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https://www.readbyqxmd.com/read/29329162/reorganizing-care-with-the-implementation-of-electronic-medical-records-a-time-motion-study-in-the-picu
#1
Nadia Roumeliotis, Geneviève Parisien, Sylvie Charette, Elizabeth Arpin, Fabrice Brunet, Philippe Jouvet
OBJECTIVES: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. DESIGN: A prospective, observational, time-motion study. SETTING: A level 3 PICU. PARTICIPANTS: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. INTERVENTIONS: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29324947/cognitive-changes-in-nurses-working-in-intensive-care-units
#2
Daniel Aragão Machado, Nébia Maria Almeida de Figueiredo, Luciane de Souza Velasques, Cleonice Alves de Melo Bento, Wiliam César Alves Machado, Lúcia Alves Marques Vianna
OBJECTIVE: To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours. METHOD: An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning. RESULTS: Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99...
January 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29317259/adherence-to-contact-precautions-among-different-types-of-healthcare-workers-through-video-monitoring-in-a-tertiary-hospital
#3
Yuichi Katanami, Kayoko Hayakawa, Takeshi Shimazaki, Yuko Sugiki, Saho Takaya, Kei Yamamoto, Satoshi Kutsuna, Yasuyuki Kato, Norio Ohmagari
BACKGROUND: Contact precautions are required to prevent transmission of multidrug-resistant organisms; however, reports on adherence rates vary. Through video monitoring, we evaluated adherence to the use of personal protective equipment (PPE) among different types of healthcare workers. METHODS: This study was an observational study conducted in a 781-bed tertiary hospital from July 2016 to March 2017. We installed cameras in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates...
January 6, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29315454/patients-opinions-on-outcomes-following-critical-illness
#4
H K Nedergaard, T Haberlandt, P D Reichmann, P Toft, H I Jensen
BACKGROUND: Our aim was to explore which outcomes are most important to patients following ICU-discharge, and to explore whether intensive care unit (ICU)-nurses and anesthesiologists are aware of patients' priorities. METHODS: First, interviews with adult ICU-survivors were conducted until data saturation was achieved (10 interviews), and six areas with 36 items were identified. Second, interviews with another eight ICU-survivors were conducted, narrowing the list to 20...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#5
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29308828/propofol-for-the-promotion-of-sleep-in-adults-in-the-intensive-care-unit
#6
REVIEW
Sharon R Lewis, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: People 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 people perceive the quality of their sleep to be poor whilst in the ICU. Propofol is an anaesthetic agent which can be used in the ICU to maintain patient sedation and some studies suggest it may be a suitable agent to replicate normal sleep...
January 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29304857/a-qualitative-exploration-of-the-discharge-process-and-factors-predisposing-to-readmissions-to-the-intensive-care-unit
#7
Uchenna R Ofoma, Yue Dong, Ognjen Gajic, Brian W Pickering
BACKGROUND: Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. METHODS: Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29300237/dedicated-afternoon-rounds-for-icu-patients-families-and-family-satisfaction-with-care
#8
Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kevin B Huang, Muhammad Hamza, Jessica White, Anna Coppola, Kathleen M Akgün, David M Greer, Evie G Marcolini, Emily J Gilmore, Nils H Petersen, Nona Timario, Kelly Poskus, Kevin N Sheth, David Y Hwang
OBJECTIVE: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN: Pre- and postimplementation (pre-I and post-I) design. SETTING: Single academic neuroscience ICU. PATIENTS: Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29299787/spiritual-health-and-outcomes-in-muslim-icu-patients-a-nationwide-cross-sectional-study
#9
Farshid R Bashar, Amir Vahedian-Azimi, Mahmood Salesi, Mohammadreza Hajiesmaeili, Seyedpouzhia Shojaei, Behrooz Farzanegan, Reza Goharani, Seyed J Madani, Kivan G Moghaddam, Sevak Hatamian, Hosseinali J Moghaddam, Abilio Arrascaeta-Llanes, Andrew C Miller
The aim of the present study is to describe how religiosity and spirituality affect the psychiatric morbidity of Muslim intensive care unit (ICU) patients. We conducted a prospective nationwide cross-sectional study of ICU patients discharged from 45 medical centers spanning 31 proivinces in Iran. Adults (age ≥ 18 years) admitted to the ICU and treated with invasive mechanical ventilation were eligible. Nine validated survey tools were administered to detect direct and indirect associations between spiritual health (SH) and depression, anxiety, and post-traumatic disorder...
