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The equipment, made by a 6-year-old Baltimore
company called VISICU, is installed at Walter
Reed Army Medical Center in Washington, Swedish
Medical Center in Seattle, and Sacramento, Calif.-based
Sutter Health.
VISICU describes the eICU as a “mission
control” operation, in which eICU team
members sit like air traffic controllers in front
of a bank of monitors. Besides watching for anomalies
that require emergency intervention, the eICU
team also follows predefined procedures ordered
up by the patient’s tending physician.
The eICU team also makes decisions from online,
evidence-based care guidelines that aid physicians
and nurses in decision-making.
Janine Mazabob, RN, an eICU team member at Memorial
Hermann, said the nurses trained to work with
the eICU are excited to have a single resource
for medication history, white blood cell count
trends, and blood pressure for each patient. “It
really is an additional tool for them,” Mazabob
said.
Studies point to some dramatic results for facilities
with eICUs. In a Critical Care Medicine article,
the six-hospital Sentara Healthcare system in
Norfolk, Va., reported a 27% reduction in mortality
for ICU patients, a 17% decrease in ICU length
of stay, and a savings of $2,150 per patient — or
$3 million above program costs — since
incorporating the eICU program in 2000.
Another supplemental article to the Critical
Care Medicine study cautioned that the eICU program
should not replace the remote intensivist model
as the “ideal” above a bedside specialist,
because it may introduce roadblocks to family
communication and ICU teamwork.
“These barriers can perhaps be overcome
by collaboration in the development of patient
care protocols, the rotation of staff through
the e-ICU, and communication with the family
by on-site personnel,” wrote Carolyn Bekes,
MD, of Cooper Health System and the Robert Wood
Johnson Medical School in Camden, N.J.
In at least one case at Memorial Hermann, Mazabob
said, a teenager’s mother was actually
reassured of her son’s safety when they
explained the vigilant monitoring available.
Many of Memorial Hermann’s critical care
nurses also are more comfortable working with
the system.
Critical care nurses know that “ICUs are
needing to put more junior nurses in there,” Mazabob
said. “And now you know you’ve got
a safety net.”
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