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icu checklist

Ilona Willempje Maria Verburg, Alireza Atashi, Saeid Eslami, Rebecca Holman, Ameen Abu-Hanna, Everest de Jonge, Niels Peek, Nicolette Fransisca de Keizer
OBJECTIVE: We systematically reviewed models to predict adult ICU length of stay. DATA SOURCES: We searched the Ovid EMBASE and MEDLINE databases for studies on the development or validation of ICU length of stay prediction models. STUDY SELECTION: We identified 11 studies describing the development of 31 prediction models and three describing external validation of one of these models. DATA EXTRACTION: Clinicians use ICU length of stay predictions for planning ICU capacity, identifying unexpectedly long ICU length of stay, and benchmarking ICUs...
October 20, 2016: Critical Care Medicine
Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
Kelsey Chinnadurai, Lindy Fenlason, Brian Bridges, Mana Espahbodi, Sivakumar Chinnadurai, Jane Blood-Siegfried
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in pediatric intensive care units (ICUs). Ventilator-associated pneumonia protocols decrease the incidence of VAP; however, many components of these protocols are not feasible in all settings. This study was done in a large pediatric hospital in Nicaragua. OBJECTIVE: The aim of this study is to implement a sustainable evidence-based VAP protocol, in a different culture, for the purpose of decreasing VAP rates...
November 2016: Dimensions of Critical Care Nursing: DCCN
Glauco A Westphal, Elisabeth Coll, Rafael L de Souza, Silvana Wagner, Artur Montemezzo, Fernanda Carolina Cani de Souza, Gabriel Torres, Stefan Halla, Tiago C Carnin, Míriam C Machado, Eduardo Berbigier, Fernando Busetto, Ivonei Bittencourt, Karine Gerent, Bruno S de Souza, Manoel Tassinari, Joel de Andrade
BACKGROUND: The disproportion between the large organ demand and the low number of transplantations performed represents a serious public health problem worldwide. Reducing the loss of transplantable organs from deceased potential donors as a function of cardiac arrest (CA) may contribute to an increase in organ donations. Our purpose was to test the hypothesis that a goal-directed protocol to guide the management of deceased donors may reduce the losses of potential brain-dead donors (PBDDs) due to CA...
October 11, 2016: Critical Care: the Official Journal of the Critical Care Forum
Rafaela Guilherme Monte Cassiano, Claudia Maria Gaspardo, Guilherme Cordaro Bucker Furini, Francisco Eulogio Martinez, Maria Beatriz Martins Linhares
Children born preterm are at risk for later developmental disorders. The present study examined the predictive effects of neonatal, sociodemographic, and temperament characteristics on behavioral outcomes at toddlerhood, in children born preterm. The sample included 100 toddlers born preterm and with very-low-birth-weight, and their mothers. Neonatal characteristics were evaluated using medical records. The mothers were interviewed using the Early Childhood Behavior Questionnaire for temperament assessment, and the Child Behavior Checklist for behavioral assessment...
October 1, 2016: Early Human Development
L Dupree Hatch, Peter H Grubb, Amanda S Lea, William F Walsh, Melinda H Markham, Patrick O Maynord, Gina M Whitney, Ann R Stark, E Wesley Ely
OBJECTIVE: To improve patient safety in our NICU by decreasing the incidence of intubation-associated adverse events (AEs). METHODS: We sequentially implemented and tested 3 interventions: standardized checklist for intubation, premedication algorithm, and computerized provider order entry set for intubation. We compared baseline data collected over 10 months (period 1) with data collected over a 10-month intervention and sustainment period (period 2). Outcomes were the percentage of intubations containing any prospectively defined AE and intubations with bradycardia or hypoxemia...
October 2016: Pediatrics
M Gruß, F Salomon
In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and legal representatives must ascertain the previously expressed or presumed will of the patient and act accordingly. The legal principles are specified in the Patient Advance Directives Act and the Patient Rights Act. Any indications for medical treatment need a clearly defined aim of the therapy, which can be questioned during the progress of the disease...
September 29, 2016: Der Anaesthesist
Joseph A Carrese, Gail Geller, Emily D Branyon, Lindsay K Forbes, Rachel J Topazian, Brian W Weir, Omar Khatib, Jeremy Sugarman
OBJECTIVE: Treating patients and family members with respect and dignity is a core objective of health care, yet it is unclear how best to measure this in the ICU setting. Accordingly, we sought to create a direct observation checklist to assess the "respect and dignity status" of an ICU. DESIGN: A draft checklist based on previous work was iteratively revised to enhance accuracy and feasibility. SETTING: Seven ICUs within the Johns Hopkins Health System...
September 22, 2016: Critical Care Medicine
Mahmood Shamshiri, Boudouin Fuh Suh, Nooredin Mohammadi, Reza Nabi Amjad
BACKGROUND: Healthcare-associated infections (HAIs) are acquired by patients while receiving care. The highest incidence of HAIs has been documented in admissions to intensive care units. Adherence to evidence-based practices is the most important step for preventing HAIs. OBJECTIVES: To determine the rate of adherence to evidence-based post-insertion recommended care practices after admission into the intensive care unit for the following devices: central line catheter, indwelling urinary catheter, and mechanical ventilator...
