechanical ventilation induced weakness on musculoskeletal function
- ADL performance
- Cognition and motor skills, strength
Early mobility indications/contraindications to safe patient mobilization
>ul>
Vital considerations and vent parameters
Techniques to assist with therapy-induced changes in blood flow

Strategies to gain confidence mobilizing vent/trach dependent patients
Implementing early mobilization protocols

Education on properly setting up trach/vent in preparation for early mobility session
Proper Management of speaking valve/trach during mobility
Responding to adverse symptoms

Shared outcomes of early mobility programming as a team focus

OT/PT facilitation of SLP goals
Recognizing opportunities for co treatments

Copyright : 07/19/2023

The Importance of Positioning, Play and Purpose for Babies and Children In The PICU

When babies and children find themselves in the Pediatric Intensive Care Unit, the tendency can be to ‘allow them to rest to heal.’ While there is truth in this ideal, oftentimes movement and basic activities are actually what can lead them on the path to healing more quickly. Even in illness, kids should be kids and be allowed to express this in different ways. In this session, you will learn the value of these ideas through tangible and experiential case studies.

Program Information

Objectives

Develop understanding of importance and value of early mobility in the PICU.
Demonstrate why play in children must go on, despite illness.
Recognize the side effects of illness and medications and integrate safe therapeutic interventions to promote activity.

Outline

Understanding the PICU environment

Comparative Analysis of the PICU vs Adult ICU to identify similarities and differences
Exploring the type of patients encountered

Interactive Case Studies

Joey R (preschooler)
- 5yo male born with Trisomy 21 h/o CHD s/p complete repair and h/o duodenal reconstruction s/p ladds procedure with h/o small bowel obstruction and multiple abdominal surgeries. A few years had passed since these surgeries. Several days of viral symptoms, lethargy and diarrhea leading to ER. Decompensated within 10 min of arrival in ED, leading to code and CPR, placed on VA-ECMO for cardiac and severe multi-organ failure … lead to long term PICU stay with interventions in mobility and plan.
Barry E (baby)
- Born with DeGeorge Syndrome: this led to repair of CHD, cleft lip palate, consistent pulmonary issues, intestinal issues requiring colostomy bag as well as gtube placement for GI feeding issues … lead long term hospitalization from PICU to stepdown unit. Main interventions were localized around mobility, positioning and basic developmental intervention..
Will S (preschooler)
- 5yo polytrauma s/p MVA, suffered TBI with R subdural hematoma IVH, subarachnoid hemorrhage , skull fx, faial fx, Pulmonary contusion, and several other orthopedic fractures/injuries. Increased social piece to this case as the family happen to be travelling home through our town when the accident occurred, leading to the death of the sibling in our PICU as this patient recovered from TBI.
Katie (6yo)
- 6-year-old born with Prader Willi Syndrome, dx with posterior fossa tumor, s/p resection, extended respiratory needs, leading to longer PICU stay. She was one of best examples of the benefits to early mobility for improved recovery.
Ethics in caregivers in the PICU

Questions

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/19/2023

Walking Home From the ICU: Regaining Alertness, Orientation, and Mobility

Program Information

Objectives

Integrate the research on short and long-term outcomes of ICU patients during and after prolonged sedation and immobility.
Develop tools to critically think through the risk and repercussions of sedation and immobility and customize the ABCDEF bundle for each patient.
Exemplify advanced competence to help ICU teams provide evidence-based sedation and mobility practices to their patients.

Outline

History of the Awake and Walking ICU

Brief overview of the history
Patient story/testimonial

Understanding the ABCDEF Bundle

How should it be implemented?
Addressing optimal practices for sedation and mobility
Championing a shared care model
Improving departmental resource utilization
Proven leadership strategies

Modern Evidence-Based Practices in the ICU

Preventing and managing delirium
Preventing and overcoming ICU acquired weakness
Improved outcomes management

Understanding causative conditions such as …

Post-ICU PTSD
Post-ICU dementia
Reconnecting normal – brain activity, cognitive functioning, orientation, sleep, and rem cycles

Reimaging early mobility in the ICU

The inter-organ connection between muscle function and other vital systems
Effect of muscular atrophy on functional performance (i.e., postural control to sit EPB)
- Examples in the CVICU, Neuro, Trauma, ECMO, etc.
Research supporting safety, practicability, and effectiveness of early mobility
Documentation to support patient mobility accomplishments
Championing a multidisciplinary approach

