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https://www.readbyqxmd.com/read/28105127/clinical-study-on-cluster-care-to-prevent-multi-drug-resistant-infection-in-icu-patients-with-severe-encephalopathy
#1
Liu Qiong, Zhu Hui
The value of clinical cluster nursing in the prevention of multi-drug resistant (MDR) infection in patients with severe encephalopathy in ICU was evaluated. ICU patients (n=129) diagnosed with severe encephalopathy between 2012 and 2014 were selected as the study group, while 106 cases of ICU patients diagnosed with severe encephalopathy between 2010 and 2012 were retrospectively selected as the control group. Control group patients were offered conventional integrated nursing care, while the study group patients were offered cluster nursing care...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104599/telephone-follow-up-calls-for-older-patients-after-hospital-discharge
#2
Ebony Lewis, Sarah Samperi, Christopher Boyd-Skinner
Population ageing poses many challenges. Recurrent readmission to hospital by frail older people places a strain on health systems and the individual. Registered nurses with experience in emergency department, ICU and aged care conducted telephone follow-up calls to patients or bereaved family members after an acute hospital admission. During follow-up calls, many patients reported feelings of loneliness and social isolation post-discharge. It was also found that patients may not be aware of support services available in the community...
January 18, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#3
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28095838/communication-with-families-regarding-organ-and-tissue-donation-after-death-in-intensive-care-comfort-protocol-for-an-intervention-study
#4
Julie E Potter, Robert G Herkes, Lin Perry, Rosalind M Elliott, Anders Aneman, Jorge L Brieva, Elena Cavazzoni, Andrew T H Cheng, Michael J O'Leary, Ian M Seppelt, Val Gebski
BACKGROUND: Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation. METHODS: This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28088171/assessing-the-sustainability-of-daily-chlorhexidine-bathing-in-the-intensive-care-unit-of-a-veteran-s-hospital-by-examining-nurses-perspectives-and-experiences
#5
Jackson S Musuuza, Tonya J Roberts, Pascale Carayon, Nasia Safdar
BACKGROUND: Daily bathing with chlorhexidine gluconate (CHG) of intensive care unit (ICU) patients has been shown to reduce healthcare-associated infections and colonization by multidrug resistant organisms. The objective of this project was to describe the process of daily CHG bathing and identify the barriers and facilitators that can influence its successful adoption and sustainability in an ICU of a Veterans Administration Hospital. METHODS: We conducted 26 semi-structured interviews with a convenience sample of 4 nurse managers (NMs), 13 registered nurses (RNs) and 9 health care technicians (HCTs) working in the ICU...
January 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#6
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#7
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28072939/evaluating-team-based-inter-professional-advanced-life-support-training-in-intensive-care-a-prospective-observational-study
#8
D J Brewster, J A Barrett, E Gherardin, J A O'Neill, D Sage, G Hanlon
Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff. Our new inter-professional team-based advanced life support program involved ICU staff in a large private metropolitan ICU...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28069249/barriers-to-intensive-care-unit-nurses-autonomy-in-iran-a%C3%A2-qualitative-study
#9
Maryam AllahBakhshian, Nasrollah Alimohammadi, Fariba Taleghani, Ahmadreza Yazdan Nik, Saeed Abbasi, Leila Gholizadeh
BACKGROUND: The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. PURPOSE: The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. METHODS: In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method...
December 20, 2016: Nursing Outlook
https://www.readbyqxmd.com/read/28061873/prophylactic-melatonin-for-delirium-in-intensive-care-pro-medic-study-protocol-for-a-randomised-controlled-trial
#10
F Eduardo Martinez, Matthew Anstey, Andrew Ford, Brigit Roberts, Miranda Hardie, Robert Palmer, Lynn Choo, David Hillman, Michael Hensley, Erin Kelty, Kevin Murray, Bhajan Singh, Bradley Wibrow
BACKGROUND: Delirium is an acute state of brain dysfunction characterised by fluctuating inattention and cognitive disturbances, usually due to illness. It occurs commonly in the intensive care unit (ICU), and it is associated with greater morbidity and mortality. It is likely that disturbances of sleep and of the day-night cycle play a significant role. Melatonin is a naturally occurring, safe and cheap hormone that can be administered to improve sleep. The main aim of this trial will be to determine whether prophylactic melatonin administered to critically ill adults, when compared with placebo, decreases the rate of delirium...
January 6, 2017: Trials
https://www.readbyqxmd.com/read/28057565/development-and-validation-of-a-continuously-age-adjusted-measure-of-patient-condition-for-hospitalized-children-using-the-electronic-medical-record
#11
Michael J Rothman, Joseph J Tepas, Andrew J Nowalk, James E Levin, Joan M Rimar, Albert Marchetti, Allen L Hsiao
Awareness of a patient's clinical status during hospitalization is a primary responsibility for hospital providers. One tool to assess status is the Rothman Index (RI), a validated measure of patient condition for adults, based on empirically derived relationships between 1-year post-discharge mortality and each of 26 clinical measurements available in the electronic medical record. However, such an approach cannot be used for pediatrics, where the relationships between risk and clinical variables are distinct functions of patient age, and sufficient 1-year mortality data for each age group simply does not exist...
