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https://www.readbyqxmd.com/read/27933637/association-of-temporal-variations-in-staffing-with-hospital-acquired-pressure-injury-in-military-hospitals
#1
Patricia A Patrician, Mary S McCarthy, Pauline Swiger, Dheeraj Raju, Sara Breckenridge-Sproat, Xiaogang Su, Kelly H Randall, Lori A Loan
To more precisely evaluate the effects of nurse staffing on hospital-acquired pressure injury (HAPI) development, data on nursing care hours per patient day (NCHPPD), nursing skill mix, patient turnover (i.e., admissions, transfers, and discharges), and patient acuity were merged with patient information from pressure injury prevalence surveys that were collected annually for the Military Nursing Outcomes Database (MilNOD) project. The MilNOD included staffing and adverse events from 56 medical-surgical, stepdown, and critical care units in 13 military hospitals over a 4-year-period...
December 9, 2016: Research in Nursing & Health
https://www.readbyqxmd.com/read/27932214/a-regional-assessment-of-chemicals-of-concern-in-surface-waters-of-four-midwestern-united-states-national-parks
#2
Sarah M Elliott, David D VanderMeulen
Anthropogenic chemicals and their potential for adverse biological effects raise concern for aquatic ecosystem health in protected areas. During 2013-15, surface waters of four Midwestern United States national parks were sampled and analyzed for wastewater indicators, pharmaceuticals, personal care products, and pesticides. More chemicals and higher concentrations were detected at the two parks with greater urban influences (Mississippi National River and Recreation Area and Indiana Dunes National Lakeshore) than at the two more remote parks (Apostle Islands National Lakeshore and Isle Royale National Park)...
December 5, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/27932050/icu-telemedicine-program-financial-outcomes
#3
Craig M Lilly, Christine Motzkus, Teresa Rincon, Shawn E Cody, Karen Landry, Richard S Irwin
BACKGROUND: Intensive care unit (ICU) telemedicine improves access to high quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following tele-ICU implementation and after the addition of logistic center function has not been published. METHODS: Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across 3 groups that differed with regard to telemedicine support: a group without tele-ICU support (Pre-ICU intervention group), a group with tele-ICU support (ICU Telemedicine group) and a tele-ICU group with added logistical center functions and support for quality care standardization (Logistic Center Group)...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27931280/safety-profile-of-oral-immunotherapy-with-cows-milk-and-hen-egg-a-10-year-experience-in-controlled-trials
#4
Giovanni B Pajno, Lucia Caminiti, Fernanda Chiera, Giuseppe Crisafulli, Giuseppina Salzano, Stefania Arasi, Giovanni Passalacqua
BACKGROUND: Oral immunotherapy (OIT) for food allergy is gaining interest due to the favorable clinical results reported with cow's milk, hen egg and peanut. The safety of the procedure remains a critical aspect that can limit the introduction of OIT in clinical practice. OBJECTIVE: We described herein, in detail, the occurrence and characteristics of adverse events (AE) with OIT in children who participated in controlled trials at our unit. METHODS: The clinical records of 68 children who received active treatment (40 for cow's milk and 28 for hen egg) were carefully reviewed...
September 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27930921/nursing-students-attitudes-toward-persons-who-are-aged-an-integrative-review
#5
REVIEW
Susan Hovey, Mary J Dyck, Cynthia Reese, MyoungJin Kim
OBJECTIVES: To analyze empirical studies from the United States and Canada to gain an understanding on how nursing education affects nursing students' attitudes toward persons who are aged. DESIGN: An integrative literature review was completed using Garrard's (2011) Matrix Method. DATA SOURCES: Articles were identified through the electronic database search engines of CINAHL, Pub Med, and Academic Search Complete. Only peer reviewed research articles from 2009 to 2015 were reviewed...
