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https://www.readbyqxmd.com/read/28793138/temporal-changes-in-the-racial-gap-in-survival-after-in-hospital-cardiac-arrest
#1
Lee Joseph, Paul S Chan, Steven M Bradley, Yunshu Zhou, Garth Graham, Philip G Jones, Mary Vaughan-Sarrazin, Saket Girotra
Importance: Previous studies have found marked differences in survival after in-hospital cardiac arrest by race. Whether racial differences in survival have narrowed as overall survival has improved remains unknown. Objectives: To examine whether racial differences in survival after in-hospital cardiac arrest have narrowed over time and if such differences could be explained by acute resuscitation survival, postresuscitation survival, and/or greater temporal improvement in survival at hospitals with higher proportions of black patients...
August 9, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28783942/codeine-precipitating-serotonin-syndrome-in-a-patient-in-therapy-with-antidepressant-and-triptan
#2
Giulia Milano, Werner Maria Natta, Alfredo Bello, Antonietta Martelli, Francesca Mattioli
The serotonin syndrome is a serioius medical condition due due to an intensive stimulation of setonin receptors. It is a rare, but severe, consequence of interaction between serotomimetic agents. This is a report of a 70-year-old woman steadily in therapy with venlafaxine and rizatriptan for migraine and major depressive syndrome. She was admitted to neurology unit for decreased light reflex with miotic pupils, global hyperreflexia, tremor, anxiety, ataxia and incoordination. The patient was diagnosed as a probable case of serotonin syndrome due to a pharmacological interaction between venlafaxine and rizatriptan trigged by opioid intake...
August 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28762632/complexity-perspectives-on-clinical-decision-making-in-an-intensive-care-unit
#3
Ben A de Bock, Dick L Willems, Henry C Weinstein
RATIONALE, AIMS, AND OBJECTIVES: How to clarify the implications of complexity thinking for decision making in the intensive care unit (ICU)? METHOD: Retrospective qualitative empirical research. Practitioners in an ICU were interviewed on how their decisions were made regarding a particular patient in a difficult, clinical situation. Transcriptions of these interviews were coded and retrieved in Maxqda, a software program. Assisted by complexity thinking, researchers focused on the decision-making process and the shift from analytic approaches to complex approaches...
August 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28752794/relationship-between-perceived-organizational-justice-and-moral-distress-in-intensive-care-unit-nurses
#4
Ghazaleh Haghighinezhad, Foroozan Atashzadeh-Shoorideh, Tahereh Ashktorab, Jamileh Mohtashami, Maasoumeh Barkhordari-Sharifabad
BACKGROUND: The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28746800/the-changing-nature-of-relationships-between-parents-and-healthcare-providers-when-a-child-dies-in-the-paediatric-intensive-care-unit
#5
Ashleigh E Butler, Helen Hall, Beverley Copnell
AIM: To explore bereaved parents' interactions with healthcare providers when a child dies in a paediatric intensive care unit. BACKGROUND: Though most children admitted to a paediatric intensive care unit will survive, 2-5% will die during their stay. The parents of these children interact and form relationships with numerous healthcare staff during their child's illness and death. Though previous studies have explored the parental experience of child death in intensive care generally, the nature of their relationships with healthcare providers during this time remains unknown...
July 26, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28746556/potential-intravenous-drug-interactions-in-intensive-care
#6
Maiara Benevides Moreira, Maria Gefé da Rosa Mesquita, Marluci Andrade Conceição Stipp, Graciele Oroski Paes
OBJECTIVE: To analyze potential intravenous drug interactions, and their level of severity associated with the administration of these drugs based on the prescriptions of an intensive care unit. METHOD: Quantitative study, with aretrospective exploratory design, and descriptive statistical analysis of the ICU prescriptions of a teaching hospital from March to June 2014. RESULTS: The sample consisted of 319 prescriptions and subsamples of 50 prescriptions...
July 20, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28743147/-development-of-anaesthesia-related-mortality-and-impact-on-perioperative-outcome
#7
Peter Rosenberger, Berthold Drexler
Achievements in anaesthesiology form the basis for the tremendous development of surgical therapy. Reliable monitoring technology, which is scrutinized on a regular basis using checklists, is allowing anaesthesia at the borders of physiology. During the last decades, anaesthesia-related mortality has been decreasing considerably. Well-trained anaesthesiology staff, who considers patient- and procedure-specific risks in anaesthetic management, is of major importance. Furthermore, postoperative care in specialised units and intensive care wards is a key factor of improved patient outcome after surgery...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#8
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28705527/reducing-stat-portable-chest-radiograph-turnaround-times-a-pilot-study
#9
REVIEW
Pratik Rachh, Alexa O Levey, Andrew Lemmon, Aurora Marinescu, William F Auffermann, Daniel Haycook, Eugene A Berkowitz
BACKGROUND: Our health system orders a high number of STAT priority portable chest radiographs (62%) compared to Routine (35%) and Today (3%). Retrospective chart review of 1000 chest radiographs ordered with the STAT priority revealed that 38% of studies did not indicate clinical urgency. Given the high number or STAT priority portable chest radiographs ordered, prioritizing acquisition and interpretation of true STATs has become challenging for technologists and radiologists, leading to process inefficiencies, long turnaround times (TATs), communication failures, and patient-safety errors...