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists

Copyright : 07/18/2023

Innovative Rehab Strategies: Redefining Functional Goals in Acute Care

Program Information

Objectives

State the critical elements of analysis and assessment in mobilizing medically fragile patients.
Develop an appropriate plan of care for patients who present with a critically ill cardiac, neurological and/or respiratory diagnosis.
Demonstrate competency to initiate and progress therapeutic interventions for common diagnoses in the Acute Care setting to improve outcomes and functional independence with occupational tasks such as dressing, grooming, and toileting.

Outline

Introduction to Acute Care

The importance of early and aggressive mobilization and intervention
Effects of immobility on organ systems (respiratory, cardiac, digestive, musculoskeletal systems)

Goal Overview – Big Picture of goals across the spectrum

Advanced Transfers and Mobility – Ensuring Safe and Successful Transfers and Mobility for Any Patient

Decision making process and specific mobility considerations
- Patients with PE (pulmonary embolism), DVT (deep vein thrombosis), etc.
Mobility with multiple lines, wire, tubs (including chest tubes, art lines, IV management, etc.)

Lines, Wires, Tubes and ICU/IMC Management

Management of lines, wire and tubes during intervention and mobility
Vitals interpretation: What does it all mean? HR, BP, PsO2, RR and more!
Addressing the medically fragile patient

Common Diagnosis in the Acute Care Arena – Advanced Rehab Strategies for Improved Outcomes

Orthopedic Intervention Across the Spectrum
- Managing the orthopedically complex patient
- Cutting edge interventions and looking into the future!
- Transfer considerations for the acute care ortho patient
Cardiac Diagnoses
- Cardiac surgery and the progression of therapeutic intervention
- Sternal precautions and the implementation of strength training with surgical cardiac patient
Neurological Emergencies and Trends in Intervention
- tPA administration and its impact on therapeutic intervention
- Management of the severe stroke
- Considerations for the patient with brief neurological deficits
- Thinking outside the box! New methods to achieving improved therapeutic outcomes
The Respiratory Compromised Patient
- Managing a patient with high-flow oxygen during therapeutic intervention
- Consideration for the COPD patient
- A fresh take on energy conservation techniques
Closing, Question and Answer

Copyright : 07/18/2023

Connecting Brain to Body: Early Functional Rehab for Neurological Trauma

Program Information

Objectives

Demonstrate proficiency in managing safety and adequate intensity post stroke in the Intensive Care Unit.
Foster an environment breeding neuroplasticity and early mobilization post stroke within the Intensive Care Unit.
Employ treatment interventions to optimize balance and coordination, reduce fall risk, and enhance return to functional independence and activities of daily living.

Outline

Early Mobilization

Stroke
- Hemorrhagic
- Ischemic
- Early Mobilization Clinical Practice Guidelines
Early Mobility and Intensive Care
- Gait, balance and coordination training
- Range of motion and managing spasticity
Enhancing Functional Independence
- Evidence-based Medicine
- Safety considerations
  - Line Management
  - Vitals
  - Exercise and positional changes on cerebral hemodynamics
Integrating Neuroplasticity
- Clinical assessment and screening
- Dual task training to improve: visual-spatial functioning, proprioception and fatigue
- Implementation and treatment interventions
Neurological Impairments
- Neglect
- Pushing
- Fear
- Anxiety
- Emotional Resistance

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/18/2023

Polypharmacy & Delirium: Impaired Mobility for the Geriatric Patient

Program Information

Objectives

Analyzing the impact of polypharmacy, drug to drug interactions, and the gap of bedside education on early mobility after critical illness.
Investigate reasons leading to acute delirium and demonstrate reversible causes to integrate in care plans for improved patient outcomes.
Demonstrate an effective interdisciplinary team framework through communication, care plan development, achievable goal planning, and collaborative needs assessments.

