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Why This NDIS (National Disability Insurance Scheme) Client with Myasthenia Gravis on BIPAP (Bi-level Positive Airway Pressure) Needs 24/7 Critical Care Nurses (CCRNs) at Home

“Why a myasthenia gravis client with BIPAP (Bi-level Positive Airway Pressure) dependency needs 24/7 critical care nurses at home.”

My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, and where we also provide home care for medically complex clients including Home TPN (Total Parenteral Nutrition), IV antibiotics, palliative care at home, home tracheostomy care without ventilation, ventilation without tracheostomy such as BIPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure), cough assist management, nasogastric tube management, PEG (Percutaneous Endoscopic Gastrostomy) tube management, and much more.

So today, I want to share with you why one of our clients requires 24/7 critical care registered nurses at home, and why an independent nursing assessment is absolutely critical in the NDIS (National Disability Insurance Scheme) advocacy process to secure the right level of funding that actually keeps clients alive and out of ICU.

Our client is a client who has myasthenia gravis complicated by a recurrent pulmonary emboli, multiple spinal fractures, severe pain, and PEG or PEJ (Percutaneous Endoscopic Jejunostomy) feeding requirements. Her condition is extremely complex and high risk, so she requires BIPAP, which is non-invasive mechanical ventilation, multiple times a day and continuously overnight.

If the machine fails or the mask leaks, she cannot breathe. Only a CCRN has the training to troubleshoot the ventilator, interpret data, and manage emergencies. The client also requires daily anticoagulation injections to prevent fatal blood clots, as well as morphine injections to manage escalating pain. Again, this is well outside of the scope of support workers or even general registered nurses.

Client is also at very high risk of choking and aspiration. Aspiration needing advanced airway management skills that, once again, only critically care registered nurses can provide. The client’s PEG and PEJ tube needs skilled management to prevent blockages, leaks, and infections. She also has brittle bones, severe mobility issues, and high pressure sore risk requiring expert wound and pressure area care.

Basically, without 24/7 CCRN nursing care, the client would be at constant risk of respiratory arrest, aspiration pneumonia, uncontrolled pain, blocked feeding tubes, and avoidable ICU readmissions.

So, I really also want to illustrate why an independent nursing assessment is so critical for NDIS advocacy.  One of the most important steps in securing adequate NDIS funding for clients like this is having an independent nursing assessment by another qualified CCRN.

Here is why. The NDIS will not automatically understand the clinical complexity, unless it is clearly documented by an experienced critical care nurse, the NDIS may underestimate the level of support required. Support worker level care is unsafe for someone like this client. Without a CCRN assessment, there’s a high risk the NDIS will only approve lower level support funding which could be life threatening.

Independent nursing assessments provide objective professional evidence. They outline in detail the clinical risks, the daily nursing interventions required, and the consequences of inadequate care.

Next, those independent nursing assessments strengthen advocacy. Families often feel overwhelmed in NDIS planning meetings. An independent nursing assessment gives families the evidence they need to fight for 24/7 CCRN funding. It’s the difference between hospital and home without the right level of funding clients often remain stuck in ICU or are discharged unsafely.

A strong independent assessment makes it clear that the only safe alternative to the hospital and an ICU is 24/7 CCRN care at home. In fact, in this client’s case, the independent nursing assessment highlighted the BIPAP dependency, airway risks, injection requirements, PEG feeding, and pressure area care. It became the foundation for the NDIS application was crucial in ensuring her needs were properly understood and funded.

Let’s look at the conclusion. If you have a loved one with high medical complexity, whether it’s ventilation, tracheostomy, PEG/PEJ feeding, myasthenia gravis like this client, you cannot rely on the NDIS alone to understand their needs. If anything, you’d be relying on the NDIS bureaucrats, it will go nowhere. You need to provide the right evidence and we can help you with that.

So, you need an independent nursing assessment carried out by a critical care nurse who understands ICU level care and can clearly document why 24/7 Intensive Care at Home with CCRNs are essential. This is the only way to secure the right level of NDIS funding and keeping your loved ones safe at home rather than in hospital.

At Intensive Care at Home, we understand that intimately, and we not only provide the CCRNs, but we also provide the independent nursing assessments with our network of independent nursing assessors. That makes a difference in the NDIS advocacy.

So, if you need help in getting NDIS funding or other funding approved for 24/7 CCRN care at home, contact us at Intensive Care at Home. We can provide the specialist nursing assessments with our independent nursing assessors and the advocacy that ensures the loved one receives the care they need and deserve to keep them alive.

Now, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies  with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care for clients without ventilation
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life is much improved surrounded by families and by a team of dedicated intensive care nurses in the home care setting instead of in an intensive care unit.

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 work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a service provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home since 2012. No other provider in Australia has created more intellectual property when it comes to Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or you’re stuck in an ICU long-term, or if you’re going to the hospital and ED all the time, and you realize that you don’t have the right level of support at home, or if you are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

One of our first clients when we first got started in 2012 was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a cabin crew instead of the pilot. Because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at high risk of dying if they don’t have a team of dedicated critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps, including how to get funding with different funding bodies.

This is also why we are providing NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches (one of our NDIS support coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS support coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, and high performing team of critical care nurses in the community, we’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team if you are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular staff. So, if you’re looking for agency work, where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts, and you’re really keen on building solid relationships with us and with our clients.

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well. We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, or for home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. and 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 with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website, or simply 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 this video with your friends and families, and comment below what you want to see next or 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.