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Intensive care unit visiting policies

Motohiro Matoba
The newly revised 2014 Set of Standards for"Designated Cancer Care Hospitals"mandated the screening of all cancer patients6 for their physical and psychological suffering systematically in both outpatient and inpatient settings as well as rapid response to the suffering detected. It is a step forward as a cancer control policy, but because the pain associated with cancer changes by time depending on factors such as disease progression and treatment, it must be evaluated repeatedly. Simply complying with the standard by measuring once, say on admission or at the initial visit, will not help patients...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Nathalie Gaucher, Sophie Nadeau, Alexandre Barbier, Annie Janvier, Antoine Payot
OBJECTIVE: To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery. STUDY DESIGN: In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study. RESULTS: Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks...
September 2, 2016: Journal of Pediatrics
Michael S Wilkes, James P Marcin, Lois A Ritter, Sherilyn Pruitt
BACKGROUND: Use of tele-intensive care involves organizational and teamwork factors across geographic locations. This situation adds to the complexity of collaboration in providing quality patient-centered care. OBJECTIVE: To evaluate cross-agency teamwork of health care professionals caring for patients in tele-intensive care units in rural and urban regions. METHODS: A national qualitative study was conducted in 3 US geographic regions with tele-intensive care programs...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Maité Garrouste-Orgeas, Isabelle Vinatier, Alexis Tabah, Benoit Misset, Jean-François Timsit
BACKGROUND: The relatives of intensive care unit (ICU) patients must cope with both the severity of illness of their loved one and the unfamiliar and stressful ICU environment. This hardship may lead to post-intensive care syndrome. French guidelines provide recommendations on welcoming and informing families of ICU patients. We questioned whether and how they are applied 5 years after their publication. METHODS: We conducted a large survey among French ICUs to evaluate their visiting policies and how information was provided to patient's family...
December 2016: Annals of Intensive Care
Kate Kynoch, Anne Chang, Fiona Coyer, Annie McArdle
BACKGROUND: Attending to the needs of family members of critically ill patients is an important and necessary step in providing appropriate holistic care for both the patient and the family. Family interaction can significantly impact on the experience of critical illness, notwithstanding the challenge of meeting families' needs for many clinicians in the intensive care unit (ICU). Family needs have been extensively researched; however, a previous Joanna Briggs Institute (JBI) systematic review was the first published systematic review recommending effective interventions for addressing family needs of critically ill patients in an acute intensive care setting...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Shiva Khaleghparast, Soodabeh Joolaee, Majid Maleki, Hamid Peyrovi, Behrooz Ghanbari, Naser Bahrani
BACKGROUND: Families play a vital role in the recovery of patients admitted to Intensive Care Units. They can help patients to adapt themselves to the crisis and feel more satisfied. OBJECTIVE: In this study, we examined the patients' and families' satisfaction with the current visiting policies in Cardiac Intensive Care Units in the largest Cardiovascular Medical and Research Center of Iran. METHOD: This research used a cross-sectional design with a simple random sampling...
2016: Global Journal of Health Science
Fernando C I Marcucci, Marcos A S Cabrera, Anamaria Baquero Perilla, Marilia Maroneze Brun, Eder Marcos L de Barros, Vanessa M Martins, John P Rosenberg, Patsy Yates
BACKGROUND: The Brazilian healthcare system offers universal coverage but lacks information about how patients with PC needs are serviced by its primary care program, Estratégia Saúde da Família (ESF). METHODS: Cross-sectional study in community settings. Patients in ESF program were screened using a Palliative Care Screening Tool (PCST). Included patients were assessed with Karnofsky Performance Scale (KPS), Edmonton Symptom Assessment System (ESAS) and Palliative Care Outcome Scale (POS)...
2016: BMC Palliative Care
A Sánchez-Vallejo, D Fernández, A Pérez-Gutiérrez, M Fernández-Fernández
OBJECTIVE: To describe the needs of the families of patients admitted to the Intensive Care Unit (ICU) and the opinion of ICU professionals on aspects related to the presence of patient relatives in the unit. DESIGN: A prospective descriptive study was carried out between March and June 2015. SETTING: Polyvalent ICU of León University Healthcare Complex (Spain). PARTICIPANTS: Two samples of volunteers were studied: one comprising the relatives emotionally closest to the primarily non-surgical patients admitted to the Unit for over 48hours, and the other composed of ICU professionals with over three months of experience in the ICU...
