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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home, otherwise medically complex clients, adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition, home IV potassium infusions, home IV magnesium infusions, and home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management as well as Hickman’s line management, and we also provide palliative care services at home.

We’re also sending our critical care nurses into the home for emergency department bypass services as we have done so in the past successfully for the Western Sydney Local Area Health District for their in-touch program.

In my last blog, I was talking about, “Can Intensive Care at Home look after nasogastric tubes at home?” I actually talked about the case study from one of our previous clients.

Now, one thing that I actually forgot to mention in that blog was how do we actually change nasogastric tubes at home. That’s what I want to focus on today, because it’s one skill to look after nasogastric tubes at home, which we obviously have because all of our staff are critical care nurses with a minimum of two years critical care nursing experience. Most of them have done a postgraduate critical care qualification, similar to an intensive care unit, which keeps our quality standards extremely high.

Nasogastric tube is part of our skill set, of course. But the question is, how do we actually change them at home? Because a nasogastric tube needs to be changed in sort of a 3 to 6 monthly interval or, God forbid, a client might also pull out the nasogastric tube or a nasogastric tube might get blocked every so often and then the nasogastric tube needs to be changed.  So obviously, it is within the skill and scope of practice of a critical care nurse to change a nasogastric tube.

So, once it’s been changed, the position needs to be confirmed, making sure it’s actually in the stomach and not in the lungs, God forbid. So, you can check the position by using a stethoscope and a bladder syringe and inject some air and you hear a bubble. You need to know what you’re doing; you need to have done a competency for that, or you check the pH of the nasogastric tube. Basically, aspirate from the nasogastric tube and you check the pH making sure it’s within a certain range which also indicates that it’s in the stomach.

However, those two tests are not enough by itself. It also needs to be followed up by a chest X-ray to confirm the position. So, you might think, “Oh, Patrik, how can that be done at home?” Well, it can be done at home and a big shout out to Mobile Radiology in Melbourne, but they’re now also in Sydney, Brisbane, and Adelaide. They have helped us with home x-ray. So, big shout out to Michael Montalto and his team from Mobile Radiology in Melbourne that are doing the home X-rays. It’s a fantastic service and it is so well aligned with what we are doing, which is keeping our clients at home predictably.

But also, where would these patients go if it wasn’t for our service and for home X-ray? They would be ending up in emergency departments, so it’s a win-win situation because we are keeping those clients out of emergency departments that are overcrowded already, going on bypass all the time. So, once again, it’s a win-win situation with what we are doing.

So, I just wanted to highlight that this is how we do it. In the past, like I said, we have also changed nasogastric tubes at home for the in-touch service for the Local Sydney Western Area Health District. Again, working together with the mobile radiology company who has been very, very supportive for our service, but also keeping clients out of hospital and out of EDs.

So, that’s what I wanted to talk about today. So, I hope that makes sense.

If you’re watching this, how we can help you or even how we can help your hospital, you might be wondering, you’ve got patients coming into your ED that need nasogastric tube changes. There’s absolutely no need for your patients to go to ED for a nasogastric tube change. We can do that at home. Once again, it’s all about that predictability. We can do it at home predictably, that’s our point of difference.

Now, with Intensive Care at Home, we are currently operating all around Australia, in all major capital cities and in all regional and rural areas. We are a NDIS (National Disability Insurance Scheme) accredited Intensive Care at Home nursing service. We are a TAC (Transport Accident Commission) approved nursing service in Victoria, WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland. We are also a DVA (Department of Veteran Affairs) approved service provider all around Australia. Our clients have received funding through public hospitals, private health funds as well as departments of health.

Intensive Care at Home in 2024 is the only service provider in Australia that is accredited for Intensive Care at Home nursing. We are third party accredited for that. There’s no other organization in the country in 2024 that has achieved the same level of accreditation than we do or that brings the same level of skill in the community. We are employing hundreds of years of intensive care nursing experience combined in the community. I believe that is unmatched in 2024 in Australia.

Most of our staff have a postgraduate critical care qualification, approximately 70 to 80% of our staff have completed a postgraduate critical care qualification. Once again, I argue that is unmatched in the community and that enables us to look after the highest acuity clients in the community in Australia.

We’re also providing Level 2 and Level 3 NDIS Support Coordinator which is critical for most NDIS participants to obtain the right level of funding and the right level of support they need.

If you’re at home already with a ventilator, with a tracheostomy, or with a tracheostomy without ventilation or with ventilation without a tracheostomy, or your family member is at home in a situation like that and you don’t have enough support, you think you don’t have enough funding, you don’t have the right team, please reach out to us.

We have expertise at building the right teams, obtaining the right funding, that is all part of our skill set, otherwise we wouldn’t be in business. So, I strongly encourage you to reach out to us as well because we keep our clients at home predictably so that you don’t go back to hospital or to ICU all the time. Our success rate in keeping patients at home and our clients is very, very high.

If you’re a NDIS support coordinator and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding from a nursing care, I also encourage you to reach out to us. We can help you with the advocacy and we also provide specialist NDIS nursing assessments.

If you are a critical care nurse and you’re looking for a career change, we’re currently offering jobs for critical care nurses in the home in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo in Victoria, as well as in Warragul and Leongatha in Victoria. If you have worked in critical care for a minimum of two years, pediatric ICU, ED and you have already completed a postgraduate critical care qualification, we will be delighted hearing from you.

Please keep in mind we are offering a tailor-made solution to our clients, which includes regular staff. Our clients want to have the same staff coming to their home over and over again because they are very vulnerable and it’s all about building those critical relationships and having regular and stable teams. So, if you’re looking potentially for agency work where you can come and go, this may not be the right fit for you. But if you’re interested in a long-term engagement with us and the long-term engagement with our highly valued clients and their families and building those critical relationships, then this is a win-win situation for everyone.

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We are currently expanding our medical team as well.

If you have bed blocks in your ICU and you’re an ED or ICU consultant, we can help you eliminate some of your bed blocks for long-term patients or for patients that come in frequently. We can help you take the pressure off your ICU and ED bed blocks and in most cases, you won’t even pay for it.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED and respiratory wards, please reach out to us as well. We can help you with our critical care nurses taking the pressure off your bed blocks.

Lastly, if you’re in the U.S. or in the U.K. and you’re watching this, we want to hear from you as well. We can help you there privately.

All of that you get at intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for the YouTube live if you’re a subscriber to my YouTube channel, or if you’re a subscriber to our email newsletter at intensivecareathome.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.