PICU nurses “bundle” practices for quicker recovery

PICU nurses “bundle” practices for quicker recovery

Nurses in the pediatric intensive care unit at McMaster Children’s Hospital are vital part of a dynamic team that cares for very sick children. Patients in the PICU need highly specialized care, and its RNs are responsible for coordinating many moving parts to deliver that care.

To provide the quickest recovery possible for these children, the PICU team led by physician Dr. Choong and quality and safety nurse, Filomena Canci Tavares, launched a “liberation bundle”. The team adapted a series of practices from the adult ICU environment to suit their young patients

“The PICU nursing team has been crucial in the early adoption of this bundle.” -Filomena Canci Tavares

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Filomena Canci Tavares

The bundle of practices has been shown to speed up recovery and improve outcomes for vulnerable patients. The goal is to minimize their dependence on machines and medications so they can move out of intensive care and onto a quick recovery. Canci Tavares says, “The PICU nursing team has been crucial in the early adoption of this bundle.”

Examples of practices in the bundle include reducing the amount of sedating medications patients are receiving as their condition begins to improve. This allows the child to communicate their needs and concerns which is an essential first step in getting better. Another practice is to initiate physical activity to strengthen weakened muscles. This reduces the amount of time a child must be on a breathing machine. Nurses work with families to create daily routines as well as promote individualized sleep schedules to help children maintain a regular day-night cycle. This improves sleep, which plays a huge role in recovery.

By embracing this bundled approach to care, nurses are supporting team collaboration to enhance communication within their team and with young patients and their families. Their leadership on this initiative is driving the ultimate goal of the best and earliest possible recovery for all children.


Want to learn about another great initiative in McMaster Children’s Hospital’s PICU? Check out this video on their therapy dog program.