January 2, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28054195/innovative-power-of-health-care-organisations-affects-it-adoption-a-bi-national-health-it-benchmark-comparing-austria-and-germany
#12
Jens Hüsers, Ursula Hübner, Moritz Esdar, Elske Ammenwerth, Werner O Hackl, Laura Naumann, Jan David Liebe
Multinational health IT benchmarks foster cross-country learning and have been employed at various levels, e.g. OECD and Nordic countries. A bi-national benchmark study conducted in 2007 revealed a significantly higher adoption of health IT in Austria compared to Germany, two countries with comparable healthcare systems. We now investigated whether these differences still persisted. We further studied whether these differences were associated with hospital intrinsic factors, i.e. the innovative power of the organisation and hospital demographics...
February 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28050895/passive-leg-raise-testing-effectively-reduces-fluid-administration-in-septic-shock-after-correction-of-non-compliance-to-test-results
#13
Arjanne Rameau, Eldert de With, Evert Christiaan Boerma
BACKGROUND: Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many strategies to predict 'fluid responsiveness.' The use of PLR testing is applicable to a wide range of clinical situations and has the potential to reduce fluid administration, since PLR testing is based upon (reversible) autotransfusion. Despite these theoretical advantages, data on the net effect on fluid balance as a result of PLR testing remain scarce...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#14
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28030488/a-novel-method-of-optimizing-patient-and-family-centered-care-in-the-icu-family-presence-on-icu-rounds
#15
Steven R Allen, Jose Pascual, Niels Martin, Patrick Reilly, Gina Luckianow, Elizabeth Datner, Kimberly A Davis, Lewis J Kaplan
BACKGROUND: Patient and family centered care permeates critical care where there are often multiple teams involved in management. A method of facilitating information sharing to support shared decision-making is essential in appropriately rendering care.This study sought to determine whether incorporating family members on rounds in the ICU improves patient and family knowledge, and whether doing so improves team time management and satisfaction with the process. METHODS: A nonrandomized, comparative before and after trial of incorporating family members on rounds (July-December 2009 vs January-July 2010) in a single quarternary center's Surgical ICU assessed: 1) family member knowledge, 2) nurse and physician satisfaction with the intervention, 3) frequency and timing of family meetings, and 4) physician workflow...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28013104/the-impact-of-nursing-delirium-preventive-innterventions-in-the-intensive-care-unit-underpin-icu-a-study-protocol-for-a-multi-centre-stepped-wedge-randomized-controlled-trial
#16
Annelies Wassenaar, Paul Rood, Lisette Schoonhoven, Steven Teerenstra, Marieke Zegers, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium is a common disorder in Intensive Care Unit (ICU) patients and is associated with serious short- and long-term consequences, including re-intubations, ICU readmissions, prolonged ICU and hospital stay, persistent cognitive problems, and higher mortality rates. Considering the high incidence of delirium and its consequences, prevention of delirium is imperative. This study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the ICU, called UNDERPIN-ICU (nUrsiNg DEliRium Preventive INterventions in the ICU)...
December 8, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27979608/early-mobilization-reduces-duration-of-mechanical-ventilation-and-intensive-care-unit-stay-in-patients-in-acute-respiratory-failure
#17
Chih-Cheng Lai, Willy Chou, Khee-Siang Chan, Kuo-Chen Cheng, Kuo-Shu Yuan, Chien-Ming Chao, Chin-Ming Chen
OBJECTIVES: To evaluate the effects of a quality improvement program to introduce early mobilization on the outcome of mechanical ventilation (MV) patients in the Intensive Care Unit (ICU). DESIGN: A retrospective observational study SETTING: 19-beds ICU at a medical center PARTICIPANTS: All adults MV patients admitted a medical ICU INTERVENTION: A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, and patients' family) initiated the protocol within 72 hours of MV, when patients become hemodynamically stable...
December 12, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27976489/improving-the-quality-of-nurse-influenced-patient-care-in-the-intensive-care-unit
#18
Lynsey J Sutton, Rebecca J Jarden
BACKGROUND: Quality of care is a major focus in the intensive care unit (ICU). AIM: To describe a nurse-initiated quality improvement (QI) project that improved the care of critically ill patients in a New Zealand tertiary ICU. DESIGN: A framework for QI was developed and implemented as part of a practice change initiative. METHODS: Audit data were collected, analysed and reported across seven nurse-influenced patient care standards...
December 14, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27969044/a-preliminary-evaluation-of-trust-and-shared-decision-making-among-intensive-care-patients-family-members
#19
Elizabeth G Epstein, Katherine Wolfe
PURPOSE: The purpose of this study was to preliminarily evaluate ICU family members' trust and shared decision making using modified versions of the Wake Forest Trust Survey and the Shared Decision Making-9 Survey. METHODS: Using a descriptive approach, the perceptions of family members of ICU patients (n=69) of trust and shared decision making were measured using the Wake Forest Trust Survey and the 9-item Shared Decision Making (SDM-9) Questionnaire. Both surveys were modified slightly to apply to family members of ICU patients and to include perceptions of nurses as well as physicians...
November 2016: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/27966302/cost-analysis-and-evaluation-of-nosocomial-infections-in-intensive-care-units
#20
Uğur Kostakoğlu, Sedat Saylan, Mevlüt Karataş, Serap İskender, Firdevs Aksoy, Gürdal Yılmaz
BACKGROUND/AIM: The purpose of this study was to evaluate nosocomial infections occurring in our hospital intensive care units (ICUs) and the risk factors for these, and to determine the effect of these infections on mortality and cost. MATERIALS AND METHODS: This retrospective study was performed via infection control committee surveillance data, ICU records, and information processing data between 1 January and 31 December 2013 at the Kanuni Education and Research Hospital...
November 17, 2016: Turkish Journal of Medical Sciences
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