Outline

Medical Reconciliation
Recognizing the importance of early identification and deprescribing >

Mobility Impairment
- Assessing Risk versus Benefit when reviewing a patient’s med list
- Determining Achievable Goals
- Reviewing Comorbid Risk Stratification
Reviewing the Most Common Reason for Acute Delirium
Understanding reversible causes for the acute delirious state with specific attention to the ICU climate and role of the ICU team
- Metabolic causes
- Body system review
- Interdisciplinary team Communication
- Integration of Outpatient and Inpatient Needs Assessment
Positive Outcomes
- Creating successful patient care plans
- Continuous evaluations of patient progress

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapy Assistants
Speech Language Pathologists

Copyright : 07/19/2023

Reimagining Speech, Swallowing, and Mobility in Critical Care Settings

Program Information

Objectives

Outline steps to assess both vent and nonvent dependent patients for speaking valve utilization.
Distinguish three mechanical vent settings for which a speaking valve can be safely used in the tracheotomized patient while recognizing contraindications for placement.
Prepare/Establish the foundation for early mobilization with vented patients including therapy roles, team responsibilities, and rehab strategies for maximizing both patient safety/cotreating opportunities.

Outline

Mechanical ventilation and the application of speaking values

Physiology of utilization, anatomical review
Population and timing
Warning and Precautions
Assessment and placement on vented and non-vented patients
Special considerations when placing valve
- Timing/populations valves are utilized
- Trouble shooting difficult placement

Respiratory intervention related dysphagia

Effect of extubation and tracheostomy upon swallowing physiology
Determining options for informal vs formal assessments of the tracheotomized patient
Rehabilitative effect of speaking valve upon swallowing

Team approach to early mobilization and optimizing patient outcomes

Physical inactivity and mechanical ventilation induced weakness on musculoskeletal function
- ADL performance
- Cognition and motor skills, strength
Early mobility indications/contraindications to safe patient mobilization
>ul>
Vital considerations and vent parameters
Techniques to assist with therapy-induced changes in blood flow

Strategies to gain confidence mobilizing vent/trach dependent patients
Implementing early mobilization protocols

Education on properly setting up trach/vent in preparation for early mobility session
Proper Management of speaking valve/trach during mobility
Responding to adverse symptoms

Shared outcomes of early mobility programming as a team focus

OT/PT facilitation of SLP goals
Recognizing opportunities for co treatments

Copyright : 07/19/2023

The Importance of Positioning, Play and Purpose for Babies and Children In The PICU

Program Information

Objectives

Develop understanding of importance and value of early mobility in the PICU.
Demonstrate why play in children must go on, despite illness.
Recognize the side effects of illness and medications and integrate safe therapeutic interventions to promote activity.

Outline

Understanding the PICU environment

Comparative Analysis of the PICU vs Adult ICU to identify similarities and differences
Exploring the type of patients encountered

Interactive Case Studies

Joey R (preschooler)
- 5yo male born with Trisomy 21 h/o CHD s/p complete repair and h/o duodenal reconstruction s/p ladds procedure with h/o small bowel obstruction and multiple abdominal surgeries. A few years had passed since these surgeries. Several days of viral symptoms, lethargy and diarrhea leading to ER. Decompensated within 10 min of arrival in ED, leading to code and CPR, placed on VA-ECMO for cardiac and severe multi-organ failure … lead to long term PICU stay with interventions in mobility and plan.
Barry E (baby)
- Born with DeGeorge Syndrome: this led to repair of CHD, cleft lip palate, consistent pulmonary issues, intestinal issues requiring colostomy bag as well as gtube placement for GI feeding issues … lead long term hospitalization from PICU to stepdown unit. Main interventions were localized around mobility, positioning and basic developmental intervention..
Will S (preschooler)
- 5yo polytrauma s/p MVA, suffered TBI with R subdural hematoma IVH, subarachnoid hemorrhage , skull fx, faial fx, Pulmonary contusion, and several other orthopedic fractures/injuries. Increased social piece to this case as the family happen to be travelling home through our town when the accident occurred, leading to the death of the sibling in our PICU as this patient recovered from TBI.
Katie (6yo)
- 6-year-old born with Prader Willi Syndrome, dx with posterior fossa tumor, s/p resection, extended respiratory needs, leading to longer PICU stay. She was one of best examples of the benefits to early mobility for improved recovery.
Ethics in caregivers in the PICU

Questions

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/19/2023

Walking Home From the ICU: Regaining Alertness, Orientation, and Mobility

Program Information

Objectives

Integrate the research on short and long-term outcomes of ICU patients during and after prolonged sedation and immobility.
Develop tools to critically think through the risk and repercussions of sedation and immobility and customize the ABCDEF bundle for each patient.
Exemplify advanced competence to help ICU teams provide evidence-based sedation and mobility practices to their patients.

