Hi it’s Patrik Hutzel from INTENSIVE CARE AT HOME where we provide tailor made solutions for long-term ventilated Adults & Children with Tracheostomies and where we also provide tailor made solutions for hospitals and Intensive Care Units whilst providing quality services for long-term ventilated patients and medically complex patients at home.
In last week’s blog, I talked about,
You can check out last week’s blog by clicking on the link below this video:
In today’s blog post, I want to answer a question from one of our clients and the question today is
Intensive Care at Home Frequency & Management of Respiratory Incidents in Invasive Home Ventilation
Hi, it’s Patrik Hutzel from Intensive Care at Home where we provide tailor-made solutions for long-term ventilated, adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated patients and medically complex patients at home.
In today’s video blog, I want to talk about frequency and management of respiratory incidents in invasive home ventilation. So for those of you that are new to Intensive Care at Home, that’s pretty much all we do all day every day. We provide specialized services at home for a long-term mechanically ventilated patients, with tracheostomy, but also if they’re ventilated non-invasively, or if they only have a tracheostomy.
Now we are a third party accredited service provider. We are accredited through ISO 9001 2015 similar to hospitals. We’re also accredited for the NDIS here in Australia for the TAC, the Transport Accident Commission, and also for the DVA, the Department of Veteran Affairs. And we also provide services through hospitals directly and through private health insurances.
Now, why is safety so important? Now think about it. When it comes to Intensive Care at Home, patients leave intensive care directly and they go home. Previously or prior to the existence of our service, patients from intensive care had two ways to go. One, they were going to a hospital ward or to a hospital floor, or they would die. Very limited mindsets, so we have revolutionized this area by creating a proven third pathway for intensive care patients that stay in intensive care long-term, and can’t be weaned off the ventilator and the tracheostomy. So therefore, we are replicating at home what’s being done in intensive care. We provide 24-hour intensive home care nursing with intensive care nurses with a minimum of two years’ intensive care experience.
Now, are incidents happening? Yes they are, but with having 24-hour intensive home care nursing, it’s similar to an intensive care unit so we can manage all incidents at home. Now, should be a no brainer. Shouldn’t it? I mean I shouldn’t even have to say that, but the unfortunate reality is that, some intensive care units are reluctant to discharge because of safety aspects. That’s one end of the spectrum. But then on the other end of the spectrum, you have some service providers wanting to provide services for ventilated patients, with support workers, with untrained staff. They’re basically, with all due respect to the individuals, they’re basically picking staff off the streets without any formal education. And they “train them”, on ventilated patients.
Now in intensive care, there’s intensive care nurses that go through years of training, looking after ventilated patients. So not even general nurses are looking after ventilated patients. It takes years of training, years of exposure, years of experience. And then you have some service providers taking people off the street and “training them” on ventilated patients. In my mind, that is a criminal offense. I have no other words for this. And I know some people might feel offended by that, but it is a criminal offense. It is like flying the airplane with the cabin crew instead of the pilot. So you can picture what’s going to happen. If you’re flying the airplane with the cabin crew, instead of the pilot, there’s going to be some collateral damage from that probably some people dying. And this is exactly what’s happening, unfortunately, with Intensive Care at Home.
So we have provided services to some clients where there was only funding for night shift. And if you look at the mechanical home ventilation guidelines that we publish on our website and the mechanical home ventilation guidelines are evidence-based and they clearly demand that an intensive care nurse needs to be present 24 hours a day in a homecare setting for a ventilated client. And some funding bodies do not fund 24-hour nursing care. And again, that is a criminal offense in my mind. Again, I know that some people might feel offended by that, but there’s no other words for it because we have evidence. We know last year we had three clients that were only funded for night shifts, and we have highlighted to the funding body, but he’s saying, look, those clients only have night shifts. They’re ventilated. They had the tracheostomy and all of those clients passed away during the day because medical emergency could not be managed by either a family member or by support workers. Clients have died because of that mismanagement of funding from funding bodies.
