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icu admition priority

Beatriz Soares, Susana Pissarra, Ana Lídia Rouxinol-Dias, Sandra Costa, Hercília Guimarães
OBJECTIVE: To investigate the incidence and risk factors for central line related complications in neonates. METHODS: A retrospective cohort study of infants who underwent central line (CL) placement, from 1 July 2014 to 31 June 2016, was conducted in Neonatal Intensive Care Unit of Centro Hospitalar de São João. Infants hospitalized more than 2 days and CLs placed for more than 24 hours were included. Patients' demographic characteristics, hospital data and information on CLs were collected...
July 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
J C King, J E Schweinle, R J Hatchett, Y Gao, R Lichenstein, J Zhou
We utilized de-identified data to evaluate increases in four outcomes during influenza outbreak periods (IOPs) including: hospitalization, intensive care unit admission, mechanical ventilation or death for adults aged 18 years or older with medically attended acute respiratory illnesses (MAARI) admitted to any of Maryland's 50 acute-care hospitals over 12 years. Weekly numbers of positive influenza tests in the Maryland area were obtained from the US Center for Disease Control and Prevention interactive website...
June 9, 2017: Epidemiology and Infection
Ankit Soni, Sandeep Kadam, Anand Pandit, Sanjay Patole
INTRODUCTION: Early home discharge of preterm infants is a priority in developing countries due to bed shortage and poor socio-economic status. There is wide variation in home discharge policies for preterm infants. Limited data exists on optimal timing for discharging such infants. In view of the socio-economic and medico-legal importance of the issue, we aimed to study the outcomes of our ex-preterm infants discharged home 'early', to guide our clinical practice. AIM: To study the rates of re-admissions/mortality within 4 weeks after discharge in preterm (born <34 weeks) infants...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
A Deptuła, E Trejnowska, G Dubiel, M Żukowski, A Misiewska-Kaczur, T Ozorowski, W Hryniewicz
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals...
January 4, 2017: Journal of Hospital Infection
Bruno François, Marc Clavel, Philippe Vignon, Pierre-François Laterre
BACKGROUND: Critical care is a complex field of medicine, especially because of its diversity and unpredictability. Mortality rates of the diseases are usually high and patients are critically ill, admitted in emergency, and often have several overlapping diseases. This makes research in critical care also complex because of patients' conditions and because of the numerous ethical and regulatory requirements and increasing global competition. Many clinical trials in critical care have thus failed and almost no drug has yet been developed to treat intensive care unit (ICU) patients...
2016: Journal of Intensive Care
Eli L Diamond, Katherine S Panageas, Alexis Dallara, Ariel Pollock, Allison J Applebaum, Alan C Carver, Elena Pentsova, Lisa M DeAngelis, Holly G Prigerson
CONTEXT: Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life are almost invariably a matter of "when," not a matter of "if." Optimizing symptom management and quality of life in later stages of disease is of the utmost priority. OBJECTIVES: To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM. METHODS: Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission...
February 2017: Journal of Pain and Symptom Management
Y M Ye, F M Wang, C Jin, L L Zhou, D Q Chen
Objective: To investigate the hospital costs and related influencing factors in patients with acute poisoning. Methods: A retrospective analysis was performed for the general status and hospital costs of 373 patients with acute poisoning who were admitted to The Second Affiliated Hospital of Wenzhou Medical College from January 2009 to March 2015. The questionnaires were completed, the data were entered into Excel forms, and SPSS 18.0 was used to perform statistical analysis. Results: Among the 373 patients, 44...
July 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Sean M Bagshaw, Dawn Opgenorth, Melissa Potestio, Stephanie E Hastings, Shelanne L Hepp, Elaine Gilfoyle, David McKinlay, Paul Boucher, Michael Meier, Jeanna Parsons-Leigh, R T Noel Gibney, David A Zygun, Henry T Stelfox
OBJECTIVES: Discrepancy in the supply-demand relationship for critical care services precipitates a strain on ICU capacity. Strain can lead to suboptimal quality of care and burnout among providers and contribute to inefficient health resource utilization. We engaged interprofessional healthcare providers to explore their perceptions of the sources, impact, and strategies to manage capacity strain. DESIGN: Qualitative study using a conventional thematic analysis...
