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Intensive care Syndrome: Promoting Independence and Return to Employment
Tara Quasim, and Joanne Mc Peake
ICU Management & Practice
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Critical Care Physicians
It is now well established that many patients and caregivers suffer physical, psychological and social problems in the years and months following critical care discharge (Herridge et al. 2011). Similar to many centres, our intensive care unit (ICU) had no follow-up service available to support patients through this difficult recovery period (Griffiths et al. 2006). To understand how best to create a service that was safe, effective and person-centred, two members of our multidisciplinary team (MDT) undertook research programmes to help identify the problems that patients faced after ICU and to help understand the context for change (Quasim et al. 2015; McPeake et al. 2016).
From this work, four main challenges were identified:
There is minimal evidence of how and when rehabilitation services should be delivered (Mehlhorn et al. 2010), despite an abundance of literature describing the issues for ICU survivors and their families.
The hardships facing ICU patients are often not apparent to hospital management. Readmissions to hospital, increased general practitioner (family physician) visitations and the increased reliance on welfare benefits are distributed amongst a variety of budgets, which do not necessarily appear related to an ICU admission.
Finding staff with the time and ability to do something new that is different from their traditional ICU role can be problematic.
Finding physical space with a suitable area to hold a rehabilitation programme can be difficult.
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