January 3, 2018: Journal of Religion and Health
https://www.readbyqxmd.com/read/29295760/the-contents-of-a-patient-diary-and-its-significance-for-persons-cared-for-in-an-icu-a-qualitative-study
#10
Sandra Strandberg, Lisa Vesterlund, Åsa Engström
OBJECTIVES: The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU. RESEARCH METHODOLOGY: An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis...
December 30, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29289914/incidence-outcomes-and-outcome-prediction-of-unplanned-extubation-in-critically-ill-children-an-11year-experience
#11
R Al-Abdwani, C B Williams, C Dunn, J Macartney, K Wollny, H Frndova, N Chin, D Stephens, C S Parshuram
PURPOSE: Unplanned extubation represents loss of control in the ICU, is associated with harm and is used as a measure of quality of care. We evaluated the rates and consequences of unplanned extubation. MATERIALS AND METHODS: Eligible patients were intubated, <18years, and in ICU. Patient, care-related and environmental characteristics were compared in patients who did and did not receive positive pressure ventilation in the 24h after events. Rates are expressed per 100 intubation-days...
December 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29288367/antimicrobial-resistance-and-antibiotic-stewardship-programs-in-the-icu-insistence-and-persistence-in-the-fight-against-resistance-a-position-statement-from-esicm-escmid-waaar-round-table-on-multi-drug-resistance
#12
Jan J De Waele, Murat Akova, Massimo Antonelli, Rafael Canton, Jean Carlet, Daniel De Backer, George Dimopoulos, José Garnacho-Montero, Jozef Kesecioglu, Jeffrey Lipman, Mervyn Mer, José-Artur Paiva, Mario Poljak, Jason A Roberts, Jesus Rodriguez Bano, Jean-François Timsit, Jean-Ralph Zahar, Matteo Bassetti
Antimicrobial resistance (AMR) is a clear and present danger to patients in any intensive care unit (ICU) around the world. Whereas AMR may affect any patient in the hospital, patients in the ICU are particularly at risk of acquiring AMR infections due to the intensity of the treatment, use of invasive devices, increased risk of transmission and exposure to antibiotics. AMR is present in every ICU, although prevalence is geographically different and AMR pathogens encountered are variable. Intensive care and infectious disease specialists from the European Society of Intensive Care Medicine, European Society of Microbiology and Infectious Diseases and World Alliance Against Antimicrobial Resistance, united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population...
December 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29285846/development-of-a-modified-swallowing-screening-tool-to-manage-post-extubation-dysphagia
#13
Martin Christensen, Michaela Trapl
Post-extubation dysphagia is a condition that is becoming a growing concern. The condition occurs in 3-62% of extubated patients and can be related to mixed aetiologies, such as neuromuscular impairment, critical illness and laryngeal damage. The risk factors for developing dysphagia in critically ill patients are under-diagnosed and perhaps underestimated. Recent studies recommend the implementation of a standardized swallowing screen to prevent aspiration and decrease pneumonia rate and mortality. The aim of this quality improvement initiative was the development of a bedside swallowing screening tool to assess effective swallowing post-endotracheal extubation...