Also talking about funding for a minute. It’s a win-win situation, an intensive care bed costs around five to $6,000 per bed day. Whereas we cut that cost of the intensive care bed by around 50% plus intensive care units need the bed. Anyway, they’re so busy, especially now with COVID, so it’s a win-win situation. So funding is not an excuse for any funding body, because we’re cutting the cost of an intensive care bed by 50%.
So now looking at this research paper that I have in front of me here, there is another research paper, just the title of this blog, where it says frequency and management of respiratory incidents in invasive home ventilation. Obviously, someone has done a research paper and clearly said that, again, confirmed what’s in the home mechanical ventilation guidelines that only intensive care nurses with a minimum of two years ICU experience can manage ventilated patients at home safely.
Let me read out the conclusions of this research paper and I have attached here the link to the pdf file (Frequency & Management of Respiratory Incidents in Invasive Home Ventilation). “The conclusion of this study is that invasive out-of-hospital ventilation needs to be organized safely because respiratory incidents are to be expected and common, occurring in 50% of the examined patients over a 2-month period. Specific expertise consisting of specialist nursing and a key ventilator expert providing consultant support is needed. However, we have shown that these incidents can be managed in the community setting largely by intensive care nursing staff. The alliance with a weaning center and coordination of patient care thus helps to organize invasive home mechanical ventilation in a safe manner over the long-term. Guidelines for home mechanical ventilation assist those who look after invasively ventilated patients.”
Enough said. Just confirms everything that we’ve been doing from day one. It confirms everything that’s been happening in other countries too. The pioneering country for Intensive Care at Home was Germany about 20 years ago. I was part of it then. Now we are the pioneering service here in Australia. And clearly it works hundreds of thousands, millions of hours of Intensive Care at Home have been provided in Germany, Austria, Switzerland, and now in Australia as well. So it’s all backed up by science. It’s all backed up by research and it’s about time for the funding bodies here to step up, fund the Intensive Care at Home more and more, and make sure costs can be cut for intensive care units and freeing up intensive care beds, and most importantly, providing quality of life. And in some instances, quality of end-of-life for patients and families at home in a loving family environment, rather than in a sterile and depressing intensive care environment. And that’s what it is, especially nowadays with COVID where COVID is still running rampant as of November, 2021. And you certainly don’t want to be in a COVID infested unit at the moment you want to be at home.
So thank you for watching this video. So if you have a loved one in intensive care, go and check out Intensive Care at Home and contact us on one of the numbers on the top of our website. Also have a look at our case studies on our website. And if you want to find out how to get funding for our service and how it all works, please contact us again on one of the numbers are now on the top of our website, or send me an email to [email protected]. That’s [email protected].
As I said, also have a look at our case studies because there we highlight more about how we can help clients at home, how clients can live at home with ventilation and tracheostomies or with medical complexities, or with a tracheostomy only without ventilation or just with BiPAP or CPAP ventilation. Again, you can look at our case studies as well at our service section.
And if you are at home already and you need support for your last one at home, and you have insufficient funding or support, please contact us as well. We know how to steer the territory.
And, if you are an intensive care nurse or a pediatric intensive care nurse with a minimum of two years, ICU or pediatric ICU experience and you ideally have a postgraduate critical care qualification. Please contact us as well. Check out our career section on our website. We are currently hiring ICU and PICU nurses for clients in the Melbourne, Metropolitan area, Northern Suburbs, Mornington Peninsula, Frankston, South Gibson, Warragul, Trafalgar, Moe, Drouin, Wollongong in New South Wales, but also in Bendigo in Victoria and in Oakley.
So we are an NDIS, TAC and DVA approved community service provider in Australia. Also have a look at our range of full service provisions. We have been part of the Royal Melbourne health accelerator program in the past for innovative health care companies.
Thank you so much for watching this video and thank you for tuning into this week’s blog.
This is Patrik Hutzel from Intensive Care at Home, i’ll see you again next week in another update.
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Take care for now.