“Keeping you in touch with our
collective critical care team”
Welcome to The Advocate!
The ‘Name Our Newsletter’ contest winner
is Chantelle Moore, 3A Patient Attendant,
with the winning submission of “The
Advocate”. Our group felt this was a
fitting name for our Quality Newsletter as
Chantal said “this is what we do for our
patient’s every day, through education,
communication, quality assurance and
critical thinking tools”.
advocate:
 to speak or write in favor of;
 one that pleads the cause of
another;
 a person who argues for or
supports a cause or policy;
QUALITY TEAM GOALS
The Critical Care Scorecard was first built on the template provided by
Performance Excellence, to align with Capital Health’s Our Promise in
Action. In the fall of 2014 the inter-disciplinary Critical Care Quality Team
met to review the Scorecard and to identify priorities. We recognize that in
order to be successful, we need to focus our efforts. By focusing on priority
areas, we can work together to effectively identify solutions and make a
positive impact on patient care.
The goals identified as priority focuses relate to: Medication Safety, Infection
Prevention and Control, Clinical Best Practice Projects, and Team Process /
Decision-Making. We recognize that all of our work needs to be done in a
sustainable manner.
Work on developing Action Plans on each of these focus areas has begun.
If you have a specific area of interest and would like to be involved in some
of the initial planning, please let Sarah or Karen know.
Atlantic Respirology & Critical
Care Conference (ARCC 2014)
Thank you to all that attended the annual ARCC
this past November at the Westin. We had
tremendous representation from Capital Health,
with the largest nursing contingent yet!
Thank you to Dr. Sam Minor who Chaired the
Critical Care stream, and congratulations to Dr.
Rob Green who received the ARCC Achievement
Award for his contributions to the conference over
the past 10 years. The Critical Care stream was
well-attended. SIX KEY take-home messages are:
(1) In your moderate-severe ARDS patient, prone early and prone often! (Dr. T Witter)
(2) Volume resuscitate your patients before intubating them, and preemptively start vasoactive
medications when necessary, to avoid peri-intubation hypotension! (Dr. R Green)
(3) Be respectful of your ICU patients and explain procedures even when they are “out”; be
cognizant of longterm neuropsychiatric complications such as depression, PTSD and cognitive
dysfunction. Prevent delirium where possible and recognize its morbidity and mortality! (Dr. M
Cornish)
(4) FEED YOUR PATIENTS! Mitigate feeding interruptions. (Dr. D Heyland, Guest Speaker, Queens)
(5) Develop a caring and compassionate approach to discussion goals of therapy and end of life
care with your ICU patients; be open, honest, and speak plainly. (Dr. D Heyland, Queens)
(6) Respectful and clear team communication is a key contributor to patient safety! (Dr. B Haroon)
The structure of the conference may change in upcoming years; be on the lookout for a
needs assessment survey that will be distributed in the near future- we look forward to
hearing from you about what you would like to see at this conference in future!
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Critical Care Quality News● December 2014 ● Issue 2
THANK YOU!
EBOLA PREPARDNESS
Serious preparations are underway for a potential Ebola case hitting
Nova Scotia. With the current outbreak in West Africa, we must remain
vigilant given the international nature of our port city.
A big Thank You to Dr. Rick Hall
and Dr. Marion Cornish for their
superb Critical Care presentations
in October and November. Dr. Hall
presented on Delirium and Dr. Cornish on
life after the intensive care unit.
Ebola is a viral haemorrhagic fever that is highly contagious through
infected body fluids. The incubation period is 2-21 days; patients
become sick with a profound shock state complicated by disseminated
intravascular coagulation (DIC) and multiple organ failure, including
acute kidney injury (AKI) requiring dialysis.
Ebola patients and suspect Ebola patients will be housed in one of two
designated rooms at the VG site, in 3A ICU. Even though Ebola is
NOT transmitted in an airborne fashion, the two rooms chosen
for use are negative pressure rooms. They have been chosen
because they have anterooms already in place.
*If you have not
already practiced
donning/doffing
your PPE, please
make this a priority!
These two rooms have already been
renovated
to
accommodate
new
portable air conditioning in order to help
frontline workers work comfortably and
effectively while garbed in their Personal
Protective Equipment (PPE). We are
working
on
devising
a
secure
communication system to improve
communication between workers IN
patient rooms and those outside, as
hearing is difficult.
STAFF SAFETY is of UTMOST concern! Personnel are being
trained in how to appropriately don/doff their PPE. This is
done following a step-by-step checklist using a "buddy
system" (PPE partner) in order to prevent errors. Staff on 3A are encouraged to
practice with PPE each shift.
PPE is extensive and includes head covering, neck covering, masks, splash-visors,
2 pairs of nitrile gloves, full gown and knee-high booties. You may choose to wear
an N95 mask although N95 is not required. Donning and doffing properly
takes time and care! Nursing staff have been integral in testing the PPE and
making suggestions for improved safety gear. Ebola patients will be treated to the
best of our capability but safety of frontline personnel is of utmost importance. NO
patient contact will ever occur without proper donning of PPE, even in
emergency situations!
New Additions to our Critical Care Family! WELCOME!
 3A New Staff: Bethany Gaudet and Vicki Kirschner plus a Welcome Back to Judy Theriault,
Amanda Parsons, and Kerri Webster-MacIsaac
 5.2 New Staff & Graduates: Susan Hall & Tamara Mitterer CONGRATULATIONS to you both!
Produced by
Department of Critical
Care
1276 South Park St
Rm 377 Bethune Bldg
Halifax, Nova Scotia
B3H 2Y9
Phone:
(902) 473-3486
Fax:
(902) 473-3610
Email:
kristen.griffiths@cdha.
nshealth.ca
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Critical Care Quality News● December 2014 ● Issue 2