May 12, 2016: Medicina Intensiva
Hakan Leblebicioglu, Alfonso J Rodriguez-Morales, Gian Maria Rossolini, Rogelio López-Vélez, Jean-Ralph Zahar, Jordi Rello
Depending on their destinations and activities, international travellers are at a significant risk of contracting both communicable and non-communicable diseases. On return to their home countries, such travellers may require intensive care. The emergence of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), and more recently Ebola haemorrhagic fever, has highlighted the risks. Other well-known communicable pathogens such as methicillin-resistant Staphylococcus aureus and carbapenemase-producing Enterobacteriaceae have been described previously...
July 2016: International Journal of Infectious Diseases: IJID
Naveen Salins, Jayita Deodhar, Mary Ann Muckaden
INTRODUCTION: Family satisfaction of Intensive Care Unit (FS-ICU) care is believed to be associated with ICU survival and ICU outcomes. A review of literature was done to determine factors influencing FS-ICU care in ICU deaths. RESULTS: Factors that positively influenced FS-ICU care were (a) communication: Honesty, accuracy, active listening, emphatic statements, consistency, and clarity; (b) family support: Respect, compassion, courtesy, considering family needs and wishes, and emotional and spiritual support; (c) family meetings: Meaningful explanation and frequency of meetings; (d) decision-making: Shared decision-making; (e) end of life care support: Support during foregoing life-sustaining interventions and staggered withdrawal of life support; (f) ICU environment: Flexibility of visiting hours and safe hospital environment; and (g) other factors: Control of pain and physical symptoms, palliative care consultation, and family-centered care...
February 2016: Indian Journal of Critical Care Medicine
Julius Cuong Pham, Christine A Goeschel, Sean M Berenholtz, Renee Demski, Lisa H Lubomski, Michael A Rosen, Melinda D Sawyer, David A Thompson, Polly Trexler, Sallie J Weaver, Kristina R Weeks, Peter J Pronovost
A national collaborative helped many hospitals dramatically reduce central line-associated bloodstream infections (CLABSIs), but some hospitals struggled to reduce infection rates. This article describes the development of a peer-to-peer assessment process (CLABSI Conversations) and the practical, actionable practices we discovered that helped intensive care unit teams achieve a CLABSI rate of less than 1 infection per 1000 catheter-days for at least 1 year. CLABSI Conversations was designed as a learning-oriented process, in which a team of peers visited hospitals to surface barriers to infection prevention and to share best practices and insights from successful intensive care units...
April 2016: Quality Management in Health Care
Mini Jacob, Cynthia Horton, Sharon Rance-Ashley, Tera Field, Robbie Patterson, Claudette Johnson, Holly Saunders, Tracy Shelton, Jessica Miller, Carmen Frobos
BACKGROUND: Although many critical care experts and national organizations support open visitation in intensive care units (ICUs), most ICU visiting policies do not allow unrestricted presence of patients' family members. OBJECTIVE: To describe how well the needs of family members were met in an adult neuroscience ICU with a continuous visitation policy and an adjoining private suite for patients' family members. METHODS: An exploratory, descriptive study design was used to identify the effects of continuous family visitation in the neuroscience ICU on patients' family members and their needs and experiences during their time in the unit...
March 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Hayley B Gershengorn, Allan Garland
Critical illness does not keep to regular, daytime business hours; we must provide high-quality care and support for intensive care unit (ICU) patients 24 hours per day, 7 days per week. Whether this mandates the presence of similar numbers and types of personnel throughout all hours of the day, however, has been the subject of much debate and substantial research. In this article, we review the available literature on the consequences of having three groups of care providers at a patient's bedside overnight: physicians, visitors, and nurses...
