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https://www.readbyqxmd.com/read/27903210/resource-use-governance-and-case-load-of-rapid-response-teams-in-australia-and-new-zealand-in-2014
#1
(no author information available yet)
BACKGROUND: Rapid response teams (RRTs) are a mandatory element of Australian national health care policy. However, the uptake, resourcing, case load and funding of RRTs in Australian and New Zealand hospitals remain unknown. AIM: To assess the clinical activity, funding, staffing and governance of RRTs in Australian and New Zealand hospitals. METHODS: Survey of Australian and New Zealand hospitals as part of a biannual audit of intensive care resources and capacity...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27777550/benefits-of-an-outreach-education-coordinator-a-burn-center-s-experience
#2
K A Hollowed, T E Travis, M H Jordan, J W Shupp
Education of first responders and referring medical professionals is considered vital to high-quality burn care. Prior to 1999, the community education program at The Burn Center of MedStar Washington Hospital Center (MWHC) was staffed by ICU nurses who volunteered their time. As the program became more popular in the mid-1990s, the requests for lectures exceeded the capacity of a volunteer program. A request to hospital administration for a full-time education coordinator position was rejected in the climate of budget cut-backs and declining reimbursement...
December 31, 2015: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/27451146/activities-undertaken-by-intensive-care-unit-liaison-nurses-in-argentina
#3
Laura Alberto, Brigid M Gillespie, Anna Green, Maria Del Carmen Martínez, Angel Cañete, Haydee Zotarez, Carlos Alberto Díaz, Marcelino Enriquez, Mario Gerónimo, Wendy Chaboyer
BACKGROUND: The Intensive Care Unit Liaison Nurse (ICULN), also known as an outreach nurse, is an advanced practice nursing role that emerged in the late 1990s in Australia and the United Kingdom (UK). Little is known about this role in less developed economies. OBJECTIVE: To describe the activities undertaken by ICULNs in Argentina. METHODS: Prospective, descriptive, observational, single site study in an Argentinean metropolitan tertiary referral hospital...
July 19, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27428118/icu-admission-discharge-and-triage-guidelines-a-framework-to-enhance-clinical-operations-development-of-institutional-policies-and-further-research
#4
Joseph L Nates, Mark Nunnally, Ruth Kleinpell, Sandralee Blosser, Jonathan Goldner, Barbara Birriel, Clara S Fowler, Diane Byrum, William Scherer Miles, Heatherlee Bailey, Charles L Sprung
OBJECTIVES: To update the Society of Critical Care Medicine's guidelines for ICU admission, discharge, and triage, providing a framework for clinical practice, the development of institutional policies, and further research. DESIGN: An appointed Task Force followed a standard, systematic, and evidence-based approach in reviewing the literature to develop these guidelines. MEASUREMENTS AND MAIN RESULTS: The assessment of the evidence and recommendations was based on the principles of the Grading of Recommendations Assessment, Development and Evaluation system...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26861417/a-multicenter-pragmatic-interrupted-time-series-analysis-of-chlorhexidine-gluconate-bathing-in-community-hospital-intensive-care-units
#5
Kristen V Dicks, Eric Lofgren, Sarah S Lewis, Rebekah W Moehring, Daniel J Sexton, Deverick J Anderson
OBJECTIVE To determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). DESIGN Interrupted time series analysis. SETTING The study included 33 community hospitals participating in the Duke Infection Control Outreach Network from January 2008 through December 2013. PARTICIPANTS All ICU patients at study hospitals during the study period...
July 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/26157581/risk-prediction-of-icu-readmission-in-a-mixed-surgical-and-medical-population
#6
Frida Kareliusson, Lina De Geer, Anna Oscarsson Tibblin
BACKGROUND: Readmission to intensive care units (ICU) is accompanied with longer ICU stay as well as higher ICU, in-hospital and 30-day mortality. Different scoring systems have been used in order to predict and reduce readmission rates. METHODS: The purpose of this study was to evaluate the Stability and Workload Index for Transfer (SWIFT) score as a predictor of readmission. Further, we wanted to study steps and measures taken at the ward prior to readmission...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26152568/a-multifaceted-feedback-strategy-alone-does-not-improve-the-adherence-to-organizational-guideline-based-standards-a-cluster-randomized-trial-in-intensive-care
#7
RANDOMIZED CONTROLLED TRIAL
Maartje L G de Vos, Sabine N van der Veer, Bram Wouterse, Wilco C Graafmans, Niels Peek, Nicolette F de Keizer, Kitty J Jager, Gert P Westert, Peter H J van der Voort
BACKGROUND: Organizational data such as bed occupancy rate and nurse-to-patient ratio are related to clinical outcomes and to the efficient use of intensive care unit (ICU) resources. Standards for these performance indicators are provided in guidelines. We studied the effects of a multifaceted feedback strategy to improve the adherence to these standards. METHODS: In a cluster randomized controlled study design the intervention ICUs received extensive monthly feedback reports, they received outreach visits and initiated a quality improvement team...
