Rehabilitation after critical illness in adults is the latest addition to the fantastic NICE resource.
The 2009 Rehabilitation after critical illness guidelines have recently been updated and offer food for thought about how we can improve our practice and outcomes on critical care units. They emphasize the need for an MDT approach to treatment, formulation of SMART goals and identification of both morbidity risk and rehabilitation needs early in a patient’s stay. This will facilitate early, optimal interventions, tailored to the individual patient to reduce their morbidity, length of stay and improve long-term outcomes.
Key points to take away:
- CPAx (measure of morbidity) completed on admission.
- Structured, individualized MDT rehab plan within 4 days of admission.
- Goals should focus on physical, sensory and communication problems as well as psychological symptoms such as delirium and depression.
- Goals revisited and adjusted upon discharge which should promote self-management.
- Essential that planning for community rehabilitation begins ASAP as preliminary evidence suggests this is effective.
- Providing more information for patients and their families about their stay on critical care units and side effects such as delirium, poor nutrition and prolonged muscle weakness.
- Functional reassessment should take place at 2-3 months after critical care stay to assess progress with rehabilitation.
If you are interested in learning more about CPAx and developing the skills required to complete an assessment, there is a free module available online. All you have to do is make an account for free.