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St. Michael’s nurse helps patients through transitions in care

Toronto, May 14, 2014

By Patricia Favre

Cecilia Santiago reviews a patient care plan
Cecilia Santiago (right) reviews a patient care plan with nurse colleague Rachel Craig (left) in the MSICU. (Photo by Katherine Cooper)

Cecilia Santiago has a plan. Whether patients are waiting to get into the Medical Surgical ICU or transition out of it, her plan will help get them there.

Santiago, the clinical nurse specialist at St. Michael’s MSICU, works with Toronto Central LHIN co-ordinators to develop and execute care plans for patients who require ongoing invasive ventilator support.

Thanks to these care plans, Santiago has helped 28 ventilator-dependent patients transition out of the MSICU and into an environment that is better suited for their long-term care needs.

“Patients who are dependent on mechanical ventilators have often gone through some kind of life-altering incident – such as a spinal infarction causing quadriplegia,” said Santiago. “Patients have to be stable for 21 days before transitioning to another care facility, but often families are anxious about leaving the ICU where patients receive one-on-one care.”

Santiago collaborates with the MSICU interprofessional team to develop and implement care plans that address such things as optimizing ventilation through consultation with a respiratory therapist, improving communication by working with a speech language pathologist and enhancing mobility by involving nurses, physiotherapists and occupational therapists.

“The goal is to get patients to a point where they can safely transition to a better environment for them,” said Santiago. “But care plans also aim to put families at ease by preparing them for a setting that isn’t constantly monitored.”

Patients’ families are educated about leaving the ICU setting and Santiago helps with the preparation of patient medical history and applications for long-term care facilities.

“By helping patients transition to a long-term care facility we can help them attain a better quality of life,” said Santiago. “These facilities offer a home-like setting where patients have private rooms and often access to gardens. In turn, beds in our MSICU are opened up for other patients who need the ICU setting.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.