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https://www.readbyqxmd.com/read/29033992/patient-safety-culture-in-intensive-care-units-from-the-perspective-of-nurses-a-cross-sectional-study
#1
Sedigheh Farzi, Azam Moladoost, Masoud Bahrami, Saba Farzi, Reza Etminani
BACKGROUND: One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. MATERIALS AND METHODS: This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences...
September 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28984007/navigating-difficult-conversations-the-role-of-self-monitoring-and-reflection-in-action
#2
Anita Cheng, Kori LaDonna, Sayra Cristancho, Stella Ng
CONTEXT: Clinicians draw upon experiential knowledge to manoeuvre difficult conversations, using tacit knowledge that is difficult to explicitly teach. Instead, learners are taught to communicate through role-play and checklists, both of which are approaches that may fail during moments of clinical complexity. We know that difficult conversations may provoke anxiety in learners, but we know little about how they learn to navigate them. Without a deeper understanding, we may fail to equip learners with the skills to manoeuvre these conversations in practice...
October 6, 2017: Medical Education
https://www.readbyqxmd.com/read/28976482/it-s-in-your-hands-an-educational-initiative-to-improve-parent-family-hand-hygiene-compliance
#3
Celeste J Chandonnet, Kristan M Boutwell, Nadine Spigel, Judith Carter, Michele DeGrazia, Al Ozonoff, Kathleen Flaherty
BACKGROUND: Health care-associated infections contribute to increased morbidity and mortality, increased resource use, higher costs, and extended hospitalizations. Proper hand hygiene (HH) is essential to health care-associated infection prevention. Low compliance among parents in our neonatal intensive care unit (NICU) was identified and prompted development of an HH initiative. OBJECTIVE: The objective of this quality improvement project was to improve parent HH practices with the ultimate goal of achieving 100% compliance with parent HH...
November 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28948595/-improve-the-ability-of-nurses-to-implement-continuous-veno-venous-hemodialysis
#4
Wei-Ling Hsiao, Chin-Yuan Tsan
BACKGROUND & PROBLEM: Many critically ill patients require continuous veno-venous hemodialysis (CVVH) due to their hemodynamic instability and high-dose inotropic use. However, our surgical intensive care unit nursing staffs are often unable to set up the dialysis circuit in a correct and timely manner, which necessitates requesting the assistance of nearby units. After detailed investigation and analysis, this problem is attributable to the lack of nursing staff hands-on practice, an over reliance on oral instructions, the insufficiency of in-service education, and a lack of familiarity with CVVH set-up equipment...
October 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#5
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28904476/a-methodological-study-to-develop-a-standard-operational-protocol-for-nurses-on-central-line-catheter-care-of-patients-in-selected-intensive-care-units
#6
Rashmita Devi, Sandhya Ghai, Neena Vir Singh, G D Puri
AIM: This study aims to develop a standard operational protocol (SOP) for central line catheter care for nurses. MATERIALS AND METHODS: A preliminary draft of protocol based on extensive review of the literature was developed. The current practices of the nurses regarding central line catheter care were observed. Focus group discussions (FGD) were conducted with the nurses to identify the problems encountered by them during care of central line. Four rounds of Delphi were conducted to validate the protocol...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28895691/implementation-of-a-checklist-to-increase-adherence-to-evidence-based-practices-in-a-single-pediatric-intensive-care-unit
#7
Pablo Eulmesekian, Augusto Pérez, Silvia Díaz, Mateo Ferrero
INTRODUCTION: The use of checklists to increase adherence to evidence-based practices is not yet widespread in pediatric intensive care units. The objective of this study was to achieve 90% compliance with studied practices using an ad hoc checklist. POPULATION AND METHDOS: Time series quasiexperimental study conducted in ventilated children hospitalized in the pediatric intensive care unit. Studied practices included sedation breaks, plateau pressure ≤ 30 cm H 2O, fraction of inspired oxygen ≤ 60%, maintenance of headboard at > 30°, chlorhexidine mouthwash, weekly ventilator circuit changes, preference for enteral feeding, reduction in the threshold for blood transfusions (hemoglobin: 7 g/dL), daily consideration of spontaneous breathing trials and central venous catheter removal...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28857850/interventions-to-improve-hand-hygiene-compliance-in-the-icu-a-systematic-review
#8
Sinéad Lydon, Michael Power, Jennifer McSharry, Molly Byrne, Caoimhe Madden, Janet Elaine Squires, Paul O'Connor
OBJECTIVES: To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES: Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. STUDY SELECTION: English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28854530/intelligent-dynamic-clinical-checklists-improved-checklist-compliance-in-the-intensive-care-unit
#9
A J R De Bie, S Nan, L R E Vermeulen, P M E Van Gorp, R A Bouwman, A J G H Bindels, H H M Korsten
Background: Checklists can reduce medical errors. However, the effectiveness of checklists is hampered by lack of acceptance and compliance. Recently, a new type of checklist with dynamic properties has been created to provide more specific checklist items for each individual patient. Our purpose in this simulation-based study was to investigate a newly developed intelligent dynamic clinical checklist (DCC) for the intensive care unit (ICU) ward round. Methods: Eligible clinicians were invited to participate as volunteers...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#10