June 2016: Iranian Red Crescent Medical Journal
P Nydahl, R Dubb, S Filipovic, C Hermes, F Jüttner, A Kaltwasser, S Klarmann, H Mende, S Nessizius, C Rottensteiner
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters...
September 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Nahla Tayyib, Fiona Coyer, Peter A Lewis
BACKGROUND: The incidence of pressure ulcers (PUs) in intensive care units (ICUs) is high and numerous strategies have been implemented to address this issue. One approach is the use of a PU prevention bundle. However, to ensure success care bundle implementation requires monitoring to evaluate the care bundle compliance rate, and to evaluate the effectiveness of implementation strategies in facilitating practice change. AIMS: The aims of this study were to appraise the implementation of a series of high impact intervention care bundle components directed at preventing the development of PUs, within ICU, and to evaluate the effectiveness of strategies used to enhance the implementation compliance...
December 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Gerald Sendlhofer, Karina Leitgeb, Brigitte Kober, Gernot Brunner, Christa Tax, Lars-Peter Kamolz
BACKGROUND: Patient safety has become a hot topic, and there are numerous initiatives ongoing to improve patient-relevant processes. But how can both the effectiveness and sustainability of these initiatives be evaluated? The aim of the present paper was to describe the development of an instrument to assess patient safety aspects which can be used for normal hospital ward and intensive care unit rounds or in the operating room. METHODOLOGY: All relevant patient safety guidelines and checklists of the University Hospital Graz were screened...
2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Sarah Soh, Jae-Kwang Shim, Jong-Wook Song, Keung-Nyun Kim, Hyun-Young Noh, Young-Lan Kwak
BACKGROUND: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO2 variations were linked to delirium in elderly patients after spinal surgery. MATERIALS AND METHODS: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist...
August 25, 2016: Journal of Neurosurgical Anesthesiology
Stephanie Halvorson, Brian Wheeler, Marge Willis, Jennifer Watters, Jamie Eastman, Randy O'Donnell, Matthias Merkel
QUALITY ISSUE: Transfers from intensive care units to acute care units represent a complex care transition for hospitalized patients. Within our institution, variation in transfer practices resulted in unpredictable processes in which patient safety concerns were raised. INITIAL ASSESSMENT: Key stakeholders were engaged across the institution. Patient safety ('incident') reports and a staff survey identified safety concerns. CHOICE OF A SOLUTION: Using lean methodology, current transfer processes were mapped for the four adult intensive care units and waste was identified...
August 17, 2016: International Journal for Quality in Health Care
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
Stacie C Bennett, Neil Finer, Louis P Halamek, Nick Mickas, Mihoko V Bennett, Courtney C Nisbet, Paul J Sharek
BACKGROUND: The 2015 American Academy of Pediatrics Neonatal Resuscitation Program (NRP) and International Liaison Committee on Resuscitation (ILCOR) resuscitation guidelines state, "It is still suggested that briefing and debriefing techniques be used whenever possible for neonatal resuscitation." Effective communication and reliable delivery of evidence-based best practices are critical aspects of the 2015 NRP guidelines. To promote optimal communication and best practice-focused checklists use during active neonatal resuscitation, the Readiness Bundle (RB) was integrated within the larger change package deployed in the California Perinatal Quality Care Collaborative's (CPQCC) 12-month Delivery Room Management Quality Improvement Collaborative...
August 2016: Joint Commission Journal on Quality and Patient Safety
A Nama, S Sviri, A Abutbul, I Stav, P V van Heerden
We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient...
July 2016: Anaesthesia and Intensive Care
Ursel Heudorf, Miriam Grünewald, Ulla Otto
AIM: The Commission for Hospital Hygiene and Infection Prevention (KRINKO) updated the recommendations for the prevention of catheter-associated urinary tract infections in 2015. This article will describe the implementation of these recommendations in Frankfurt's hospitals in autumn, 2015. MATERIAL AND METHODS: In two non-ICU wards of each of Frankfurt's 17 hospitals, inspections were performed using a checklist based on the new KRINKO recommendations. In one large hospital, a total of 5 wards were inspected...
2016: GMS Hygiene and Infection Control
Oroma B Nwanodi
Globally, preeclampsia-eclampsia (PE-E) is a major cause of puerperal intensive care unit admission, accounting for up to 10% of maternal deaths. PE-E primary prevention is possible. Antepartum low-dose aspirin prophylaxis, costing USD $10-24 can cut the incidence of PE-E in half. Antepartum low molecular weight heparin combined with low-dose aspirin prophylaxis can cut the incidence of early onset PE-E and fetuses that are small for their gestational age in half. Despite predictive antepartum models for PE-E prophylaxis, said prophylaxis is not routinely provided...
2016: Healthcare (Basel, Switzerland)
Kristof Faes, Veerle De Frène, Joachim Cohen, Lieven Annemans
CONTEXT: Patients with chronic obstructive pulmonary disease (COPD) in their final months of life potentially place a high burden upon health care systems. Concrete knowledge about resources used and costs incurred by those patients at the end of life is crucial for policymakers. OBJECTIVES: The aim of this systematic review was to describe the resources used and costs incurred by patients with COPD at the end of life. METHODS: We performed a comprehensive literature search in Medline, Web of Science and Econlit...
July 8, 2016: Journal of Pain and Symptom Management
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