Outline

History of the Awake and Walking ICU

Brief overview of the history
Patient story/testimonial

Understanding the ABCDEF Bundle

How should it be implemented?
Addressing optimal practices for sedation and mobility
Championing a shared care model
Improving departmental resource utilization
Proven leadership strategies

Modern Evidence-Based Practices in the ICU

Preventing and managing delirium
Preventing and overcoming ICU acquired weakness
Improved outcomes management

Understanding causative conditions such as …

Post-ICU PTSD
Post-ICU dementia
Reconnecting normal – brain activity, cognitive functioning, orientation, sleep, and rem cycles

Reimaging early mobility in the ICU

The inter-organ connection between muscle function and other vital systems
Effect of muscular atrophy on functional performance (i.e., postural control to sit EPB)
- Examples in the CVICU, Neuro, Trauma, ECMO, etc.
Research supporting safety, practicability, and effectiveness of early mobility
Documentation to support patient mobility accomplishments
Championing a multidisciplinary approach

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists

Copyright : 07/18/2023

Innovative Rehab Strategies: Redefining Functional Goals in Acute Care

Program Information

Objectives

State the critical elements of analysis and assessment in mobilizing medically fragile patients.
Develop an appropriate plan of care for patients who present with a critically ill cardiac, neurological and/or respiratory diagnosis.
Demonstrate competency to initiate and progress therapeutic interventions for common diagnoses in the Acute Care setting to improve outcomes and functional independence with occupational tasks such as dressing, grooming, and toileting.

Outline

Introduction to Acute Care

The importance of early and aggressive mobilization and intervention
Effects of immobility on organ systems (respiratory, cardiac, digestive, musculoskeletal systems)

Goal Overview – Big Picture of goals across the spectrum

Advanced Transfers and Mobility – Ensuring Safe and Successful Transfers and Mobility for Any Patient

Decision making process and specific mobility considerations
- Patients with PE (pulmonary embolism), DVT (deep vein thrombosis), etc.
Mobility with multiple lines, wire, tubs (including chest tubes, art lines, IV management, etc.)

Lines, Wires, Tubes and ICU/IMC Management

Management of lines, wire and tubes during intervention and mobility
Vitals interpretation: What does it all mean? HR, BP, PsO2, RR and more!
Addressing the medically fragile patient

Common Diagnosis in the Acute Care Arena – Advanced Rehab Strategies for Improved Outcomes

Orthopedic Intervention Across the Spectrum
- Managing the orthopedically complex patient
- Cutting edge interventions and looking into the future!
- Transfer considerations for the acute care ortho patient
Cardiac Diagnoses
- Cardiac surgery and the progression of therapeutic intervention
- Sternal precautions and the implementation of strength training with surgical cardiac patient
Neurological Emergencies and Trends in Intervention
- tPA administration and its impact on therapeutic intervention
- Management of the severe stroke
- Considerations for the patient with brief neurological deficits
- Thinking outside the box! New methods to achieving improved therapeutic outcomes
The Respiratory Compromised Patient
- Managing a patient with high-flow oxygen during therapeutic intervention
- Consideration for the COPD patient
- A fresh take on energy conservation techniques
Closing, Question and Answer

Copyright : 07/18/2023

Connecting Brain to Body: Early Functional Rehab for Neurological Trauma

Program Information

Objectives

Demonstrate proficiency in managing safety and adequate intensity post stroke in the Intensive Care Unit.
Foster an environment breeding neuroplasticity and early mobilization post stroke within the Intensive Care Unit.
Employ treatment interventions to optimize balance and coordination, reduce fall risk, and enhance return to functional independence and activities of daily living.