November 27, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27930420/performance-of-spectrogram-based-seizure-identification-of-adult-eegs-by-critical-care-nurses-and-neurophysiologists
#6
Edilberto Amorim, Craig A Williamson, Lidia M V R Moura, Mouhsin M Shafi, Nicolas Gaspard, Eric S Rosenthal, Mary M Guanci, Venkatakrishna Rajajee, M Brandon Westover
INTRODUCTION: Continuous EEG screening using spectrograms or compressed spectral arrays (CSAs) by neurophysiologists has shorter review times with minimal loss of sensitivity for seizure detection when compared with visual analysis of raw EEG. Limited data is available on the performance characteristics of CSA-based seizure detection by neurocritical care nurses. METHODS: This is a prospective, cross-sectional study that was conducted in two academic neurocritical care units and involved thirty-three neurointensive care unit nurses and four neurophysiologists...
December 3, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27928193/developing-a-business-plan-for-critical-care-pharmacy-services
#7
Brian L Erstad, Henry J Mann, Robert J Weber
Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927920/validation-of-autoclave-protocols-for-the-successful-decontamination-of-category-a-medical-waste-generated-from-the-care-of-patients-with-serious-communicable-diseases
#8
Brian T Garibaldi, Mallory Reimers, Neysa Ernst, Gregory Bova, Elaine Nowakowski, James Bukowski, Brandon C Ellis, Chris Smith, Lauren Sauer, Kim Dionne, Karen C Carroll, Lisa L Maragakis, Nicole M Parrish
In response to the Ebola outbreak in 2014, many hospitals designated specific areas to care for patients with Ebola and other highly infectious diseases. The safe handling of Category A infectious substances is a unique challenge in this environment. One solution is onsite waste treatment with a steam sterilizer or autoclave. The Johns Hopkins Hospital (JHH) installed two pass-through autoclaves in its Biocontainment Unit (BCU). The JHH BCU and The Johns Hopkins Biosafety Level 3 Clinical Microbiology Laboratory designed and validated waste handling protocols with simulated patient trash to ensure adequate sterilization...
December 7, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27927721/association-between-day-and-time-of-admission-to-critical-care-and-acute-hospital-outcome-for-unplanned-admissions-to-adult-general-critical-care-units-cohort-study-exploring-the-weekend-effect
#9
N Arulkumaran, D A Harrison, S J Brett
BACKGROUND: We aimed to identify any association between day and time of admission to critical care and acute hospital outcome. METHODS: We conducted a cohort study using prospectively collected data from the national clinical audit of adult critical care. We included 195 428 unplanned admissions from 212 adult general critical care units in England, Wales and Northern Ireland, between April 1, 2013 and March 31, 2015 in the analysis. RESULTS: Hourly admission rates for unplanned admissions varied more than three-fold during the 24 h cycle...
December 7, 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27927604/factors-predicting-failure-of-noninvasive-ventilation-assist-for-preventing-reintubation-among-medical-critically-ill-patients
#10
Preecha Thomrongpairoj, Surat Tongyoo, Withaya Tragulmongkol, Chairat Permpikul
PURPOSE: Reintubation after failed extubation is associated with high mortality. Noninvasive ventilation (NIV) has been used to prevent reintubation, but the results have been inconclusive. We investigated the factors predicting failure of NIV-assisted extubation among medical critically ill patients. MATERIALS AND METHODS: This retrospective cohort study enrolled patients who were admitted to medical intensive care units at Siriraj Hospital between March 2012 and August 2015 who required more than 48 hours of mechanical ventilation and who received NIV after endotracheal extubation...
November 30, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27927546/new-eos-imaging-protocol-allows-a-substantial-reduction-in-radiation-exposure-for-scoliosis-patients
#11
Peter O Newton, Yash Khandwala, Carrie E Bartley, Fredrick G Reighard, Tracey P Bastrom, Burt Yaszay
STUDY DESIGN: Prospective. OBJECTIVE: To evaluate the reliability of three-dimensional (3D) spinal models from Micro Dose EOS x-rays compared to standard, Low Dose EOS x-rays utilized for evaluating patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: There is a strong suggestion that radiation exposure to scoliosis patients can be further reduced. METHODS: Sixty AIS patients who received biplanar, posteroanterior, and lateral standard Low Dose spine x-rays in our EOS imaging unit (∼0...