June 5, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28704639/a-sense-of-agency-an-ethnographic-exploration-of-being-awake-during-mechanical-ventilation-in-the-intensive-care-unit
#10
Eva Laerkner, Ingrid Egerod, Finn Olesen, Helle Ploug Hansen
BACKGROUND: There is a current trend towards lighter or no sedation of mechanically ventilated patients in the intensive care unit. The advantages of less sedation have been demonstrated as shorter duration of mechanical ventilation and reduced length of stay in the intensive care unit and hospital. Non-sedated patients are more awake during mechanical ventilation, but little is known about how this affects the intensive care patient. AIM: To explore patients' experiences of being awake during critical illness and mechanical ventilation in the intensive care unit...
June 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28671894/midrange-braden-subscale-scores-are-associated-with-increased-risk-for-pressure-injury-development-among-critical-care-patients
#11
Jenny Alderden, Mollie Rebecca Cummins, Ginette Alyce Pepper, JoAnne D Whitney, Yingying Zhang, Ryan Butcher, Donna Thomas
PURPOSE: The purpose of the current study was to examine the relationship between pressure injury development and the Braden Scale for Pressure Sore Risk subscale scores in a surgical intensive care unit (ICU) population and to ascertain whether the risk represented by the subscale scores is different between older and younger patients. DESIGN: Retrospective review of electronic medical records. SUBJECTS AND SETTING: The sample comprised patients admitted to the ICU at an academic medical center in the Western United States (Utah) and Level 1 trauma center between January 1, 2008 and May 1, 2013...
May 30, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28661908/associations-between-hormonal-biomarkers-and-cognitive-motor-and-language-developmental-status-in-very-low-birth-weight-infants
#12
June Cho, Diane Holditch-Davis, Xiaogang Su, Vivien Phillips, Fred Biasini, Waldemar A Carlo
BACKGROUND: Male infants are more prone to health problems and developmental delays than female infants. OBJECTIVES: On the basis of theories of gender differences in brain development and social relationships, we explored associations between testosterone and cortisol levels with infant cognitive, motor, and language development ("infant development") in very low birth weight (VLBW) infants, controlling for mother-infant interactions, characteristics of mothers and infants, and days of saliva collection after birth...
June 28, 2017: Nursing Research
https://www.readbyqxmd.com/read/28656884/a-network-model-of-hand-hygiene-how-good-is-good-enough-to-stop-the-spread-of-mrsa
#13
Neal D Goldstein, Stephen C Eppes, Amy Mackley, Deborah Tuttle, David A Paul
BACKGROUND Simulation models have been used to investigate the impact of hand hygiene on methicillin-resistant Staphylococcus aureus (MRSA) transmission within the healthcare setting, but they have been limited by their ability to accurately model complex patient-provider interactions. METHODS Using a network-based modeling approach, we created a simulated neonatal intensive care unit (NICU) representing the potential for per-hour infant-infant MRSA transmission via the healthcare worker resulting in subsequent colonization...
June 28, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#14
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28630772/severe-rhabdomyolysis-due-to-presumed-drug-interactions-between-atorvastatin-with-amlodipine-and-ticagrelor
#15
Iouri Banakh, Kavi Haji, Ross Kung, Sachin Gupta, Ravindranath Tiruvoipati
Atorvastatin and ticagrelor combination is a widely accepted therapy for secondary prevention of ischaemic heart disease. However, rhabdomyolysis is a well-known rare side effect of statins which should be considered when treatments are combined with cytochrome P450 3A4 enzyme inhibitors. We report a case of atorvastatin and ticagrelor associated severe rhabdomyolysis that progressed to multiorgan failure requiring renal replacement therapy, inotropes, intubation, and mechanical ventilation. Despite withdrawal of the precipitating cause and the supportive measures including renal replacement therapy, creatinine kinase increased due to ongoing rhabdomyolysis rapidly progressing to upper and lower limbs weakness...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#16
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28627241/neonatal-intensive-care-unit-layout-and-nurses-work
#17
Megan Doede, Alison M Trinkoff, Ayse P Gurses
Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#18
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28595669/surges-of-advanced-medical-support-associated-with-influenza-outbreaks
#19
J C King, J E Schweinle, R J Hatchett, Y Gao, R Lichenstein, J Zhou
We utilized de-identified data to evaluate increases in four outcomes during influenza outbreak periods (IOPs) including: hospitalization, intensive care unit admission, mechanical ventilation or death for adults aged 18 years or older with medically attended acute respiratory illnesses (MAARI) admitted to any of Maryland's 50 acute-care hospitals over 12 years. Weekly numbers of positive influenza tests in the Maryland area were obtained from the US Center for Disease Control and Prevention interactive website...
June 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28592475/promoting-patient-and-family-centered-care-in-the-intensive-care-unit-a-dissemination-project
#20
Ruth Kleinpell, Timothy G Buchman, Lori Harmon, Melissa Nielsen
Awareness of patient-centered and family-centered care research can assist clinicians to promote patient and family engagement in the intensive care unit. Project Dispatch (Disseminating Patient-Centered Outcomes Research to Healthcare Professionals) was developed to disseminate patient- and family-centered care research and encourage its application in clinical practice. The 3-year project involved the development of an interactive website platform, online educational programming, social media channels, a podcast and webcast series, and electronic and print media...
2017: AACN Advanced Critical Care
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