February 2016: Seminars in Respiratory and Critical Care Medicine
Justin E Bekelman, Scott D Halpern, Carl Rudolf Blankart, Julie P Bynum, Joachim Cohen, Robert Fowler, Stein Kaasa, Lukas Kwietniewski, Hans Olav Melberg, Bregje Onwuteaka-Philipsen, Mariska Oosterveld-Vlug, Andrew Pring, Jonas Schreyögg, Connie M Ulrich, Julia Verne, Hannah Wunsch, Ezekiel J Emanuel
IMPORTANCE: Differences in utilization and costs of end-of-life care among developed countries are of considerable policy interest. OBJECTIVE: To compare site of death, health care utilization, and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using administrative and registry data from 2010. Participants were decedents older than 65 years who died with cancer...
January 19, 2016: JAMA: the Journal of the American Medical Association
Richard Fleet, Julien Poitras, Patrick Archambault, Fatoumata Korika Tounkara, Jean-Marc Chauny, Mathieu Ouimet, Josée Gauthier, Gilles Dupuis, Alain Tanguay, Jean-Frédéric Lévesque, Geneviève Simard-Racine, Jeannie Haggerty, France Légaré
BACKGROUND: Rural emergency departments (EDs) constitute crucial safety nets for the 20% of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED management Guide". The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide...
2015: BMC Health Services Research
Yun Sil Chang, Hyun-Young Park, Won Soon Park
Currently, in the Republic of Korea, despite the very-low-birth rate, the birth rate and number of preterm infants are markedly increasing. Neonatal deaths and major complications mostly occur in premature infants, especially very-low-birth-weight infants (VLBWIs). VLBWIs weigh less than 1,500 g at birth and require intensive treatment in a neonatal intensive care unit (NICU). The operation of the Korean Neonatal Network (KNN) officially started on April 15, 2013, by the Korean Society of Neonatology with support from the Korea Centers for Disease Control and Prevention...
October 2015: Journal of Korean Medical Science
L Cabrini, G Landoni, M Antonelli, R Bellomo, S Colombo, A Negro, P Pelosi, A Zangrillo
Modern Critical Care aims at improving patient-centered outcomes, not limited to survival. Recently, along with traditional research evaluating single drugs or procedures, more elusive elements have been evaluated, like organizational and teamwork aspects, delivery of critical care before Intensive Care Unit (ICU) admission and after discharge. The aim of this review is to offer an up-to-date, comprehensive, and maybe "visionary" big picture of Critical Care in the near future beyond its traditional boundaries...
October 16, 2015: Minerva Anestesiologica
Scott D Halpern
The disquieting patterns of end-of-life care in the United States have been well documented. In the last month of life, one in two Medicare beneficiaries visits an emergency department, one in three is admitted to an intensive care unit, and one in five has inpatient surgery. But one of the most..
November 19, 2015: New England Journal of Medicine
Ramesh Venkataraman, Lakshmi Ranganathan, V Rajnibala, Babu K Abraham, Senthilkumar Rajagopalan, Nagarajan Ramakrishnan
OBJECTIVE: Assessing and enhancing family satisfaction are imperative for the provision of comprehensive intensive care. There is a paucity of Indian data exploring family's perception of Intensive Care Unit (ICU) patients. We wanted to explore family satisfaction and whether it differed in families of patients admitted under intensivists and nonintensivists in our semi-open ICU. METHODOLOGY: We surveyed family members of 200 consecutive patients, between March and September 2009 who were in ICU for >3 days...
September 2015: Indian Journal of Critical Care Medicine
D Escudero, L Martín, L Viña, B Quindós, M J Espina, L Forcelledo, L López-Amor, B García-Arias, C del Busto, S de Cima, E Fernández-Rey
OBJECTIVE: To determine the design and comfort in the Intensive Care Units (ICUs), by analysing visiting hours, information, and family participation in patient care. DESIGN: Descriptive, multicentre study. SETTING: Spanish ICUs. METHODS: A questionnaire e-mailed to members of the Spanish Society of Intensive Care Medicine, Critical and Coronary Units (SEMICYUC), subscribers of the Electronic Journal Intensive Care Medicine, and disseminated through the blog Proyecto HU-CI...
September 2015: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
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