Critical Care Outreach Teams support patients and staff

Vancouver Island - Patient care is being bolstered by an initiative led by Intensive Care Unit staff at Island Health hospitals. Critically-ill patients in Intensive Care Units are cared for by specially-trained Registered Nurses, Registered Respiratory Therapists, physicians and allied health professionals. Members of those ICU teams are now also working in Critical Care Outreach Teams (CCOT) to collaborate with nurses on inpatient medical and surgical wards to assess patients whose conditions deteriorate.

The CCOT nurses and respiratory therapists respond to consultation requests from ward nurses who are concerned about changes in a patient’s vital signs or general condition. The CCOT nurse and respiratory therapist work with the ward nurse and the patient’s physician to assess and stabilize the patient, and possibly prevent admission to the ICU.

These teams are now in place at five Island Health facilities, including Victoria General Hospital, Royal Jubilee Hospital (RJH), Cowichan District Hospital (CDH), West Coast General Hospital (WCGH) and, most recently, Nanaimo Regional General Hospital (NRGH).

“The CCOT program allows nurses to mentor each other, and it enables the CCOT nurse and the ward nurse to collaborate,” says Janet Vennard, a Clinical Nurse Educator at NRGH for the ICU and Floor 1. “It allows me as an ICU nurse to go out and work with the challenges that the ward nurses are having, to see the actual picture of what’s wrong with their patient.”

Joanne Paul, an ICU Clinical Nurse Educator at VGH and RJH, says the CCOT programs at those hospitals have been a success. “They definitely increased and improved communication, specifically around meeting the needs of patients,” she notes.

“We feel that they’ve led to better patient care, because ward nurses have increased resources that they can access for help. When they feel like they’re not sure what to do, they can call an ICU nurse for mentorship and coaching.”

The CCOTs at VGH and RJH each see about 100 patients annually. In 2017, 75 per cent of the patients consulted on by the teams were able to be supported and kept on other wards instead of being admitted to the ICU. The top reason that the CCOTs were called at those sites was due to concerns on behalf of the ward nurse. This was followed by patients with increased respiratory rates, and then those with a decreased level of consciousness.

Vennard, who has been busy training NRGH’s ICU nurses about the CCOT program, underlines the initiative’s importance. “We need to do this,” she says. “It’s the right thing for our patients and the right thing for our staff.”

Island Health provides health care and support services to more than 767,000 people on Vancouver Island, the islands in the Salish Sea and the Johnstone Strait, and mainland communities north of Powell River.

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