Tele-ICU helps health system face COVID-19 challenges

Aug. 6, 2020

“Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic” describes how Atrium Health’s teleICU quickly adjusted its patient-centered focus to include supporting and protecting bedside nurses caring for patients in isolation, as part of the system’s planning and preparation for the pandemic, states an Atrium Health press release. The article is published in the August issue of Critical Care Nurse (CCN).

The pandemic has not only highlighted existing nursing shortages but also created unique concerns of its own, as surge planning strains already-stretched staffing resources. In addition, the nursing profession has grown especially concerned about the health and safety of its workforce, specifically the consistent availability of critical care nurses and sufficient supplies of personal protective equipment (PPE) throughout the pandemic.

The virtual critical care (VCC) unit has been providing teleICU care in Atrium Health’s network of hospitals and ICUs across the Carolinas since 2013. The VCC uses real-time, two-way audio and high-definition video communication to hundreds of critical care beds and via mobile carts in two emergency departments in the health system. The VCC team has more than 80 board-certified tele-intensivists and 40 board-certified critical care nurses.

“We modified workflows, deployed home workstations and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving PPE,” said co-author and VCC program coordinator Sandy Arneson, MSN, RN, CCRN-E. “VCC capabilities facilitate both a high level of care for patients and protection for front-line providers.”

As part of the system’s surge preparation, VCC coverage was quickly expanded to the facilities that were first to admit patients diagnosed with COVID-19. At these facilities, the VCC expansion enabled conversion of existing hospital beds to critical care beds, more than doubling the capacity for ICU-level care.

The infrastructure expansion included deploying telemedicine mobile carts throughout the system. Many non-VCC providers were granted access to its teleICU software to facilitate team-based care of patients with COVID-19, and handheld tablets were distributed to increase family-centered visitation and virtual communication. To ensure consistent coverage in the event of a required quarantine or exposure, a team of VCC nurses, as well as members of the VCC operational and leadership team, received home workstations with laptops and additional monitors. Workflow modifications help reduce time spent in isolation rooms and thereby reduce the risk of exposure for front-line caregivers.

The COVID-19 pandemic has the potential to exacerbate any staffing challenges, and the VCC team provides an additional layer of clinical support to nurses at the bedside. At the push of a button, bedside clinicians have immediate access to experienced ICU nursing support. This ease of access also gives bedside nurses peace of mind, knowing that changes in a patient’s status can be brought to their attention quickly, even when they are not in the same room. For example, a VCC nurse can perform clinical documentation while the bedside ICU nurse conducts a physical patient assessment, a task that could be challenging in full PPE.

The article is part of AACN’s growing library of clinical resources related to caring for critically ill patients with COVID-19, including a free self-paced course, “COVID-19 Pulmonary, ARDS and Ventilator Resources.” The COVID-19 resources also include free pocket cards, webinars, procedure manual excerpts and journal articles.

AACN has the release.

More COVID-19 coverage HERE.