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https://www.readbyqxmd.com/read/29618112/critical-care-in-the-military-health-system-a-survey-based-summary-of-critical-care-services
#1
Jason J Nam, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Ferdinand Bacomo, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Introduction: Critical care is an important component of in-patient and combat casualty care, and it is a major contributor to U.S. healthcare costs. Regular exposure to critically ill and injured patients may directly contribute to wartime skills retention for military caregivers. Data describing critical care services in the Military Health System (MHS), however, is lacking. This study was undertaken to describe MHS critical care services, their resource utilization, and differences in care practices amongst military treatment facilities (MTFs)...
March 29, 2018: Military Medicine
https://www.readbyqxmd.com/read/29606481/frequency-and-risk-factors-for-subsyndromal-delirium-in-an-intensive-care-unit
#2
Chikayo Yamada, Yoko Iwawaki, Kiyomi Harada, Michihiko Fukui, Masafumi Morimoto, Ryuya Yamanaka
OBJECTIVE: Delirium and subsyndromal delirium in critically ill patients are important determinants of long-term functional disability and cognitive impairment. However, few outcome studies on sub-syndromal delirium have been reported. Thus, this study aimed to evaluate the incidence of delirium and sub-syndromal delirium as well as the risk factors and progression to delirium. DESIGN: A prospective cohort study. SETTING: Six bed medical and surgical intensive care unit in Otsu Municipal Hospital in Japan...
March 29, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29605703/variability-in-the-time-to-initiation-of-cpr-in-continuously-monitored-pediatric-icus
#3
M Olson, E Helfenbein, L Su, M Berg, L Knight, L Troy, L Sacks, D Sakai, F Su
AIM: To study the influence of patient characteristics and unit ergonomics and human factors on the time to initiation of CPR. METHODS: A single center study of children, 0 to 21 years old, admitted to an ICU who experienced cardiopulmonary arrest (CPA) requiring >1 minute of chest compressions. Time of CPA was determined by analysis of continuous ECG, plethysmography, arterial blood pressure, and end-tidal CO2 (EtCO2 ) waveforms. Initiation of CPR was identified by the onset of cyclic artifact in the ECG waveform...
March 29, 2018: Resuscitation
https://www.readbyqxmd.com/read/29599071/maintaining-normothermia-why-and-how
#4
Daniele Trevisanuto, Daniela Testoni, Maria Fernanda B de Almeida
A high incidence of postnatal hypothermia has been reported in high-as well low-resource countries and it remains an independent predictor of neonatal morbidity and mortality, especially in very preterm infants in all settings. The temperature of newly born infants should be maintained between 36.5 and 37.5 °C after birth through admission and stabilization. Interventions to achieve this may include environmental temperature 23-25 °C, use of radiant warmers, exothermic mattresses, woollen or plastic caps, plastic wraps, humidified and heated gases...
March 21, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29596292/informing-leadership-models-nursing-and-organizational-characteristics-of-neonatal-intensive-care-units-in-freestanding-children-s-hospitals
#5
Cheryl A Toole, Michele DeGrazia, Jean Anne Connor, Kimberlee Gauvreau, Hillary Bishop Kuzdeba, Patricia A Hickey
BACKGROUND: Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. OBJECTIVES: Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29573855/sleep-at-night-and-association-to-aggressive-behaviour-patients-in-a-psychiatric-intensive-care-unit
#6
Knut Langsrud, Håvard Kallestad, Arne Vaaler, Roger Almvik, Tom Palmstierna, Gunnar Morken
Evaluations of associations between sleep at night and aggressive behaviour in Psychiatric Intensive Care Units (PICU) are lacking. The aims were to explore if sleep duration or night-to-night variations in sleep duration correlated with aggressive behaviour and aggressive incidents the next day and through the whole admission. Fifty consecutive patients admitted to a PICU were included (521 nights) and the nurses registered the time patients were sleeping, aggressive behaviour with The Brøset Violence Checklist (BVC) and aggressive incidents with The Staff Observation Aggression Scale-Revised (SOAS-R)...
March 6, 2018: Psychiatry Research
https://www.readbyqxmd.com/read/29572299/perceptions-of-rounding-checklists-in-the-intensive-care-unit-a-qualitative-study
#7
Bethany Danae Hallam, Courtney C Kuza, Kimberly Rak, Jessica C Fleck, Melanie M Heuston, Debjit Saha, Jeremy M Kahn
BACKGROUND: Rounding checklists are an increasingly common quality improvement tool in the intensive care unit (ICU). However, effectiveness studies have shown conflicting results. We sought to understand ICU providers' perceptions of checklists, as well as barriers and facilitators to effective utilisation of checklists during daily rounds. OBJECTIVES: To understand how ICU providers perceive rounding checklists and develop a framework for more effective rounding checklist implementation...
