eICU...is it for you?

The eICU is very different from computerized charting. I'm sure I'll do a horrible job explaining it, but...we've basically been calling it the "eye in the sky."

I think Advocate Healthcare is the first to be implementig it here in the midwest(?). There are 2 camera's installed in each patient's room. One is directed at the patient and the other at the monitor (I think). Mind you I don't work there anymore, so forgive me if this is a crude explanation. There is a centralized office (in Oakbrook I believe) that will be manned 24/7 w/ physicians/nurses etc. They will have the capability to have realtime access to all patient data (everything is already computer based documentation there) as well as a video stream so that they can observe the patient whenever necessary. Some important points that were brought up when this was presented to the ICU staff:

1. There will be an audible notification (some sort of chime or bell mechanism) when the eICU staff is observing via their cameras. This presumably is to address the issue of privacy.

2. Not every patient has to be subjected to, oops, I mean managed by the eICU team. Allegedly if the patient or attending does not want the patient to be covered by the eICU they have that option.

The objective here is to provide the best possible care for the patient (my thoughts on this in another thread...) allowing the healthcare team to monitor your loved one theoretically every minute as needed...essentially providing the best possible care.

My thoughts: sounds fantastic in theory, but some things to consider...

This is being marketed as yet another "cost-effective" way to provide quality healthcare and is not intended to replace hands-on care by the bedside nurse but rather "enhance" it. Enhance? How about replace? Right now nurses on this Level I trauma unit care for 1 or 2 patients depending on acuity and the unit is staffed accordingly. Are the nurses going to become so adept at efficiently providing care that management will say "hey, you're handling it so well, there's no reason you can't handle just one more patient!" So instead of 10 nurses taking care of 14 SICU/trauma patients we're so efficient it only takes 7 nurses now!

Or, as if there aren't already enough chefs in the kitchen, let's add another team of experts to consult on this patient with a complicated diagnosis/injury. Those of you who work trauma/SICU know what I'm talking about here. An attending "team" , the surgical "team", the ortho "team", the cardiologist, the cardiac surgeon, the pulmonologist, the intensivist, the residents, social services, environmental services, the butcher, the baker, the candelstickmaker!!! There's already enough politics involved for the night shift nurse faced with the daunting task of whom to call when her/his patient "goes bad" at 3 a.m.

And I can't imagine any patient wanting to be on a live video feed when there are 2 or 3 nurses and techs cleaning them up after they've had an explosive BM! Would that video come with sound bytes like "whoa, that's gonna leave a mark!"

I guess what frustrates me most, is that it seems like, from a lowly bedside nurse's perspective, they were asking for our input after the fact. For crying out loud, it's like going to a restaurant and the only thing on the menu is chicken and then having the waiter politely ask what you'll be having that evening:confused: !

Originally posted by liberalrn

I work in the Advocate system...

Sorry to hear that, liberalrn:chuckle Oops, there's my jaded side showing through again...

The bedside nurse still provides all the hands-on care, she just has yet another doctor to deal with! The concept is geared toward getting more immediate attention for a patient who is going down the tubes. So, instead of paging a resident or physician, who may or may not know the patient very well, and having delays in responses, you'd have this "nifty" system at your disposal.

I could see it being useful at a facility where there isn't 24 hour in-house coverage, say a remote rural institution or something, but in a large Level I trauma center and teaching hsopital. I'd be curious to know what the residents think of this. On the one hand it could be a great resource for them (god knows they already work a trillion hours...and there are those that are about as useful as teats on a bull!) but I'm not sold.