July 8, 2015: Implementation Science: IS
https://www.readbyqxmd.com/read/25916486/maternal-critical-care-what-can-we-learn-from-patient-experience-a-qualitative-study
#8
Lisa Hinton, Louise Locock, Marian Knight
OBJECTIVE: For every maternal death, nine women develop severe maternal morbidity. Many of those women will need care in an intensive care unit (ICU) or high dependency unit (HDU). Critical care in the context of pregnancy poses distinct issues for staff and patients, for example, with breastfeeding support and separation from the newborn. This study aimed to understand the experiences of women who experience a maternal near miss and require critical care after childbirth. SETTING: Women and some partners from across the UK were interviewed as part of a study of experiences of near-miss maternal morbidity...
April 27, 2015: BMJ Open
https://www.readbyqxmd.com/read/25800768/early-versus-delayed-initiation-of-concurrent-palliative-oncology-care-patient-outcomes-in-the-enable-iii-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Marie A Bakitas, Tor D Tosteson, Zhigang Li, Kathleen D Lyons, Jay G Hull, Zhongze Li, J Nicholas Dionne-Odom, Jennifer Frost, Konstantin H Dragnev, Mark T Hegel, Andres Azuero, Tim A Ahles
PURPOSE: Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. PATIENTS AND METHODS: Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later...
May 1, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/25498252/effect-of-a-2-tier-rapid-response-system-on-patient-outcome-and-staff-satisfaction
#10
Leanne M Aitken, Wendy Chaboyer, Amanda Vaux, Shannon Crouch, Elizabeth Burmeister, Michael Daly, Chris Joyce
BACKGROUND: Rapid response systems (RRS) have been recommended as a strategy to prevent and treat deterioration in acute care patients. Questions regarding the most effective characteristics of RRS and strategies for implementing these systems remain. AIMS: The aims of this study were to (i) describe the structures and processes used to implement a 2-tier RRS, (ii) determine the comparative prevalence of deteriorating patients and incidence of unplanned intensive care unit (ICU) admission and cardiac arrest prior to and after implementation of the RRS, and (iii) determine clinician satisfaction with the RRS...
August 2015: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/24741491/evaluation-of-critical-care-outreach-services-in-a-tertiary-care-hospital-in-india-a-retrospective-analysis
#11
Nidhi Srivastava, Mohan Deep Kaur, Sandeep Sharma
BACKGROUND: Critical care outreach services (CCOS) is a relatively a new concept in India and is not as developed as in Western countries. Efficient utilization of limited intensive care service requires comprehensive CCOS. Appropriate activation of such services will limit excess burden on already scarce human resources. AIM: To evaluate the functioning of CCOS in a tertiary care hospital and also to identify factors leading to its overactivation. MATERIALS AND METHODS: Data of 400 calls received in resuscitation room (RR) of the Trauma Center during January 2011-June 2011 was analyzed...
January 2014: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/24467882/the-impact-of-the-use-of-the-early-warning-score-ews-on-patient-outcomes-a-systematic-review
#12
REVIEW
N Alam, E L Hobbelink, A J van Tienhoven, P M van de Ven, E P Jansma, P W B Nanayakkara
BACKGROUND: Acute deterioration in critical ill patients is often preceded by changes in physiological parameters, such as pulse, blood pressure, temperature and respiratory rate. If these changes in the patient's vital parameters are recognized early, excess mortality and serious adverse events (SAEs) such as cardiac arrest may be prevented. The Early Warning Score (EWS) is a scoring system which assists with the detection of physiological changes and may help identify patients at risk of further deterioration...
May 2014: Resuscitation
https://www.readbyqxmd.com/read/23863224/effect-of-a-multifaceted-performance-feedback-strategy-on-length-of-stay-compared-with-benchmark-reports-alone-a-cluster-randomized-trial-in-intensive-care
#13
RANDOMIZED CONTROLLED TRIAL
Sabine N van der Veer, Maartje L G de Vos, Peter H J van der Voort, Niels Peek, Ameen Abu-Hanna, Gert P Westert, Wilco C Graafmans, Kitty J Jager, Nicolette F de Keizer
OBJECTIVE: To assess the impact of applying a multifaceted activating performance feedback strategy on intensive care patient outcomes compared with passively receiving benchmark reports. DESIGN: The Information Feedback on Quality Indicators study was a cluster randomized trial, running from February 2009 to May 2011. SETTING: Thirty Dutch closed-format ICUs that participated in the national registry. Study duration per ICU was sixteen months...
August 2013: Critical Care Medicine
https://www.readbyqxmd.com/read/23828085/-in-hospital-emergency-management
#14
REVIEW
Tanja Jantzen, Matthias Fischer, Michael P Müller, Stephan Seewald, Jan Wnent, Jan-Thorsten Gräsner
5-10% of in-hospital patients are affected by adverse events, 10% of these requiring CPR. Standardized in-hospital emergency management may improve results, including reduction of mortality, hospital stay and cost. Early warning scores and clinical care outreach teams may help to identify patients at risk and should be combined with standard operation procedure and consented alarm criteria. These teams of doctors and nurses should be called for all in hospital emergencies, providing high-end care and initiate ICU measures at bedside...
