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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 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, as well as 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. We have done so successfully for the Western Sydney Local Area Health District. Their in-touch program saving $2,000 per ED bypass service.
Basically, we send critical care nurses into the home for a client or into residential aged care and providing emergency department bypass services. They’re saving $2,000 and keeping a client at home, which is what the clients want.
Now today, I actually want to talk about a client that we’re currently looking after, just like in my introduction, I say we are predominantly specialized on long-term ventilation with tracheostomy at home requiring critical care nurses, 24 hours a day. We basically provide a genuine alternative to a long-term stay in intensive care and we’re providing an intensive care bed in the community.
Lately, we’ve been working with a client who’s not quite fitting our criteria, but I also want to show why critical care nurses, once again, keep patients out of the emergency department by even providing 24 hour a day nursing care. Once again, saving the healthcare system $2,000 per bed day and potentially even more by providing 24-hour nursing care at home with critical care nurses.
So, here’s the case, a man in his 50s with an acquired brain injury after a motor vehicle accident has had about 20 to 30 emergency department admissions between August 2024 going back as far as November 2023. So, the time of this recording here is around the 11th of October 2024.
So, the client had numerous emergency department admissions often ending in lengthy hospital admissions, not in ICU but on medical ward, and the majority of the hospital admissions were triggered by hyponatremia, which means low sodium, which is a sign of too much water on board, fluid overloaded, and also the setting of aspiration pneumonia, and the setting of seizures with a known history of epilepsy.
Furthermore, this particular client also has a PEG (Percutaneous Endoscopic Gastrostomy) tube, and the client is known to pull out his PEG tube every so often because he can’t control it, and that’s also why he ended up very often in ED.
Now, this client has been looked after by 24-hour support workers and they’re doing a marvelous job trying to keep him home but they’re simply not skilled enough to keep him home predictably.
So, our service was engaged in August 2018, and I can confidently say that this man now has been at home predictably. No more ED admissions, no more lengthy hospital admissions. And in the words of the family, not my words, in the words of the family, they said every time he was going to hospital, they were frightened, extremely frightened that the hospital was going to kill him, not out of maliciousness, but simply because they didn’t know how to look after him.
He’s non-verbal, he can’t talk. So, a lot of it depends on reading client’s verbal cues to see what he can and what he can’t do, to see what he responds to, what he doesn’t respond to, watching and reading body language. Very important.
Of course, in a busy hospital, nurses where nurses are run off their feet, where everything is counted by the minute, almost, there’s no time to really get to know the client. Whereas at home, in a home care environment where we can create and build stable teams, it’s so much easier to watch a client, to read a client, to look out for deterioration.
Watching a client sign, how does he respond to people talking to him, does he look agitated? That really makes all the difference in home care when we create stable teams on a 24-hour roster, in particular.
We can keep our clients home predictably because we get to know our clients on a really deep level and we get to know their preferences, we get to know what they like, we get to know what they don’t like, especially when they’re non-verbal. It is critically important that you have stable teams and that you don’t have people come and go like in a hospital where there’s no consistency. Once again, just like with all of our other clients, we keep this particular client home predictably, no more ED admissions.
Here’s another thing with 24-hour nursing care, we can liaise with the doctors, we can liaise with the GP, we can liaise with the specialist by picking up on things earlier. We can liaise with pathology, we can liaise with home X-ray, if needed. No need to go to hospital sitting in an ED, in an emergency department, in an emergency room for hours and hours on end. Then sending the patient to ICU or to the ward, spending many, many days on a ward and again, not having any consistency and the family has been staying there more or less day or night to be with him so that they can read on the cues that he’s giving away non-verbally that are extremely important for his well-being.
The nurses in the hospital that have never worked in the community, they wouldn’t know how to treat client and look after him properly, and that’s what we specialize in creating the right teams for the right client. So, they can maximize their quality of life and stay at home predictably.
If you want the same for your family member or maybe you’re watching this and you’re an inpatient in ICU, maybe you’re watching this, you’re at home already, you realize that what you’re currently having is not working, you might be ventilated, you might have a tracheostomy, you might not be ventilated and have a tracheostomy, you might have a tracheostomy and you might not be ventilated but you might be medically complex and you’re realizing that whatever setup you’ve got at the moment is not working and you are either at risk of going back to ICU or going back to the hospital, you’re at risk of going back to ED, you are at risk of even worse dying, which has happened in the community, especially when funding bodies like the NDIS (National Disability Insurance Scheme) is trying to push a support worker model on clients that need 24-hour intensive care nurses. People have died because of that because it’s not evidence based.
