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PedsCrit

Long Stay Patients & Primary Intensivists with Dr. Jeff Edwards and Dr. Erin Gordon Part 1

Jun 26, 2023
Dr. Jeff Edwards and Dr. Erin Gordon discuss long stay patients in the pediatric ICU, including challenges and impact, mental health consequences for families, developmental outcomes for children, and strategies for improving continuity of care.
26:50

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Quick takeaways

  • Primary intensivist programs and primary nursing can improve continuity of care and patient outcomes for long-stay patients in the pediatric ICU.
  • Long-stay patients in the PICU face higher risks of morbidity, delayed development, and mental health challenges, which primary intensivist programs aim to address through continuity and targeted interventions.

Deep dives

Improving Care for Long-Stay Patients in the Pediatric ICU

Long-stay patients in the pediatric ICU (PICU) require special attention due to their high risk for adverse events and readmissions. Primary intensivists, primary nurses, and multidisciplinary team meetings are strategies that can improve continuity of care and patient outcomes. Primary intensivists provide consistent physician resource despite changes in attending physicians, while primary nurses offer greater accountability, autonomy, and teamwork. Multidisciplinary team meetings bring together specialists to discuss complex cases and create consensus on patient care. Studies show that primary intensivist and nursing programs can reduce length of stay and improve communication and decision-making, benefiting both patients and families. However, implementing these programs may require cultural change and addressing challenges such as stress and discordant goals.

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