UW Health's Neurocritical Intensive Care Unit (ICU) at UW Hospital and Clinics in Madison, Wisconsin, provides value in the care of neurologically-ill patients by improving outcomes and reducing costs.
- Nursing in the Neurocritical ICU
- Nutrition in the Neurocritical ICU
- Physical Therapy in the Neurocritical ICU
- Occupational Therapy in the Neurocritical ICU
- Speech Therapy in the Neurocritical ICU
- Social Work in the Neurocritical ICU
Neurocritical ICU nurses provide patient care from admission to the unit to discharge. They conduct complete neurolgical examinations, monitoring the patients' respiratory, cardiac, gastrointestinal and endocrine systems.
Neurocritical care nursing is a highly-specialized profession, and the patients to whom our patients attend have unique cognitive and physical challenges. Patient safety, including how to avoid falls and injuries, and education are primary focuses. Our nurses' responsibilities including making sure patients understand what's happened to them, what that means, and what they need to do in recovery.
Our nursing case managers ensure patients meet neurocritical ICU criteria prior to admission and that their medical orders and status information are correct and complete. Case managers work with insurance companies and help coordinate care amongst the proper, interdisciplinary teams. As the patients' discharge date nears, case managers participate in rehabilitation decisions and catalyze timely discharge processes, which reduce costs to the patients.
Our registered dietitians are food and nutrition experts who ensure patients receive adequate nutrition to aid in healing and recovery. Dietitians work closely with the medical team, patients and families to develop individual nutrition plans for each patient.
Patients have special nutrition requirements when recovering from illness or surgery. Many are unable to eat and require a feeding tube. Dietitians develop individual nutrition plans to provide enteral nutrition (tube feedings) to prevent malnourishment. Other patients are able to eat but have chewing and swallowing difficulties and require a modified diet.
Dietitians work with patients who find it difficult to eat an adequate amount due to lethargy, nausea, stress, altered sense of taste, or chewing and swallowing difficulties. I will help you to develop a nutrition plan to optimize your intake when facing these obstacles.
High-risk patients automatically receive a nutrition consultation when admitted to the Neurocritical ICU, so needs are addressed in a timely manner. We collect monthly quality improvement data and consistently meet or exceed national nutrition guidelines related to nutritional adequacy in the ICU.
Physical therapists assess function in patients to determine functional limitations and proper venues of care after discharge from the Neurocritical ICU. Most of our patients require further rehabilitation work, and our physical therapists work with case managers to determine the best approach for each patients.
Physical therapists make recommendations for equipment, including wheelchairs, walkers and canes, and assess patient capacity for physical therapy, including how much physical therapy each patient can tolerate based on her level of disabiolity and cognition.
Occupational therapists evaluate our patientss abilities to perform their daily life activities, such as bathing, feeding and dressing. Our occupational therapists evaluate arm strength, range-of-motion, coordination, alertness/cognition, and visual skills, and make suggestions for how to make patients' home environments more suitable to recovery.
The goals of occupational therapy include helping patients prevent loss of function due to immobility, increasing strength and alertness and providing education about self care.
Patients may have speech difficulties due to aphasia, dysarthria or cognitive deficits. Speech therapists assess speech, language and cognition in Neurocritical ICU patients and provide appropriate treatment and education catered to patient needs.
Involving families is an area of emphasis, because patients may not be able to communicate effectively early in their stay and recovery. Our speech therapists provide education to the families during the time when patients are not yet ready for speech therapy.
Our social workers assist patients and families with the stresses associated with sudden and chronic illnesses and their impact on everyday life. Social work services include:
- Identifying advance directive status and completing documents or obtaining guardianship, if needed
- Assisting with identifying primary decision makers, if patient are unable to communicate their own needs
- Assisting families with insurance questions and issues
- Helping patients/families identify the most appropriate discharge setting and help facilitate that transition
- Connecting families to community resources
- Providing patient/family advocacy and supportive counseling