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https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#1
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792254/introduction-of-new-theory-for-hand-hygiene-surveillance-healthcare-environment-theory
#2
Sharon Lea Kurtz
BACKGROUND AND PURPOSE: The purpose of this article is to introduce a theoretical foundation, the healthcare environment theory (HET), tested in a quantitative, cross-sectional, overt observational study measuring the association of demographic variables with consistent hand hygiene compliance of the ICU nurse. METHODS: Six environments found in a hospital ICU setting (family, church, work, administration, community, and culture) work bi-directionally to influence and be influenced by the nurse, simultaneously influencing each of the other environments in a multidirectional manner...
May 1, 2018: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/29788110/long-term-compliance-with-a-validated-intravenous-insulin-therapy-protocol-in-cardiac-surgery-patients-a-quality-improvement-project
#3
Guillaume Besch, Andrea Perrotti, Lucie Salomon du Mont, Raphaelle Tucella, Guillaume Flicoteaux, Aline Bondy, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
Quality problem: Safe and efficient blood glucose (BG) level control after cardiac surgery relies on an intensive care unit (ICU) team-based approach, including implementation of a dynamic insulin therapy protocol (ITP). Long-term compliance with such a complex protocol is poorly addressed in the literature. The aim of this study was to assess the long-term compliance of nurses with the ITP, 7 years after its implementation in the ICU. Initial assessment: A professional practice evaluation, integrated in a process of quality improvement program, was retrospectively conducted on 224 consecutive cardiac surgery patients over a 6-month period (PHASE 1)...
May 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29787309/predicting-intensive-care-unit-readmission-with-machine-learning-using-electronic-health-record-data
#4
Juan C Rojas, Kyle A Carey, Dana P Edelson, Laura R Venable, Michael D Howell, Matthew M Churpek
RATIONALE: Patients transferred from the intensive care unit (ICU) to the wards who are later readmitted to the ICU have increased length of stay, healthcare expenditure, and mortality compared to those who are never readmitted. Improving risk-stratification for patients transferred to the wards could have important benefits for critically ill hospitalized patients. OBJECTIVE: We aimed to use a machine-learning technique to derive and validate an ICU readmission prediction model with variables available in the electronic health record (EHR) in real-time and compare it to previously published algorithms...
May 22, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#5
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29775510/educational-intervention-on-delirium-assessment-using-confusion-assessment-method-icu-cam-icu-in-a-general-intensive-care-unit
#6
Vimala Ramoo, Harlinna Abu, Vineya Rai, Surindar Kaur Surat Singh, Ayuni Asma' Baharudin, Mahmoud Danaee, Raveena Rajalachimi R Thinagaran
AIMS AND OBJECTIVES: The primary objective was to assess intensive care unit nurses' knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses' perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives. BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#7
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29765580/predictive-factors-associated-with-mortality-and-discharge-in-intensive-care-units-a-retrospective-cohort-study
#8
Mohammad Ghorbani, Haleh Ghaem, Abbas Rezaianzadeh, Zahra Shayan, Farid Zand, Reza Nikandish
Background and aim: Accurate prediction of prognosis of patients admitted to intensive care units (ICUs) is very important for the clinical management of the patients. The present study aims to identify independent factors affecting death and discharge in ICUs using competing risk modeling. Methods: This retrospective cohort study was conducted on enrolling 880 patients admitted to emergency ICU in Namazi hospital, Shiraz University of Medical Sciences, Shiraz, Iran during 2013-2015...
March 2018: Electronic Physician
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#9
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29759596/implementing-an-educational-program-to-improve-critical-care-nurses-enteral-nutritional-support
#10
Hyunjung Kim, Sun Ju Chang
BACKGROUND: Although international nutrition societies recommend enteral nutrition guidelines for patients in intensive care units (ICUs), large gaps exist between these recommendations and actual clinical practice. Education programs designed to improve nurses' knowledge about enteral nutrition are therefore required. In Korea, there are no educational intervention studies about evidence-based guidelines of enteral nutrition for critically ill patients. OBJECTIVES: We aimed to evaluate the effects of an education program to improve critical care nurses' perceptions, knowledge, and practices towards providing enteral nutritional support for ICU patients...
May 11, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29757845/impact-of-the-acute-care-nurse-practitioner-in-reducing-the-number-of-unwarranted-daily-laboratory-tests-in-the-intensive-care-unit
#11
Brian K Jefferson, Joan E King
BACKGROUND: Frequent laboratory testing may be necessary at times for critically ill patients. However, the practice of indiscriminate laboratory test ordering is common. PURPOSE: The purpose of this quality improvement project was to assess the effectiveness of the acute care nurse practitioner (ACNP) in reducing the number of unwarranted laboratory tests ordered for ICU patients. To determine whether the presence of an ACNP would make a difference, an ACNP was present on daily ICU multidisciplinary rounds to facilitate the discussion of the laboratory testing needs for each patient for the following 24-hour period...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757412/development-of-a-provincial-initiative-to-improve-glucose-control-in-critically-ill-patients
#12
Peter Dodek, Shari McKeown, Eric Young, Vinay Dhingra
Objective: To describe the development, implementation and initial evaluation of an initiative to improve glucose control in critically ill patients. Design: Glucose control in critically ill patients was chosen by critical care leaders as a target for improvement. This was an observational study to document changes in processes and measures of glucose control in each intensive care unit (ICU). ICU nurse educators were interviewed to document relevant changes between April 2012 and April 2016...
