CONSIDERATIONS FOR TRANSITION FROM ICU TO INPATIENT REHAB

CITATION

Merbitz NH, Westie K, Dammeyer JA, Butt L, Schneider J. After critical care: Challenges in the transition to inpatient rehabilitation. Rehabilitation Psychology 2016;61(2):186–200. doi:10.1037/rep0000072

SUMMARY

I chose this article because it is highly relevant to psychologists who are working on inpatient rehabilitation and about to see an influx of post-intensive care COVID-19 patients. This 2016 article on biopsychosocial factors influencing the transition of patients from intensive care units (ICU) to inpatient rehabilitation (IPR) is not a research study. Rather, it is a prescient practical summary of the scientific literature on post-intensive care syndrome (PICS) plus clinical pearls from the authors’ own professional experiences. While the article does not cover the unique features of ICU care in the era of COVID-19, there is much in the article to give the reader a head-start on understanding ICU culture, patient/family experiences and how the psychologist can optimize the ICU to IPR transition process. The authors detail some of the features of the ICU environment that contribute to PICS and how critical care experts have been transforming care to improve outcomes including the “ABCDEF Bundle.” The cultures of the ICU and rehabilitation can clash leaving patients and family members confused and unprepared which presents psychologists with an opportunity to act as a guide. They describe common cognitive and emotional complications of ICU stays and tips on assessment and treatment. Figure 2 presents a pithy summary of issues to assess and suggestions for prevention/interventions during each phase of treatment. The article includes strategies to help family members cope and to foster productive collaborative working relationships between the patient and the rehabilitation team. The article wraps up with an elegant summary of how the psychologist can aid patients, family members and the rehabilitation team in the transition from ICU to IPR and to home. There are 4.5 pages of references and multiple links to resources ICU and critical care related resources at the end of the article (and those links still work).

https://psycnet.apa.org/fulltext/2016-23955-008.pdf

THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was chosen by Chuck Bombardier, PhD, Professor, Department of Rehabilitation Medicine, University of Washington.