June 2013: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/23764971/effect-of-a-multifaceted-performance-feedback-strategy-on-length-of-stay-compared-with-benchmark-reports-alone-a-cluster-randomized-trial-in-intensive-care
#15
Sabine N van der Veer, Maartje L G de Vos, Peter H J van der Voort, Niels Peek, Ameen Abu-Hanna, Gert P Westert, Wilco C Graafmans, Kitty J Jager, Nicolette F de Keizer
OBJECTIVE:: To assess the impact of applying a multifaceted activating performance feedback strategy on intensive care patient outcomes compared with passively receiving benchmark reports. DESIGN:: The Information Feedback on Quality Indicators study was a cluster randomized trial, running from February 2009 to May 2011. SETTING:: Thirty Dutch closed-format ICUs that participated in the national registry. Study duration per ICU was sixteen months. PATIENTS:: We analyzed data on 25,552 admissions. Admissions after coronary artery bypass graft surgery were excluded...
June 12, 2013: Critical Care Medicine
https://www.readbyqxmd.com/read/23362504/process-evaluation-of-a-tailored-multifaceted-feedback-program-to-improve-the-quality-of-intensive-care-by-using-quality-indicators
#16
MULTICENTER STUDY
L G de Vos Maartje, Sabine N van der Veer, Wilco C Graafmans, Nicolette F de Keizer, Kitty J Jager, Gert P Westert, Peter H J van der Voort
BACKGROUND: In multisite trials evaluating a complex quality improvement (QI) strategy the 'same' intervention may be implemented and adopted in different ways. Therefore, in this study we investigated the exposure to and experiences with a multifaceted intervention aimed at improving the quality of intensive care, and explore potential explanations for why the intervention was effective or not. METHODS: We conducted a process evaluation investigating the effect of a multifaceted improvement intervention including establishment of a local multidisciplinary QI team, educational outreach visits and periodical indicator feedback on performance measures such as intensive care unit length of stay, mechanical ventilation duration and glucose regulation...
March 2013: BMJ Quality & Safety
https://www.readbyqxmd.com/read/22855285/effectiveness-of-modified-early-warning-score-in-predicting-outcomes-in-oncology-patients
#17
Tim Cooksley, Emma Kitlowski, Philip Haji-Michael
BACKGROUND: Patients at risk of rapid deterioration and critical illness often have preceding changes in physiological parameters. Track and trigger systems, such as the Modified Early Warning Score (MEWS) used in the UK, have been demonstrated to have some utility in identifying these patients particularly among general medical and surgical patients. AIM: Assess the effectiveness of MEWS and the proposed (NHS Early Warning Score) in oncology patients. Identify the key physiological parameters that predict outcome in this cohort...
November 2012: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/22391144/implementing-clinical-supervision-for-icu-outreach-nurses-a-case-study-of-their-journey
#18
Wendy M Cross, Alan G Moore, Tania Sampson, Clare Kitch, Cherene Ockerby
INTRODUCTION: Many health services with Intensive Care Units have developed ward liaison programs, managed by Outreach Nurses, to facilitate the transition for patients between the intensive care and general wards. This paper reports a case study of clinical supervision for two Outreach Nurses as they adapted to their new, largely autonomous role in an Australian tertiary hospital. METHOD: Individual clinical supervision was provided fortnightly to two Outreach Nurses over 12 months by an experienced facilitator, and evaluated using a case study methodology...
November 2012: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/22133688/a-critical-care-nurse-practitioner-s-prescribing-using-standing-orders-and-authorised-prescribing-when-performing-a-critical-care-outreach-role-a-clinical-audit
#19
Alison M Pirret
OBJECTIVE: This paper assesses the frequency of prescribing and the types of medications prescribed by a New Zealand critical care nurse practitioner (NP) whilst performing a critical care outreach role. METHOD: A before and after audit was conducted from June 2006 to July 2008. Audit data were collected prospectively and analysed retrospectively. Data collected between July 2006 and June 2007 when standing orders were used were compared to data collected between July 2007 and June 2008 when the NP was authorised to prescribe...
February 2012: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/21925408/icu-and-critical-care-outreach-for-the-elderly
#20
REVIEW
Robert C McDermid, Sean M Bagshaw
Average life expectancy has increased over the past century resulting in a shift in world population demographics. There are more elderly people alive now than throughout all of human history. The burden of comorbid disease and dependency rises with age and has been shown to independently predict need for hospitalization, institutionalization and mortality. Accordingly, there are more elderly persons living longer in more tenuous states of health. The relative proportion of patients admitted to hospital and intensive care who are elderly is considerable and recent data have suggested an increasing trend...
September 2011: Best Practice & Research. Clinical Anaesthesiology
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