You can look up the evidence on our website at intensivecareathome.com, under the Mechanical Home Ventilation Guidelines where it clearly says that only critical care nurses with a minimum of two years critical care nursing experience can safely look after ventilated and/or tracheostomy client at home, that is evidence based. Mechanical Home Ventilation Guidelines are a result of 25 years of Intensive Care at Home nursing in Germany and of 12 years Intensive Care at Home nursing in Australia. Any other model is costing casualties. Unfortunately, people have died, and I can verify and have evidence for everything that I’m saying here.
So, I hope that helps and helps you understand what else we can do.
Maybe you have a family member that goes into emergency all the time, and then it’s a bit lengthy hospital admission, I encourage you to reach out to us here at intensivecareathome.com. You also should not worry about the funding side of things because if our clients weren’t getting funding, we wouldn’t be in business. It all comes down to the advocacy. We’ve been involved with the advocacy of our clients from Day 1. I should say we have been involved in the advocacy successfully for our clients from Day 1.
With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, and we are TAC (Transport Accident Commission) approved and WorkSafe approved in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), DVA (Department of Veteran Affairs) all around the country. Our clients and, we as a provider, have also received funding through public hospitals, private health funds, as well as departments of health.
We are the only service provider in Australia in 2024 that has achieved third-party accreditation for Intensive Care at Home nursing. No other provider has created this much intellectual property for Intensive Care at Home nursing than we have. We are therefore employing hundreds of years of intensive care nursing experience in the community combined. Once again, no other provider brings this level of expertise into the community than we do.
Like I said, if you’re at home already and you realize that you’re on a ventilator, tracheostomy, BIPAP, CPAP, Home TPN, whatever the case may be, and you realize that your current setup is not working and is even dangerous and that your current team is not having the skills and expertise you need to keep you at home predictably, you feel unsafe, where you’re going back to ICU all the time, you’re going back to hospital all the time, then you should reach out here to us at intensivecareathome.com. We have turned around many of our clients’ lives by keeping them out of hospital and out of ICU predictably and improving their quality of life at home. Like I said, don’t worry about the funding levels. We can help you with getting the right funding.
That’s also why we’re providing Level 2 and Level 3 NDIS Support Coordination. Our NDIS Support Coordinator, Amanda Riches in Victoria, as well as Rosie Hammer in New South Wales have a wealth of knowledge and their team. I’ll put a link in the written version of this blog to an interview that I’ve done with Amanda a while ago. We’re also providing TAC case management and WorkSafe case management in Victoria.
If you’re an NDIS Support Coordinator, are watching this and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for more nursing care for your participants and you don’t know how to go about it and what evidence to provide, I also encourage you to reach out to us. We can help you with the advocacy and we also provide NDIS specialist nursing assessments done by critical care nurses with the legal nurse consulting background.
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 in Victoria, and in Geelong in Victoria. If you have worked in critical care for a minimum of two years pediatric ICU, ED, and you have already completed the postgraduate critical care nursing qualification. We will be delighted to hear from you.
I have a disclaimer because we are offering a tailor-made solution for our clients, which includes regular staff. Our clients will have the same staff coming over and over again because they’re so vulnerable and so special. It’s all about building those critical relationships with our clients and with our team members and having regular and stable teams.
That means if you’re looking for agency work where you can come and go, this is probably not the right fit for you on a long-term basis because our clients want regular and the same staff over and over again. So, it’s all about building those critical relationships with our clients and we want to build relationships with you as well, of course, so that it remains a win-win situation.
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. We can also help you eliminate your bed blocks in ICU and ED for your long-term patients or for your regular readmitting patients with our critical care nurse team at home. We’re here to help you take the pressure off your ICU and ED beds, 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, respiratory wards, et cetera, please reach out to us as well. We can help you.
If you’re in the U.S. or in the U.K. and you’re watching this, and you need help, we want to hear from you as well. We can help you there privately.
Once again, our website is 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 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 from this video.
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.