ICU: Innovations are leading to better patient outcomes

by Lauren Dubinsky, Senior Reporter | December 17, 2015
From the December 2015 issue of HealthCare Business News magazine


Ventilators cause 50 percent of alarms and patient monitors cause the other 50 percent in the ICU, says Forde. GE has a tool on its central workstation that enables clinicians to print reports of the alarm traffic and manage the alarm settings by bed. “What you see is one or two patients are usually the offenders for alarms and their alarms may be set inappropriately or maybe they are appropriate and the patient is having a lot of arrhythmias,” says Forde.

As the elderly population in the U.S. grows, the strain on the ICU is also growing. “You think about the growing elderly population who are so frail and malnourished and that is a lot of the patients who end up in the ICU on a ventilator these days,” says Forde. About 40 to 50 percent of patients in the ICU are malnourished, according to a study in the New England Journal of Medicine. Traditionally, the dietitian tries to estimate a patient’s caloric needs or metabolic heart rate, which involves calibrating a cart, figuring out how to get it in line with the ventilator’s breathing circuit and waiting until the patient is in a steady state to measure.

The CARESCAPE R860 can measure the patient’s energy expenditure and tell the clinician exactly how many calories are required. It’s important to get the exact amount because if patients are overfed, they retain carbon dioxide and can’t be weaned off, and if they are underfed they lose muscle mass and are more prone to infection pressure sores. If patients get the calories needed they leave the ICU in a much healthier state. “The patient has a better outcome and financially we are saving millions of dollars for our facilities,” says Forde.

In 90 days, The Jewish Hospital — Mercy Health saved almost $9,000 per ICU patient by using the CARESCAPE R860 to track patients’ nutritional status. Since there was a 28 percent decrease in the amount of time the patients needed to be ventilated, the hospital estimated it will be able to save $5 million per year.

CT in the ICU?
If ICU patients need a CT exam, they will usually have to be transported to the radiology department, since many ICUs are not equipped with a CT. But now that a new CT that only requires 130.2 square feet of space is on the market that may change in the near future. Siemens Healthcare’s SOMATOM Scope CT received FDA approval in September 2014. To date, no hospitals have installed the CT in their ICUs, but Siemens believes that it’s something they should look into because of the staff coordination and patient safety benefits.

“It’s very dangerous to move a patient that is that ill because there are so many chances of things getting unhooked or wires or IVs coming loose,” says Karol Nguyen, product manager of the SOMATOM Scope CT. At least three staff members — a respiratory therapist, ICU nurse and patient transport personnel — need to work together to transport an ICU patient to the radiology department. Eliminating that would help hospitals cut costs.

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