March 23, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29565142/-tube-feeding-monitoring-as-a-clinical-quality-indicator-at-intensive-care-units
#8
Sara Bermejo de Las Heras, Licia De la Calle de la Rosa, Javier Arias Díaz, Manuel Giner, Antonio Luis Blesa Malpica
BACKGROUND: Malnutrition is particularly prevalent among intensive care unit (ICU) patients, being associated with poor clinical results. Enteral nutrition (EN) offers multiple benefits on critically ill patients and its monitoring was established by the Spanish Society of Critical Care (SEMICYUC) as a clinical quality indicator (CQI; EN patients correctly monitorized / all EN patients, as %). However, no results have been published on its regulated monitoring. OBJECTIVES: Assessing CQI's compliance, identifying difficulties and possibilities for its use...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29559190/physical-restraints-in-intensive-care-an-integrative-review
#9
REVIEW
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
BACKGROUND: Physical restraints (PRs) are commonly used in intensive care units (ICUs) worldwide for the prevention of treatment interference. While PRs are fundamentally used to maintain patient safety, they can negatively impact the experiences of patients and their families and cause moral and ethical dilemmas for ICU nurses. OBJECTIVES: The aim of this integrative review was to explore the current literature on the use of PR in intensive care. METHODS: This article used an integrative review framework to explore the current literature available on the experiences of PR in ICU...
March 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29557594/impact-of-a-program-aimed-at-reducing-catheter-related-infections-implemented-in-nine-pediatric-intensive-care-units-in-argentina
#10
Ana M Lenz, Elena Andion, Silvina Ruvinsky, Clarisa Aguirre, Julieta Alvarez Parma, Facundo Jorro, Gabriela López Cruz, Martín Pascutto, Matías Penazzi, Silvia Santos, Marcela Zuázaga, Norma Aquino, Juan C Vassallo, Guillermo Moreno, Ricardo Magliola, Aldo Haimovich, Luis Landry, Rosa Bologna
INTRODUCTION: Catheter-related infections (CRIs) cause a high level of morbidity and mortality with the increasing use of hospital resources. OBJECTIVE: To describe the outcomes of a program implemented to reduce the rate of CRIs in pediatric intensive care units in Argentina. POPULATION AND METHODS: Collaborative, multi center, clinical-epidemiological, quasiexperimental, before-and-after intervention study. Children who had a central venous catheter during hospitalization in 9 pediatric intensive care units in the Autonomous City of Buenos Aires, Greater Buenos Aires, and other provinces between June 2011 and April 2012 were included...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29551472/the-trauma-life-initiative-the-impact-of-a-multidisciplinary-checklist-process-on-outcomes-and-communication-in-a-trauma-intensive-care-unit
#11
Kimberly Joseph, Sameer Gupta, James Yon, Renee Partida, Lee Cartagena, John Kubasiak, Vanessa Buie, Jared Miller, Dorion Wiley, Kimberly Nagy, Frederic Starr, Andrew Dennis, Matthew Kaminsky, Faran Bokhari
BACKGROUND: Checklists have been advocated to improve quality outcomes/communication in the critical care setting, but results have been mixed. A new checklist process, "TRAUMA LIFE", was implemented in our Trauma Intensive Care Unit (TICU) to replace prior checklists. The purpose of this study was to evaluate the impact of the "TRAUMA LIFE" process implementation on quality metrics and on patient/family communication in the TICU. METHODS: "TRAUMA LIFE" was considered maturely implemented by 2016...
March 9, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29545081/effect-of-organisational-factors-on-the-variation-in-incidence-of-delirium-in-intensive-care-unit-patients-a-systematic-review-and-meta-regression-analysis
#12
REVIEW
Paul Rood, Getty Huisman-de Waal, Hester Vermeulen, Lisette Schoonhoven, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium occurs frequently in intensive care unit (ICU) patients and is associated with numerous deleterious outcomes. There is a large variation in reported delirium occurrence rates, ranging from 4% to 89%. Apart from patient and treatment-related factors, organisational factors could influence delirium incidence, but this is currently unknown. OBJECTIVE: To systematically review delirium incidence and determine whether or not organisational factors may contribute to the observed delirium incidence in adult ICU patients...
March 12, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29544581/percutaneous-tracheostomy-by-physician-intensivists
#13
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29537480/screening-for-delirium-with-the-intensive-care-delirium-screening-checklist-icdsc-a-re-evaluation-of-the-threshold-for-delirium
#14
Soenke Boettger, David Garcia Nuñez, Rafael Meyer, Andre Richter, Alain Rudiger, Maria Schubert, Josef Jenewein
BACKGROUND: With its high incidence and subsequent adverse consequences in the intensive care setting, several instruments have been developed to screen for and detect delirium. One of the more commonly used is the Intensive Care Delirium Screening Checklist (ICDSC); however, the optimal cut-off score indicating delirium has been debated. METHODS: In this prospective cohort study, the ICDSC threshold for delirium set at ≥3, ≥4, or ≥5 was compared with the DSM-IV-TR-determined diagnosis of delirium (used as standard), and with the Confusion Assessment Method for the ICU (CAM-ICU), with respect to their concurrent validity...