December 28, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29282265/does-the-implementation-of-a-novel-intensive-care-discharge-risk-score-and-nurse-led-inpatient-review-tool-improve-outcome-a-prospective-cohort-study-in-two-intensive-care-units-in-the-uk
#14
Jez Fabes, William Seligman, Carolyn Barrett, Stuart McKechnie, John Griffiths
OBJECTIVE: To develop a clinical prediction model for poor outcome after intensive care unit (ICU) discharge in a large observational data set and couple this to an acute post-ICU ward-based review tool (PIRT) to identify high-risk patients at the time of ICU discharge and improve their acute ward-based review and outcome. DESIGN: Retrospective patient cohort of index ICU admissions between June 2006 and October 2011 receiving routine inpatient review. Prospective cohort between March 2012 and March 2013 underwent risk scoring (PIRT) which subsequently guided inpatient ward-based review...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29280907/a-quality-improvement-initiative-to-reduce-out-of-icu-cardiopulmonary-arrests-in-a-tertiary-care-hospital-in-india-a-2-year-learning-experience
#15
Vidya P Menon, Preetha Prasanna, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Rajesh D Pai, Sanjeev Singh
QUALITY PROBLEM OR ISSUE: To assess impact of medical emergency team (MET) in reducing "out-of-ICU" cardiopulmonary arrests and identify barriers to its optimal utilization. INITIAL ASSESSMENT: Frequently observed critical clinical signs and laboratory values of "out-of-ICU" crashes were used to develop Amrita Early Warning Criteria. CHOICE OF SOLUTION: A physician-led MET was established to respond to code MET, activated by a primary nurse...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29280605/physical-restraints-in-intensive-care-experiences-of-patients-families-and-nurses
#16
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
Critically ill patients admitted to an intensive care unit (ICU) often require many invasive procedures and medical devices (Martin and Mathisen 2005). While these interventions are a necessity, they can potentially cause patients a great amount of pain and discomfort, often leading to restlessness and agitation (Langley et al. 2011).
May 2017: Australian Nursing & Midwifery Journal
https://www.readbyqxmd.com/read/29277396/botulism-in-the-icu-nursing-care-plan
#17
G Zariquiey-Esteva, D Galeote-Cózar, P Santa-Candela, A Castanera-Duro
INTRODUCTION AND CASE EVALUATION: Botulism is a rare disease in Europe, caused by the bacterium Clostridium botulinum, notifiable, non-transmissible person-to-person and potentially fatal (between 5 and 10%) if not treated quickly. The favourable opinion of the Clinical Research Ethics Committee was obtained. We present the nursing care plan of a 49-year-old man with a diagnosis of bacterial intoxication caused by Clostridium botulinum, secondary to ingestion of beans in poor condition, who was admitted to the ICU for a total of 35 days...
December 22, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/29277137/effects-of-stress-on-critical-care-nurses-a-national-cross-sectional-study
#18
Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mari Kangasniemi, Joana Fornés-Vives, Rita L Hunsucker, Farshid Rahimibashar, Mohammad A Pourhoseingholi, Leily Farrokhvar, Andrew C Miller
BACKGROUND: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29276557/safety-and-costs-of-stroke-unit-admission-for-select-acute-intracerebral-hemorrhage-patients
#19
Corey R Fehnel, Kimberly M Glerum, Linda C Wendell, N Stevenson Potter, Brian Silver, Muhib Khan, Ali Saad, Shadi Yaghi, Richard N Jones, Karen Furie, Bradford B Thompson
Background and Purpose: There are limited data to guide intensive care unit (ICU) versus dedicated stroke unit (SU) admission for intracerebral hemorrhage (ICH) patients. We hypothesized select patients can be safely cared for in SU versus ICU at lower costs. Methods: We conducted a retrospective cohort study of consecutive patients with predefined minor ICH (≤20 cm3, supratentorial, no coagulopathy) receiving care in either an ICU or an SU. Multiple linear regression and inverse probability weighting were used to adjust for differences in patient characteristics and nonrandom ICU versus SU assignment...
January 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29275269/improving-icu-services-in-resource-limited-settings-perceptions-of-icu-workers-from-low-middle-and-high-income-countries
#20
Rashan Haniffa, A Pubudu De Silva, Luciano de Azevedo, Dilini Baranage, Aasiyah Rashan, Inipavudu Baelani, Marcus J Schultz, Arjen M Dondorp, Martin W Dünser
PURPOSE: To evaluate perceptions of intensive care unit (ICU) workers from low-and-middle income countries (LMICs) and high income countries (HICs). MATERIALS AND METHODS: A cross sectional design. Data collected from doctors using an anonymous online, questionnaire. RESULTS: Hundred seventy-five from LMICs and 43 from HICs participated. Barriers in LMICs were lack of formal training (Likert score median 3 [inter quartile range 3]), lack of nurses (3[3]) and low wages (3[4])...
December 14, 2017: Journal of Critical Care
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