Outline

Early Mobilization

Stroke
- Hemorrhagic
- Ischemic
- Early Mobilization Clinical Practice Guidelines
Early Mobility and Intensive Care
- Gait, balance and coordination training
- Range of motion and managing spasticity
Enhancing Functional Independence
- Evidence-based Medicine
- Safety considerations
  - Line Management
  - Vitals
  - Exercise and positional changes on cerebral hemodynamics
Integrating Neuroplasticity
- Clinical assessment and screening
- Dual task training to improve: visual-spatial functioning, proprioception and fatigue
- Implementation and treatment interventions
Neurological Impairments
- Neglect
- Pushing
- Fear
- Anxiety
- Emotional Resistance

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/18/2023

Polypharmacy & Delirium: Impaired Mobility for the Geriatric Patient

Program Information

Objectives

Analyzing the impact of polypharmacy, drug to drug interactions, and the gap of bedside education on early mobility after critical illness.
Investigate reasons leading to acute delirium and demonstrate reversible causes to integrate in care plans for improved patient outcomes.
Demonstrate an effective interdisciplinary team framework through communication, care plan development, achievable goal planning, and collaborative needs assessments.

Outline

Medical Reconciliation
Recognizing the importance of early identification and deprescribing >

Mobility Impairment
- Assessing Risk versus Benefit when reviewing a patient’s med list
- Determining Achievable Goals
- Reviewing Comorbid Risk Stratification
Reviewing the Most Common Reason for Acute Delirium
Understanding reversible causes for the acute delirious state with specific attention to the ICU climate and role of the ICU team
- Metabolic causes
- Body system review
- Interdisciplinary team Communication
- Integration of Outpatient and Inpatient Needs Assessment
Positive Outcomes
- Creating successful patient care plans
- Continuous evaluations of patient progress

Target Audience

Registered Nurses
Nurse Practitioners
Physician Assistants
Physical Therapists
Physical Therapist Assistants
Occupational Therapists
Occupational Therapy Assistants
Speech Language Pathologists

Copyright : 07/19/2023

Reimagining Speech, Swallowing, and Mobility in Critical Care Settings

Program Information

Objectives

Outline steps to assess both vent and nonvent dependent patients for speaking valve utilization.
Distinguish three mechanical vent settings for which a speaking valve can be safely used in the tracheotomized patient while recognizing contraindications for placement.
Prepare/Establish the foundation for early mobilization with vented patients including therapy roles, team responsibilities, and rehab strategies for maximizing both patient safety/cotreating opportunities.

Outline

Mechanical ventilation and the application of speaking values

Physiology of utilization, anatomical review
Population and timing
Warning and Precautions
Assessment and placement on vented and non-vented patients
Special considerations when placing valve
- Timing/populations valves are utilized
- Trouble shooting difficult placement

Respiratory intervention related dysphagia

Effect of extubation and tracheostomy upon swallowing physiology
Determining options for informal vs formal assessments of the tracheotomized patient
Rehabilitative effect of speaking valve upon swallowing

Team approach to early mobilization and optimizing patient outcomes

Physical inactivity and mechanical ventilation induced weakness on musculoskeletal function
- ADL performance
- Cognition and motor skills, strength
Early mobility indications/contraindications to safe patient mobilization
>ul>
Vital considerations and vent parameters
Techniques to assist with therapy-induced changes in blood flow

Strategies to gain confidence mobilizing vent/trach dependent patients
Implementing early mobilization protocols

Education on properly setting up trach/vent in preparation for early mobility session
Proper Management of speaking valve/trach during mobility
Responding to adverse symptoms

Shared outcomes of early mobility programming as a team focus

OT/PT facilitation of SLP goals
Recognizing opportunities for co treatments

Copyright : 07/19/2023

The Importance of Positioning, Play and Purpose for Babies and Children In The PICU

Program Information

Objectives

Develop understanding of importance and value of early mobility in the PICU.
Demonstrate why play in children must go on, despite illness.
Recognize the side effects of illness and medications and integrate safe therapeutic interventions to promote activity.