April 2017: Critical Care Medicine
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. DESIGN: A descriptive, cross-sectional correlational study. SETTING: Neuroscience ICU in a major medical center. PARTICIPANTS: A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015...
November 2016: Critical Care Medicine
Aaron C Spicer, Carolyn S Calfee, Matthew S Zinter, Robinder G Khemani, Victoria P Lo, Mustafa F Alkhouli, Benjamin E Orwoll, Ana L Graciano, Juan P Boriosi, James P Howard, Heidi R Flori, Michael A Matthay, Anil Sapru
OBJECTIVES: Despite declining mortality, acute respiratory distress syndrome is still involved in up to one third of pediatric intensive care deaths. The recently convened Pediatric Acute Lung Injury Consensus Conference has outlined research priorities for the field, which include the need for accurate bedside risk stratification of patients. We aimed to develop a simple yet robust model of mortality risk among pediatric patients with acute respiratory distress syndrome to facilitate the targeted application of high-risk investigational therapies and stratification for enrollment in clinical trials...
October 2016: Pediatric Critical Care Medicine
Vibeke Klastrup, Anne Mette Hvass, Julie Mackenhauer, Kurt Fuursted, Henrik Carl Schønheyder, Hans Kirkegaard
BACKGROUND: The search for the site of infection has high priority in patients with severe sepsis and septic shock. However, it is questionable whether mortality is associated with the specific site of infection in patients admitted to an intensive care unit (ICU). Therefore, the 30-day and 90-day mortalities in ICU patients admitted with suspected or confirmed community-acquired infection were studied. METHODS: A retrospective cohort study was conducted, including all adult patients admitted to a multi-specialty tertiary ICU with severe sepsis or septic shock from November 2008 to October 2010...
October 2016: Infectious Diseases
Joao Gabriel Rosa Ramos, Beatriz Perondi, Roger Daglius Dias, Leandro Costa Miranda, Claudio Cohen, Carlos Roberto Ribeiro Carvalho, Irineu Tadeu Velasco, Daniel Neves Forte
BACKGROUND: Intensive care unit (ICU) admission triage is performed routinely and is often based solely on clinical judgment, which could mask biases. A computerized algorithm to aid ICU triage decisions was developed to classify patients into the Society of Critical Care Medicine's prioritization system. In this study, we sought to evaluate the reliability and validity of this algorithm. METHODS: Nine senior physicians evaluated forty clinical vignettes based on real patients...
April 2, 2016: Critical Care: the Official Journal of the Critical Care Forum
Burcu Bursal Duramaz, Hamdi Murat Yıldırım, Hasan Serdar Kıhtır, Osman Yeşilbaş, Esra Şevketoğlu
AIM: This study aimed to determine the epidemiological and clinical characteristics of pediatric forensic cases to contribute to the literature and to preventive health care services. MATERIAL AND METHODS: Pediatric forensic cases hospitalized in our pediatric intensive care unit below the age of 17 years were reviewed retrospectively (January 2009-June 2014) . The patients were evaluated in two groups as physical traumas (Group A) and poisonings (Group B). The patients' age, gender, complaints at presentation, time of presentation and referral (season, time) and, mortality rates were determined...
September 2015: Türk Pediatri Arşivi
Lavi Oud
BACKGROUND: Contemporary reporting of maternal mortality is focused on single, mutually exclusive causes of death among a minority of maternal decedents (pregnancy-related deaths), reflecting initial events leading to death. Although obstetric patients are susceptible to the lethal effects of downstream, more proximate contributors to death and to conditions not caused or precipitated by pregnancy, the burden of both categories and related patients' attributes is invisible to clinicians and healthcare policy makers with the current reporting system...