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28806561/delirium-and-exposure-to-psychoactive-medications-in-critically-ill-adults-a-multi-centre-observational-study
#11
Lisa D Burry, David R Williamson, Sangeeta Mehta, Marc M Perreault, Ioanna Mantas, Ranjeeta Mallick, Dean A Fergusson, Orla Smith, Eddy Fan, Sebastien Dupuis, Margaret Herridge, Louise Rose
PURPOSE: Investigate the relationship between psychoactive drugs and delirium. MATERIALS AND METHODS: Prospective observational study of 520 critically ill adult patients admitted ≥24h to 6 intensive care units (ICUs). Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4). RESULTS: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28743340/-ventilator-bundle-guided-by-context-of-jci-settings-can-effectively-reduce-the-morbidity-of-ventilator-associated-pneumonia
#12
Lili Zhao, Lili Liu, Jing Chen, Caili Yang, Jianjian Nie, Minwei Zhang
OBJECTIVE: To observe the impact of improving the compliance of ventilator bundle on morbidity of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients undergoing mechanical ventilation (MV) guided by context of Joint Commission International (JCI) settings, and to study the oral care efficacy of suction tube sponge brush. METHODS: A prospective study was conducted. The patients who needed MV admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Xiamen University from January 2013 to December 2016 were enrolled...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#13
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#14
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28711430/implementation-of-a-national-bundle-care-program-to-reduce-catheter-associated-urinary-tract-infection-in-high-risk-units-of-hospitals-in-taiwan
#15
Chih-Cheng Lai, Chun-Ming Lee, Hsiu-Tzy Chiang, Ching-Tzu Hung, Ying-Chun Chen, Li-Hsiang Su, Zhi-Yuan Shi, Jein-Wei Liu, Chang-Pan Liu, Min-Chi Lu, Yin-Ching Chuang, Wen-Chien Ko, Shu-Hui Tseng, Yen-Hsu Chen, Po-Ren Hsueh
BACKGROUND/PURPOSE: This study was intended to investigate the impact of implementation of catheter-associated urinary tract infection (CA-UTI) bundle care on the incidence of CA-UTI in high-risk units. METHODS: Thirteen high-risk units, including medical (n = 5), surgical (n = 3), cardiac intensive care units (n = 2), respiratory care centers (n = 2), and respiratory care ward (n = 1) were included in this quality-improvement project. This study was divided into pre-intervention phase (from January 1 to July 31) and post-intervention phase (from August 1 to October 31) in 2013...
August 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28705759/implementation-of-an-electronic-checklist-in-the-icu-association-with-improved-outcome
#16
Gary Duclos, Sophie Medam, François Antonini, Djamel Mokart, Véronique Paone, Marie Hélène Po, Coralie Vigne, Emmanuelle Hammad, Frédéric Potié, Claude Martin, Laurent Zieleskiewicz, Marc Leone
OBJECTIVE: To assess the impact of an electronic checklist during the morning rounds on ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). PATIENTS AND METHODS: We conducted a retrospective, before/after study in a single ICU of a university hospital. A systematic electronic checklist focusing on guidelines adherence was introduced in January 2012. From January 2008 to June 2014, we screened patients with ICU stay durations of at least 48hours...
July 10, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28699144/palliative-care-needs-assessment-in-the-neuro-icu-effect-on-family
#17
Claire J Creutzfeldt, Marina G Hanna, C Sherry Cheever, Abhijit V Lele, Charles Spiekerman, Ruth A Engelberg, J Randall Curtis
BACKGROUND: Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU). METHODS: We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds...
July 11, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28697802/outcomes-of-subsyndromal-delirium-in-icu-a-systematic-review-and-meta-analysis
#18
Rodrigo B Serafim, Marcio Soares, Fernando A Bozza, José R Lapa E Silva, Felipe Dal-Pizzol, Maria Carolina Paulino, Pedro Povoa, Jorge I F Salluh
BACKGROUND: Subsyndromal delirium (SSD) is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit (ICU) remains unclear. METHODS: We performed a systematic search in PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO, with no language restrictions, up to 1 October 2016 to identify publications that evaluated SSD in ICU patients...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28685809/follow-up-after-intensive-care-treatment-a-questionnaire-survey-of-intensive-care-aftercare-in-denmark
#19
C K W Kjer, S Estrup, L M Poulsen, O Mathiesen
BACKGROUND: Rehabilitation efforts after treatment in the intensive care unit (ICU) are termed intensive care aftercare. It includes both early in-hospital follow-up after ICU-discharge and late follow-up after hospital discharge. This study aims to investigate the current ICU-aftercare activities in Denmark. METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to the heads of all 31 general ICUs in Denmark. Specialized ICUs were not included...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28638278/lifespan-and-associated-factors-of-peripheral-intravenous-cannula-among-infants-admitted-in-public-hospitals-of-mekelle-city-tigray-ethiopia-2016
#20
Eskedar Birhane, Kalayou Kidanu, Mekuria Kassa, Dawit Gerezgiher, Lidia Tsegay, Brhanu Weldu, Genet Kidane, Hadgu Gerensea
BACKGROUND: Peripheral Intravenous cannula (IV) is the most common vascular access device used to administer medications with the exception of medication or fluid with high or low PH or hyperosmolarity which may cause severe damage to small veins. The insertion of a peripheral intravenous cannula in newborn infants can be difficult. Appropriate veins with sufficient capacity to insert a cannula become less available throughout the hospital stay. Once a peripheral intravenous cannula is inserted, it is desirable that its patency can be maintained as long as possible...
2017: BMC Nursing
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