Outline

Understanding the PICU environment

Comparative Analysis of the PICU vs Adult ICU to identify similarities and differences
Exploring the type of patients encountered

Interactive Case Studies

Joey R (preschooler)
- 5yo male born with Trisomy 21 h/o CHD s/p complete repair and h/o duodenal reconstruction s/p ladds procedure with h/o small bowel obstruction and multiple abdominal surgeries. A few years had passed since these surgeries. Several days of viral symptoms, lethargy and diarrhea leading to ER. Decompensated within 10 min of arrival in ED, leading to code and CPR, placed on VA-ECMO for cardiac and severe multi-organ failure … lead to long term PICU stay with interventions in mobility and plan.
Barry E (baby)
- Born with DeGeorge Syndrome: this led to repair of CHD, cleft lip palate, consistent pulmonary issues, intestinal issues requiring colostomy bag as well as gtube placement for GI feeding issues … lead long term hospitalization from PICU to stepdown unit. Main interventions were localized around mobility, positioning and basic developmental intervention..
Will S (preschooler)
- 5yo polytrauma s/p MVA, suffered TBI with R subdural hematoma IVH, subarachnoid hemorrhage , skull fx, faial fx, Pulmonary contusion, and several other orthopedic fractures/injuries. Increased social piece to this case as the family happen to be travelling home through our town when the accident occurred, leading to the death of the sibling in our PICU as this patient recovered from TBI.
Katie (6yo)
- 6-year-old born with Prader Willi Syndrome, dx with posterior fossa tumor, s/p resection, extended respiratory needs, leading to longer PICU stay. She was one of best examples of the benefits to early mobility for improved recovery.
Ethics in caregivers in the PICU

Questions

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapist Assistants
Speech Language Pathologists
Critical Care Nurses
Nurse Practitioners
Physician Assistants

Copyright : 07/19/2023

Acute Care & ICU Rehab: Strategies for the Medically Complex Patient

Explore the latest interventions for improving functional mobility, strength, independence, and outcomes in acute care rehab. Designed for all practice levels, from the new grad to the veteran acute care professional, this hands-on course will provide you with an updated knowledge base for making appropriate decisions within the ICU and acute care environments, implement assessment and treatment tools, integrate existing treatment plans with progression into the plan of care, and adjust or accommodate treatment interventions across the hospital stay through transition out of the hospital. Discover the latest assessment techniques and learn how to integrate treatments into rehab plans during acute and post-acute phases. Practice the latest interventions, strategies, and best practices in hands-on labs throughout the day.

Discover new treatments for:

Early mobilization
Management of lines, wires, and tubes
Respiratory distress
Intubation/Vent dependency

Program Information

Objectives

Determine the critical elements of analysis and assessment in mobilizing medically fragile patients
Develop an appropriate plan of care for patients who present with a critically ill cardiac, neurological, or respiratory diagnosis
Distinguish the characteristics, similarities of, and differences between, medically fragile and general acute care patients and methods to implement successful therapeutic interventions with each
Demonstrate an understanding of the outcome tools available for assessment of the acute or critically ill patient
Evaluate strategies for addressing the behaviorally challenging patient and successful methods for patient engagement
Devise methods to effectively document progression throughout the acute care spectrum

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

Target Audience

Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapy Assistants
Respiratory Therapists
Physician Assistants
Nurses
Nurse Practitioners

Diaphragm Rehabilitation for Cardiopulmonary Patients: After Mechanical Ventilation

For many patients, recovering from COVID is just the beginning.

“I just can’t believe how hard it is for me to do simple things now.”

Many of these patients find the path to full recovery is more difficult than expected. The lingering shortness of breath, weakness and musculoskeletal pain all take a toll. As patients recover, many will need your help getting back to a healthy and normal life.

Do you have the necessary skills to appropriately address diaphragmatic rehabilitation? Dr. Rina Pandya will walk you through the new techniques and protocols that you need to successfully help this growing patient population. With this specialized training, you’ll be able to confidently address these timely challenges that rehab professionals are facing today:

Improve posture and function
Strengthen diaphragm while on bedrest or reduced mobility
Minimize complications from immobilization
Faster recovery

You’ll also learn strategies for utilizing teletherapy – allowing your patients to reduce the reduce the energy cost of physically getting to the clinic. Dr. Pandya will make evidence-based and cutting-edge resources available to you in a way that is instantly applicable to your work.

Program Information

Objectives

Evaluate anatomy and physiology of diaphragm.
Determine physical and physiological effects of mechanical ventilation.
Utilize case studies and differential diagnoses of diaphragm disorders.
Integrate strengthening and stretching exercises for diaphragm in various positions of supine, sitting, standing and ambulation through different stages of rehabilitation.

