PICULiber8: the ABCs of recovery

Last modified by Grace Scorrar on 2018/02/28 19:30

Advances in PICU care has led to a significant decrease in mortality from critical illness. Unfortunately, this improvement in survival has been offset by an increase in morbidities amongst pediatric survivors. PICU-acquired morbidities such as delirium, withdrawal, weakness and malnutrition can contribute to lingering effects and symptoms well beyond PICU discharge.

This webinar will describe the journey McMaster Children’s PICU has taken to implement a pediatric care bundle (PICULiber8) to help “liberate” children from experiencing these common, often preventable morbidities. The webinar will describe the innovative 8-part bundle designed to prevent specific PICU-acquired morbidities and improve the quality of survival within and beyond the PICU. We will highlight our approach to creating a paradigm shift from excessive sedation and prolonged bedrest, to enabling wakefulness, early mobilization and optimizing the PICU environment to prevent delirium, engage families and facilitate recovery. Families will share personal experiences from their stay to offer health care providers a glimpse into the real challenges of PICU recovery.

We look forward to an active discussion and welcome your stories and experiences as we work collaboratively to improve PICU care and functional recovery for our children and families. We hope you will join us to share your feedback and questions. 

Other resources

Click here to view the webinar presentation

Click here to view the PICULiber8 video

Dr Karen Choong.jpgDr. Karen Choong

Dr Karen Choong is a Pediatric Intensivist in the PICU at McMaster Children’s Hospital, and a Professor in the Departments of Pediatrics, Critical Care, and Health Research Methods, Evidence, and Impact at McMaster University. She has led multiple peer-review funded studies (from CIHR, Heart and Stroke, HSC Foundation and the AFP Innovation fund) focused on fluid management, septic shock and PICU-based rehabilitation. Dr. Choongs current program of research focuses on morbidity prevention and early rehabilitation in critically ill children. Her keen desire to improve outcomes for pediatric survivors of critical illness has led to the implementation of PICULiber8 at McMaster Children’s PICU. 


Dr Cynthia Cupido.jpgDr.Cynthia Cupido

Dr. Cynthia Cupido is a Pediatric Intensivist in the PICU at McMaster Children’s Hospital and Associate Professor in the Departments of Pediatrics and Critical Care at McMaster University.  She is the lead Organ Donation Physician for McMaster Children’s Hospital and is actively involved in educational and academic initiatives in collaboration with Trillium Gift of Life Network. She has provided leadership as Chair and Co-Chair of numerous committees to shape policy around quality end of life and clinical ethics at Hamilton Health Sciences. Dr. Cupido was the founding Program Director for the Royal College accredited Pediatric Critical Care Subspecialty Training Program at McMaster University.  She continues to be actively involved in postgraduate medical education and the transition to Competence by Design.  She is the medical lead for the national initiative by CPSI, “PAD your ICU” and has been instrumental in leading the PICU team through iterative tests of change to identify underlying factors that lead to and perpetuate delirium. This has led to the initiation of a care bundle within PICULiber8 to actively prevent, identify and manage PICU acquired delirium.  With a commitment to humanism, Dr. Cupido established an assisted canine therapy program to support patients, families and staff in the PICU. 


Filomena Tavares.jpg.jpegFilomena Tavares

Filomena is a Registered Nurse with over 20 years of pediatric critical care experience. Most of her career has been spent in the PICU at McMaster Children’s Hospital. Most recently through her roles as Quality and Safety Nurse and as Clinical Leader in PICU, she has provided leadership on many quality improvement initiatives focused on prevention of hospital acquired harm. She is part of the PICULiber8 implementation team and continues to work on sustainability and adoption.


Ashley Todt.jpgAshley Todt

Ashley is Registered Nurse and Clinical Educator for Pediatric Medicine, Pediatric Complex Care and Ambulatory Pediatrics at McMaster Children’s Hospital. At 12 weeks of age, her son became critically ill and was admitted to the PICU with respiratory failure requiring mechanical ventilation. Her son remained in the PICU for 15 days. He then remained on the pediatric ward for an additional 15 days recovering from delirium and iatrogenic drug withdrawal. During this stay, she gained a new perspective of the challenges of recovering from critical illness.