May 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29756746/factors-influencing-consent-to-organ-donation-after-brain-death-certification-a-survey-of-29-intensive-care-units
#13
Guya Piemonte, Maria L Migliaccio, Stefano Bambi, Marco Bombardi, Lorenzo D'antonio, Andrea Guazzini, Caterina Di Pasquale, Laura Tadini-Buoninsegni, Cristiana Guetti, Manuela Bonizzoli, Sara Bagatti, Paolo Lopane, Anna Nativi, Laura Rasero, Adriano Peris
BACKGROUND: Family refusal (FR) to heart beating donation (HBD) in Intensive Care Unit (ICU) is increasing in recent years with a significant impact on the number of transplantable organs. Fostering setting humanization, quality of relationships, respect for will and family reliance towards ICU could be relevant in containing FR to organ donation (OD) in ICU. Our aims were to highlight the effects of structural features of ICUs and humanization determinants on FR in HBD process, and to describe visiting policies, structure and modalities of support in ICUs...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29746721/melatonin-for-the-promotion-of-sleep-in-adults-in-the-intensive-care-unit
#14
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Patients in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and patients perceive the quality of their sleep to be poor whilst in the ICU. Artificial lighting during night-time hours in the ICU may contribute to reduced production of melatonin in critically ill patients...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29739651/nurses-reflections-about-caring-for-critically-ill-non-sedated-and-mechanically-ventilated-critically-ill-patients
#15
Ranveig Lind, Hilde-Irén Liland, Berit S Brinchmann, Inga Akeren
OBJECTIVE: The objective was to explore ICU nurses' experiences of caring for non-sedated, critically ill mechanically ventilated patients, when following a study protocol as part of a clinical trial. DESIGN: The study had a qualitative design with twelve nurses participating in two focus groups. The interviews were analysed using a thematic approach. FINDINGS: One overall theme emerged, "Cautious optimism", which suggests positive experiences but with a negative undertone...
May 5, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29729237/melatonin-and-sleep-in-preventing-hospitalized-delirium-a-randomized-clinical-trial-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#16
Stuti J Jaiswal, Thomas J McCarthy, Nathan E Wineinger, Dae Y Kang, Janet Song, Solana Garcia, Christoffel J van Niekerk, Cathy Y Lu, Melissa Loeks, Robert L Owens
PURPOSE: Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20-30% of hospitalized older adults that is associated with increased morbidity and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. METHODS: This was a randomized clinical trial measuring the impact of 3 mg of melatonin nightly on incident delirium and both objective and subjective sleep in inpatients age ≥ 65, admitted to Internal Medicine wards (non-ICU)...
May 2, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29726418/improving-fluid-management-in-critical-care-towards-the-icu-of-the-future
#17
Katharina Bergmoser, Lucas Pflanzl-Knizacek, Matthias Hafner, Gernot Schilcher, Christian Baumgartner
BACKGROUND: The calculation of daily fluid balances is essential in perioperative and postoperative fluid management in order to prevent severe hypervolemia or hypovolemia in critically ill patients. In this context, modern health information technology has the potential to reduce the workload for health care professionals by not only automating data collection but also providing appropriate decision support. OBJECTIVES: Within this work, current problems and barriers regarding fluid balancing in cardiac intensive care patients are outlined and improvement activities are specified...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29724444/work-system-barriers-and-strategies-reported-by-tele-intensive-care-unit-nurses-a-case-study
#18
REVIEW
Peter L T Hoonakker, Pascale Carayon
Tele-intensive care units (ICUs) are an innovation to handle issues such as personnel shortage and improving care. In tele-ICUs, clinical teams monitor ICU patients remotely and support clinicians in multiple ICUs. The tele-ICU and ICU clinicians function as virtual teams. Little is known how these teams function and what challenges they encounter. We examined the challenges from the perspective of nurses in a tele-ICU. We used a case study design and conducted interviews with 10 tele-ICU nurses. The nurses encounter challenges in interacting with the multiple ICUs that they monitor remotely and have developed strategies to cope with these challenges...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724285/testing-the-reliability-and-validity-of-the-nursing-activities-score-in-critical-care-nursing
#19
Siv K Stafseth, Tor Inge Tønnessen, Lien My Diep, Lisbeth Fagerstrøm
BACKGROUND AND PURPOSE: The purpose of this study was to test the reliability and validity of the conceptual model of critical care nursing using the Nursing Activities Score (NAS) for intensive care unit (ICU) patients. METHODS: An observational study conducted in 2011 using the NAS scores of 219 patients in Norway. The inter-rater reliability (IRR) was tested by parallel classifications. The validity was explored by an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) as the measurement models in the structural equation model...
April 1, 2018: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#20
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
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