Outline

Diaphragm

Strength and function
Role as a thoracoabdominal pump
Diaphragmatic breathing

Mechanical Ventilation

Differential diagnoses
Ventilator induced diaphragmatic dysfunction (VIDD)
Respiratory Distress
Ventilator settings – what you need to know
Precautions

Stabilization: Posture, Gait Mechanics and Core

Before you begin: initiation criteria
Mobility and muscular deconditioning
Exercise therapy
Resistance training
Sitting and standing balance training

Beyond the Vent: Exercises for the Diaphragm

Active cycle of breathing techniques
Abdominal breathing and diaphragm training
Telemedicine techniques
Contraindications for mobilizing patients

Target Audience

Physical Therapists
Physical Therapy Assistants
Occupational Therapists
Occupational Therapy Assistants
Exercise Physiologists

Keeping Patients Off the Floor: Identifying Fall Risk and Preventing Falls in Aging Adults Throughout the Continuum of Care

This session will provide insight into identification of potential patient fall risk factors throughout the continuum of care. As falls have been identified by the CDC as a public health challenge, costing aging individuals their independence and quality of life, and related healthcare costs upwards of $50 billion dollars for non-fatal falls, fall prevention has become a nationally recognized initiative. Participants will learn how to integrate approaches to facilitate prevention of falls through appropriate patient management including screening, intervention and referral.

Program Information

Objectives

Determine the magnitude of falls in the aging population.
Identify causes of patient fall risk throughout the continuum of care.
Acknowledge the signs of a patient at risk for falls in common healthcare settings and in the home.
Synthesize the impact of polypharmacy on fall risk.
Integrate strategies for fall prevention.
Perform screening for fall risk and determine appropriate referral services as indicated.

Outline

Introduction to falls; magnitude and impact
- Falls are not part of normal aging
Roles of different healthcare professionals in identifying factors that contribute to fall risk and falls, throughout the continuum of care
- It takes a team
Strategies for decreasing or preventing falls in aging adults
- Looking at the right things, subtle and obvious
Polypharmacy and impact on balance and fall causation
- One versus many
Integrating CDC STEADI – Stopping Elderly Accidents, Deaths and Injuries, recommendations for fall prevention

Target Audience

Nurses
Nurse Practitioners
Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapist Assistants
Physician Assistants
Speech Language Pathologists
Other Healthcare Professionals

Navigating Pain Management and Sedation Levels in the Critical Care Environment

Balancing analgesia and sedation for critically ill patients is challenging and we still see a discrepancy in the approach to sedation of critically ill patients. How do we avoid negative acute and long-term consequences of untreated pain and agitation? In this session, Dr. Dunwoody will help you understand how provide safe care to when patients are provided analgesia and sedation to prevent pain and anxiety, permit invasive procedures, reduce stress and oxygen consumption, and improve synchrony with mechanical ventilation. Regional preferences, patient assessment and history, unique critical care challenges and individual patient needs will be discussed. A review of how pain and sedation translate to practice will help you provide safe and quality care to your ill patients.

Program Information

Objectives

Apply the components of pain management within the critical care setting.
Analyze Sedation, opioid induced sedation and the overall patient impact.
Integrate assessment tools for sedation into patient management.
Determine the goal of maximizing analgesia while minimizing sedation.

Outline

Pain Overview

Definition
Neurotransmitters/-Pain Transmission
Acute vs. Chronic Pain
Components of the Patient’s Pain Experience

Pain Management

What Happens if We Don’t Manage Pain?
Assessment
Considerations
Management
- Nonpharmacologic
- Pharmacologic

Sedation

How Pain and Sedation Translate to Practice
Sedation as a Concept
- Intentional
- Incidental
Sedation Tools
Sedation Risks
Sedation Agents

Nurses Role

Finding Balance
Iterative Knowing
FAQs

Target Audience

Nurses
Nurse Practitioners
Physicians Assistants

Emerging and Current Infectious Diseases in the Critical Care Setting: SARs-CoV/COVID-19, Monkey Pox, Hepatitis, Tuberculosis & Influenza

Since the beginning of the 21st century, we have seen novel infectious diseases and infectious diseases not endemic to the US manifest themselves in an explosive way. The daily news programs and the internet are providing sometimes overwhelming information that is often inadequate in scope.