March 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927189/prehospital-critical-care-for-out-of-hospital-cardiac-arrest-an-observational-study-examining-survival-and-a-stakeholder-focused-cost-analysis
#12
Johannes von Vopelius-Feldt, Jane Powell, Richard Morris, Jonathan Benger
BACKGROUND: Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. METHODS: This prospective, observational study will describe the effect of CCTs on survival from OHCA, when compared to advanced-life-support (ALS), the current standard of prehospital care in the UK...
December 7, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27925078/factors-associated-with-the-occurrence-of-adverse-events-in-critical-elderly-patients
#13
Maria Cecilia Toffoletto, Ricardo Luis Barbosa, Rafaela Andolhe, Elaine Machado de Oliveira, Adriana Janzantte Ducci, Katia Grillo Padilha
Objective: to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics. Method: a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27924171/predictors-of-transition-to-hospice-care-among-hospitalized-older-adults-with-a-diagnosis-of-dementia-in-texas-a-population-based-study
#14
Lavi Oud
BACKGROUND: Decedent older adults with dementia are increasingly less likely to die in a hospital, though escalation of care to a hospital setting, often including critical care, remains common. Although hospice is increasingly reported as the site of death in these patients, the factors associated with transition to hospice care during end-of-life (EOL) hospitalizations of older adults with dementia and the extent of preceding escalation of care to an intensive care unit (ICU) setting among those discharged to hospice have not been examined...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27924081/liver-guardian-modifier-and-target-of-sepsis
#15
REVIEW
Pavel Strnad, Frank Tacke, Alexander Koch, Christian Trautwein
Sepsis and septic shock are characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The liver has a central role during sepsis, and is essential to the regulation of immune defence during systemic infections by mechanisms such as bacterial clearance, acute-phase protein or cytokine production and metabolic adaptation to inflammation. However, the liver is also a target for sepsis-related injury, including hypoxic hepatitis due to ischaemia and shock, cholestasis due to altered bile metabolism, hepatocellular injury due to drug toxicity or overwhelming inflammation, as well as distinct pathologies such as secondary sclerosing cholangitis in critically ill patients...
December 7, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27923397/pharmacological-interventions-for-delirium-in-intensive-care-patients-a-protocol-for-an-overview-of-reviews
#16
Marija Barbateskovic, Laura Krone Larsen, Marie Oxenbøll-Collet, Janus Christian Jakobsen, Anders Perner, Jørn Wetterslev
BACKGROUND: The prevalence of delirium in intensive care unit (ICU) patients is high. Delirium has been associated with morbidity and mortality including more ventilator days, longer ICU stay, increased long-term mortality and cognitive impairment. Thus, the burden of delirium for patients, relatives and societies is considerable. Today, reviews of randomised clinical trials are produced in large scales sometimes making it difficult to get an overview of the available evidence. A preliminary search identified several reviews investigating the effects of pharmacological interventions for the management and prevention of delirium in ICU patients...
December 7, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#17
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#18
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27922841/stress-resiliency-practices-in-neonatal-nurses
#19
Lisa M Pannell, Lynn Rowe, Salena Tully
BACKGROUND: Multiple environmental changes were experienced in a large level III neonatal intensive care unit (NICU) causing a perception of work-related stress leading to high nurse turnover, decreased engagement, and decreased satisfaction. PURPOSE: To identify a preintervention measure of perceived stress resiliency and ranking of interpretive styles in a population of neonatal, bedside registered nurses faced with a change in the physical practice environment...
December 5, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#20
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
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