A 4-month Q.I. program was instituted for medical intensive care unit (MICU) patients that were on mechanical ventilation for 4 days or more in order to: sustain patient comfort and physical medicine and rehabilitation (PM&R) therapies by reducing delirium and deep sedation, promote functional mobility through treatment sessions and consultations with PM&R therapies such as physical therapy (PT) and occupational therapy (OT), and to decrease the length of stay of these patients in the MICU.
The Q.I. program collected baseline data (such as demographics and comorbidities) from the patients’ medical records, the amount of doses of drugs such as benzodiazepine and other narcotics, the patients’ status of delirium and sedations using validated instruments and scales, and the patient’s pain using a 0-10 scale. Treatments and consultations related to PM&R were obtained. PTs and OTs also recorded any functional mobility activities done during the session. To evaluate the effectiveness of the QI program, the number of PT and OT treatments and consultations for all the patients in the MICU during the QI program in addition to their length of stay was recorded using administrative…show more content… The program was constantly being evaluated on a weekly basis. The hospital was also concerned about the long term effects of the program, and encouraged the patients to share their experiences of neuromuscular weakness after they were discharged from the MICU. Pain, anxiety, and distress of the patient were also a concern, and practitioners made frequent visits in order to reassure the patient of the supposed benefits of decreased sedations, early and more frequent PM&R therapies, and increased activity