December 2015: Journal of Clinical Medicine Research
J R Paño-Pardo, C Schüffelmann-Gutiérrez, L Escosa-García, M Laplaza-González, F Moreno-Ramos, R Gómez-Gil, J D López, I Jordán, C Téllez, P de la Oliva
Improving antimicrobial use is a complex process that requires an accurate assessment of ongoing problems and barriers. Paediatric intensive care units (PICU) have seldom been assessed from this perspective. Two Internet-based, self-administered surveys were conducted nationwide in Spain between January and February 2014. The first survey aimed to assess those characteristics of Spanish PICUs that could influence antimicrobial prescribing or antimicrobial stewardship. The second survey targeted Spanish PICU physicians and pursued to assess their attitudes and perceptions regarding antimicrobial resistance and antimicrobial use...
February 2016: Clinical Microbiology and Infection
Hayley L Merkeley, Juliya Hemmett, Tara A Cessford, Neda Amiri, Georgia S Geller, Nazli Baradaran, Monica Norena, Hubert Wong, Najib Ayas, Peter M Dodek
PURPOSE: The purpose of the study is to reduce unnecessary ordering of routine-priority blood tests. METHODS: In this before-after study, we studied all patients admitted to a 15-bed tertiary intensive care unit (ICU) from July 1, 2011, to June 27, 2013. Based on input from intensivists, acceptable indications for ordering routine-priority complete blood counts (CBCs) and electrolyte/renal panels were developed. Sequential interventions were (1) education sessions for ICU housestaff about the lack of evidence for routine-priority blood tests; (2) an item on the ICU rounds checklist to ask if routine-priority blood tests were indicated; (3) a rubber stamp, "routine bloodwork NOT indicated for tomorrow," was used in the chart; (4) a prompt in the electronic ordering system to allow only accepted indications; and (5) a second educational session for ICU housestaff...
February 2016: Journal of Critical Care
Deborah Steiner, Fabienne Renetseder, Alexander Kutz, Sebastian Haubitz, Lukas Faessler, Janet Byron Anderson, Svenja Laukemann, Anna Christina Rast, Susan Felder, Antoinette Conca, Barbara Reutlinger, Marcus Batschwaroff, Petra Tobias, Ulrich Buergi, Beat Mueller, Philipp Schuetz
BACKGROUND: Accurate initial patient triage in the emergency department (ED) is pivotal in reducing time to effective treatment by the medical team and in expediting patient flow. The Manchester Triage System (MTS) is widely implemented for this purpose. Yet the overall effectiveness of its performance remains unclear. OBJECTIVES: We investigated the ability of MTS to accurately assess high treatment priority and to predict adverse clinical outcomes in a large unselected population of medical ED patients...
April 2016: Journal of Emergency Medicine
Markus Lang, Susan Waterworth, Anthony O'Brien
BACKGROUND: The world's leading cause of preventable deaths, diseases and disabilities is smoking. Hospitalization can provide an opportunity for smokers to quit. Previous research found that smokers make up a high percentage of patients admitted to intensive care. Health care professionals working in critical care environments can make a valuable contribution to this public health issue by providing smoking cessation advice. AIM: To identify factors that inhibit and facilitate the delivery of smoking cessation advice by nurses and doctors in critical care settings...
July 15, 2015: Nursing in Critical Care
Frode Lindemark, Øystein A Haaland, Reidar Kvåle, Hans Flaatten, Kjell A Johansson
BACKGROUND: Knowledge about the expected life years gained from intensive care unit (ICU) admission could inform priority-setting decisions across groups of ICU patients and across medical specialties. The aim of this study was to estimate expected remaining lifetime for patients admitted to ICUs during 2008-2010 and to estimate the gain in life years from ICU admission. METHODS: This is a descriptive, population modelling study of 30,712 adult mixed ICU admissions from the Norwegian Intensive Care Registry...
2015: PloS One
A Avila-Alvarez, R Carbajal, E Courtois, S Pertega-Diaz, J Muñiz-Garcia, K J S Anand
INTRODUCTION: Pain management and sedation is a priority in neonatal intensive care units. A study was designed with the aim of determining current clinical practice as regards sedation and analgesia in neonatal intensive care units in Spain, as well as to identify factors associated with the use of sedative and analgesic drugs. METHOD: A multicenter, observational, longitudinal and prospective study. RESULTS: Thirty neonatal units participated and included 468 neonates...
August 2015: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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