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Safety of Out of Bed Ac/vity and Ambula/on in Pa/ents with Pulmonary Artery Catheters A. Pawlik, PT; C. Esbrook, OTR/L; S. Harrison, PT; C. Steinberg, OTR/L, V. Jeevanandam, MD University of Chicago Medicine, Chicago, IL, United States Background Aims The Intervention Lessons Learned Due to the absence of literature suppor2ng or refu2ng the prac2ce of mobilizing pa2ents with PACs, our aim was to gather data to support the hypothesis that mobilizing pa2ents who have a PAC is safe. Presence of PAC is not a contraindica2on to out of bed ac2vity at UCM. This allows for retrospec2ve analysis via chart review to inves2gate whether adverse events occurred in pa2ents who were mobilized while PAC was in place or within 24 hours aDer the PAC was removed. • Analysis of the preliminary data supports our current prac2ce of mobilizing pa2ents with a PAC. • There is a need for literature to support PT and OT prac2ces for consistency across ins2tu2ons and to ensure pa2ent safety. Next Steps Results • Total PT/OT sessions with PAC in place=94 sessions • Avg. dura/on of PAC in place=3.6 days • Avg. # of PT/OT sessions per pa/ent with PAC in place=2 sessions In the seKng of increased Physical Therapy (PT) and Occupa2onal Therapy (OT) involvement in the ICU, there is a need for inves2ga2on of safe mobiliza2on prac2ces in the presence of medical devices. Pa2ents with pulmonary artery catheters (PAC) oDen remain on bed rest due to concerns regarding catheterrelated adverse events, although there is limited data describing the mobiliza2on of pa2ents with PACs. Pa2ents may be subjected to unnecessary risk associated with bed rest due to the presence of a PAC. The purpose of this study is to examine the incidence of pulmonary artery catheterrelated events during PT and OT sessions in a cardiothoracic surgery intensive care unit (ICU). Addi2onally, pa2ents who remain on bedrest while hospitalized have a greater need for longterm care and rehabilita2on than those who undergo early PT and OT. • Con2nue data collec2on for larger sample size (goal=150 charts) • Complete sta2s2cal analysis to screen for trends, associa2ons • Submit and publish manuscript to disseminate informa2on Contact: A. Pawlik, [email protected] Data Collec/on 1) Administer survey to bedside nurses in cardiothoracic surgery ICU regarding loca2on in medical record of informa2on regarding adverse events 2) Review charts for evidence of the following adverse events while PAC was in place or within 24 hours aDer PAC was removed: • Catheter dislodgement • Bleeding at PAC inser2on site • New onset arrhythmia • Change in heart rhythm • Pulmonary hemorrhage Retrospec/ve Study: 48 pa&ent charts currently reviewed. Inclusion Criteria • Adults over age 18, admi‘ed to the cardiac surgery or medical ICU between January 1, 2010 and December 7, 2013. • Ac2ve referral to therapy services present in medical record at the 2me they were admi‘ed. • Subjects must have par2cipated in mobility ac2vi2es with physical or occupa2onal therapy including siKng at the edge of the bed, standing, walking or other ac2vi2es of daily living. Exclusion Criteria • Subjects unable or inappropriate to par2cipate with out of bed ac2vity while the PAC was in place for other medical reasons unrelated to the PAC. • PACs placed in the femoral artery Discharge disposi&on (n = 48) • Home = 36 (75%) • Acute Rehab = 8 (17%) • SNF = 1 (2%) • Deceased = 3 (6%) 0 20 40 60 80 100 Sit EOB Stand Ambulate ADLs % of pa/ents Ac/vity Ac/vi/es Completed with PAC in Place 0 5 10 15 20 Arrhythmia Line dislodgement PA hemorrhage Site bleeding # of pa/ents Adverse Events Prior to ini2a2on of PT/OT ADer ini2a2on of PT/OT