March 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29524917/efficacy-of-a-tool-to-predict-short-term-mortality-in-older-people-presenting-at-emergency-departments-protocol-for-a-multi-centre-cohort-study
#15
Magnolia Cardona, Ebony T Lewis, Robin M Turner, Hatem Alkhouri, Stephen Asha, John Mackenzie, Margaret Perkins, Sam Suri, Anna Holdgate, Luis Winoto, Chan-Wei Chang, Blanca Gallego-Luxan, Sally McCarthy, Mette R Kristensen, Michael O'Sullivan, Helene Skjøt-Arkil, Anette A Ekmann, Hanne H Nygaard, Jonas J Jensen, Rune O Jensen, Jonas L Pedersen, Dorothy Breen, John A Petersen, Birgitte N Jensen, Christian Backer Mogensen, Ken Hillman, Mikkel Brabrand
BACKGROUND: Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments. METHODS: Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland. Electronic and paper clinical records will be used to extract risk factors such as nursing home residency, physiological deterioration warranting a rapid response call, personal history of active chronic disease, history of hospitalisations or intensive care unit admission in the past year, evidence of proteinuria or ECG abnormalities, and evidence of frailty to be concurrently measured with Fried Score and Clinical Frailty Scale...
March 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29521868/older-nurses-experiences-of-providing-direct-care-in-hospital-nursing-units-a-qualitative-systematic-review
#16
Karen Parsons, Alice Gaudine, Michelle Swab
BACKGROUND: Most developed countries throughout the world are experiencing an aging nursing workforce as their population ages. Older nurses often experience different challenges then their younger nurse counterparts. With the increase in older nurses relative to younger nurses potentially available to work in hospitals, it is important to understand the experience of older nurses on high paced hospital nursing units. This understanding will lend knowledge to ways of lessening the loss of these highly skilled experienced workers and improve patient outcomes...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29521715/simulation-based-assessment-of-critical-care-front-line-providers
#17
Walter A Boyle, David J Murray, Mary Beth Beyatte, Justin G Knittel, Paul W Kerby, Julie Woodhouse, John R Boulet
OBJECTIVES: Develop a standardized simulation method to assess clinical skills of ICU providers. DESIGN: Simulation assessment. SETTING: Simulation laboratory. SUBJECTS: Residents, Critical Care Medicine fellows, acute care nurse practitioner students. INTERVENTIONS: Performance scoring in scenarios from multiple Critical Care Medicine competency domains. MEASUREMENTS AND MAIN RESULTS: Three-hundred eighty-four performances by 48 participants were scored using checklists (% correct) and holistic "global" ratings (1 [unprepared] to 9 [expert])...
March 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29498534/low-dose-nocturnal-dexmedetomidine-prevents-icu-delirium-a-randomized-placebo-controlled-trial
#18
Yoanna Skrobik, Matthew S Duprey, Nicholas S Hill, John W Devlin
RATIONALE: Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring sedation remains unclear. OBJECTIVES: To determine if nocturnal dexmedetomidine prevents delirium and improves sleep in critically ill adults. METHODS: This two-center, double-blind, placebo-controlled trial randomized 100 delirium-free critically ill adults receiving sedatives to receive nocturnal (21:30 to 6:15h) intravenous dexmedetomidine (0...
March 2, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29492696/the-2014-updated-version-of-the-confusion-assessment-method-for-the-intensive-care-unit-compared-to-the-5th-version-of-the-diagnostic-and-statistical-manual-of-mental-disorders-and-other-current-methods-used-by-intensivists
#19
Gérald Chanques, E Wesley Ely, Océane Garnier, Fanny Perrigault, Anaïs Eloi, Julie Carr, Christine M Rowan, Albert Prades, Audrey de Jong, Sylvie Moritz-Gasser, Nicolas Molinari, Samir Jaber
BACKGROUND: One third of patients admitted to an intensive care unit (ICU) will develop delirium. However, delirium is under-recognized by bedside clinicians without the use of delirium screening tools, such as the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU). The CAM-ICU was updated in 2014 to improve its use by clinicians throughout the world. It has never been validated compared to the new reference standard, the Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5)...
March 1, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29465177/end-of-life-care-in-the-icu-supporting-nurses-to-provide-high-quality-care
#20
Sarah Crowe
ICU care has traditionally focused on curative treatment, but making the decision to withdraw life-sustaining therapies, the there is an increasing awareness of the key role palliative and barriers to providing good end-of-life care, factors that support comfort care play. Through a review of recent literature on end- good end-of-life care, and specific guidelinesfor the withdrawal of-life care and withdrawal of life-sustaining therapies in the of life-sustaining therapies. Using this information, a checklist to intensive care unit, four themes have emerged: the challenges of support end-of-life care by critical care nurses was created...
May 2017: Canadian Journal of Critical Care Nursing
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