In this session, Paul Langlois, APN, PhD, CCRN, CCNS, will provide the latest guidelines and recommendations from the Centers for Disease Control (CDC) and Infectious Disease Society of America (IDSA) on current infectious diseases affecting our patients: SARS-CoV2/COVID-19; Monkey pox; hepatitis-A, -B and –C; tuberculosis and Influenza. In addition to history and physical assessment findings, Paul will also highlight recognition methods, FDA-approved and investigational medications and, where indicated, vaccines. Case studies will solidify learning objectives.

Program Information

Objectives

Differentiate the medications which are used to manage the patient with COVID-19.
Analyze the current methods to detect and treat monkeypox from other viruses of the genus orthopoxvirus.
Create a medication regimen for a tuberculosis patient, both newly diagnosed and with drug-resistant tuberculosis.
Distinguish Hepatitis A, B and C based upon their recognition and treatment.
Formulate a differential diagnosis for a patient with suspected influenza.

Outline

SARS-CoV2/COVID-19 Updates

Pathophysiology of SARS-CoV2/COVID-19
Why so many variants?
Laboratory parameters for SARS-CoV2
Effectiveness of all the COVID-19 vaccines
Antiviral medications: FDA approved vs. those in clinical trials
Long-COVID-19 signs and symptoms

Monkeypox

Where did it originate?
Diagnostics
Prevalence in the USA
Infection control measures
Medications: FDA approved and investigational
Vaccine priorities

Hepatitis A, B and C

Prevalence is rising in the USA
Patient history and presenting signs and symptoms
Diagnostic tests
Treatments and vaccines

Tuberculosis (TB): Still prevalent and highly contagious

What is Mycobacterium tuberculosis and how is it detected?
Newly diagnosed- and multi-drug resistant-TB in these geographic areas
First line medications for drug susceptible TB (doses, how often and how long to take)
Multi-drug resistant TB treatments

Influenza

Differentiating influenza from other conditions
Prophylactic medications
Antiviral treatments
Why do we need an annual influenza vaccine?
Combination COVID and influenza vaccine

Target Audience

Nurses
Nurse Practitioners
Clinical Nurse Specialists
Physician Assistants

Wound Prevention and Management: An Integrated Approach to Patient-Centered Care

Chronic wounds are increasing in parallel with population aging and no single discipline has the breadth of skillset needed to recognize the risks factors, the wound types, or the evidence-based management strategies. Further, working through the lens of patient-centered care means that not all 'wounds' can heal, but we can strive to heal the person with the wound. This session will provide participants with the ability to understand the risk factors of chronic wounds and non-healing, recognized the most common chronic wound types, like pressure injuries, lower extremity arterial wounds, venous leg ulcers, and neuropathic ulcers. Further, basic interventions and treatment pathways will be discussed and considered within the lens of patient-centered care. This session will provide participants with the tools to empower team collaboration and ultimately implement patient centered-wound care.

Program Information

Objectives

Describe the societal impact of the staggering increase of chronic wounds today and what that means to patients, to health providers, and to health care.
Clearly recognize the primary chronic wound types by characteristics; such as pressure injuries, lower extremity arterial wounds, venous leg ulcers, and neuropathic ulcers.
Challenge the traditional conceptual model of wound healing through evidenced based pathways of wound treatments and interventions through the lens of patient care, challenging concepts of outcomes and "healing.”
Apply evidence-based strategies to influence, implement, and sustain practice or patient-centered wound management.

Outline

I. State of Chronic Wounds today

Pop Aging
Social Determinants- causal factors, relationship to risk factors and chronic wounds
Pressure Injuries, Lower Extremity Arterial, Venous Ulcers, Neuropathic, other
Med-centric vs. Patient Centered care

II. Healing – what it takes

Pathways of care by wound type
Patient story with photos
Determining goals of care

III. Team Collaboration

Who are the players?
Game Rules
Other drivers of care (wound literacy, perception, regulation, litigation)

IV. Implementation and Behavior Change

Stages of Change
Social Cognitive Theory
Emotional impact of wounds
Metrics that matter

Target Audience

Nurses
Nurse Practitioners
Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapist Assistants
Physician Assistants
Speech Language Pathologists
Other Healthcare Professionals