AMP-ICU
The AMP Adult ICU Early Rehabilitation program is an evidence-based, multi-disciplinary intervention that has been proven safe for ICU patients, even those requiring endotracheal tubes, continuous hemodialysis and femoral catheters. The program’s goal is to reduce deep sedation and get patients mobilized and engaged in functional activities.
Promoting Early Intervention
Why We Need to Change the Standard of Care in Adult ICUs
The problem with the current care in many adult ICUs is an epidemic of deep sedation, with associated bedrest and immobility. After ICU discharge, patients often experience post-intensive care syndrome (PICS), with long-term impairments in physical, cognitive and mental health.
Conversely, when early intervention is started shortly after initiating mechanical ventilation, patients experience less hospital-acquired weakness and impairments, have shorter length of stay, and are more often discharged to their home rather than to a skilled nursing or rehabilitation facility.
How AMP-ICU Works
The Adult ICU Early Rehabilitation Program is a multi-disciplinary approach to critical care for adults that calls for early intervention to get patients wider awake and moving.
To help hospitals facilitate this important paradigm shift in ICU care, the Adult ICU Early Rehabilitation Program provides both hospital and ICU leaders, as well as front-line clinicians, with the tools needed to design and implement a structured quality improvement (QI) process, including:
- Assembling a multidisciplinary team to create and sustain culture change
- Addressing existing cultural and other barriers to changing practice
- Designing and utilizing metrics to evaluate progress.
Program Components
e-Learning Modules
To educate frontline clinicians and champions
Annual CME Meeting
Bringing together health professionals from around the world to learn the latest evidence and approaches
Practical Toolkit
For training, implementation and maintenance
Virtual and On-site Consulting
For specific advice on organizing, planning and implementation
Learn More
AMP-ICU Tools and Resources
Physical Therapy and Occupational Therapy ICU Rehabilitation Foundational Knowledge ($495)
Materials for foundational training of physical and occupational therapists for adult ICU rehabilitation
This 7-module presentation is designed to share foundational knowledge required to safely and professionally develop and perform a physical therapy and occupational therapy plan of care for the critically ill patient. Quiz and skills check-off are also included.
The 7 modules include:
- Introduction to ICU Rehabilitation: Discusses the consequences of immobility and ICU-acquired weakness and the benefits of early activity and rehabilitation
- Understanding ICU Equipment: Details common types of ICU equipment and how to utilize equipment to mobilize patients
- Oxygen Delivery Systems: Reviews the basics of PaO2 vs. SaO2 and identifies common supplemental oxygen — low flow systems
- Understanding Mechanical Ventilation: Identifies types of airways, common modes of ventilation, and possible complications associated with mechanical ventilation
- ICU Lab Values: Discusses lab values relevant to ICU patients
- ICU Delirium: Discusses how to define, assess, prevent, and manage patients with delirium
- Optimal Assessment and Treatment Planning: Discusses the development of an optimal treatment plan for patients in the ICU. Also included: Suggested Diagnoses and Disease Processes
$495 per hospital (1-4 Hospitals), $395 per hospital (5+ Hospitals)
Critical Care Physical Medicine and Rehabilitation Quality Assurance Toolkit ($49)
A collection of quality assurance forms, trackers and calculators used at Johns Hopkins. The toolkit is designed to efficiently monitor and evaluate physical rehabilitation and cognitive evaluations and interventions in the ICU, inclusive of physical therapy, occupational therapy intervention, and delirium assessment.
Toolkit includes:
- Safety guidelines for physical therapy (PT) referrals
- A system to track barriers to PT and OT implementation
- A system to log PT and OT treatments and potential safety issues during a therapy session
- A system to track data quality and training and quality assurance of assessors conducting sedation and delirium assessments, using the validated and recommended RASS and CAM-ICU instruments
Complimentary Critical Care Rehabilitation Toolkit ($0)
Includes training materials, resources, and tools utilized at Johns Hopkins in developing and sustaining the Critical Care Rehabilitation program.
ICU Welcome Packet (for patients and families)
Sedation, delirium, and sleep (for physicians, nurses)
- ICU Sleep Checklist and 4 supporting studies
- Pocket Card: Sample sedation protocol for ICU patients
- Guidance for improving tolerance of endotracheal tube in awake patients
Mobility and rehabilitation guidelines and logbooks (for therapists, physicians, nurses)
- Pocket Card: Safety guidelines for PT/OT referrals
- Monitoring system for safety events & physiological changes
- Use of iPads and apps by occupational therapists in an ICU
- Patient Mobilization Attitudes & Beliefs Survey for the ICU
- Scoring instructions for Patient Mobilization Attitudes & Beliefs Survey
Scales & scoring (for therapists, physicians, nurses)
- ICU Mobility Scale
Finance/budgeting/administration (for ICU leaders, therapists, physicians, nurses)
- Customizable Excel financial analysis model to support ICU Rehabilitation, with a user’s guide
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