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https://www.readbyqxmd.com/read/29028774/seeking-humanizing-care-in-patient-centered-care-process-a-grounded-theory-study
#1
Mohammad Ali Cheraghi, Maryam Esmaeili, Mahvash Salsali
Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician)...
November 2017: Holistic Nursing Practice
https://www.readbyqxmd.com/read/29024878/impact-of-outlier-status-on-critical-care-patient-outcomes-does-boarding-medical-intensive-care-unit-patients-make-a-difference
#2
Danish Ahmad, Katherine Moeller, Jared Chowdhury, Vishal Patel, Erika J Yoo
PURPOSE: To evaluate the impact of outlier status, or the practice of boarding ICU patients in distant critical care units, on clinical and utilization outcomes. MATERIALS AND METHODS: Retrospective observational study of all consecutive admissions to the MICU service between April 1, 2014-January 3, 2016, at an urban university hospital. RESULTS: Of 1931 patients, 117 were outliers (6.1%) for the entire duration of their ICU stay. In adjusted analyses, there was no association between outlier status and hospital (OR 1...
October 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29024199/critical-care-pharmacy-workforce-uk-deployment-and-characteristics-in-2015
#3
Mark Borthwick, Greg Barton, Richard S Bourne, Catherine McKenzie
OBJECTIVE: Clinical pharmacists reduce medication errors and optimize the use of medication in critically ill patients, although actual staffing level and deployment of UK pharmacists is unknown. The primary aim was to investigate the UK deployment of the clinical pharmacy workforce in critical care and compare this with published standards. METHODS: An electronic data entry tool was created and distributed for UK critical care pharmacy services to record their critical care workforce deployment data...
October 11, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28982652/short-and-long-term-prognosis-of-patients-with-acute-heart-failure-with-and-without-diabetes-changes-over-the-last-three-decades
#4
Jan C van den Berge, Alina A Constantinescu, Hendrik J Boiten, Ron T van Domburg, Jaap W Deckers, K Martijn Akkerhuis
OBJECTIVE: We studied differences in long-term (i.e., 10 year) prognosis among patients with acute heart failure (HF) with and without diabetes over the last three decades. In addition, we investigated whether the degree of prognostic improvement in that period was comparable between patients with and without diabetes. RESEARCH DESIGN AND METHODS: This prospective registry included all consecutive patients aged 18 years and older admitted to the Intensive Coronary Care Unit with acute HF in the period of 1985-2008...
October 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28979556/protective-mechanical-ventilation-in-united-kingdom-critical-care-units-a-multicentre-audit
#5
Christopher P Newell, Matthew J Martin, Neil Richardson, Christopher P Bourdeaux
Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg(-1) predicted body weight and overall compliance with low tidal volume ventilation (≤6...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28979534/infusion-medication-concentrations-in-uk-s-critical-care-areas-are-the-intensive-care-society-s-recommendations-being-used
#6
Yovita D Titiesari, Greg Barton, Mark Borthwick, Susan Keeling, Peter Keeling
Following two studies done in 2007 and 2009, a follow-up of the adherence to the suggested guidelines on drug standardisation has been performed with a suggestion for future standards that can be achieved, to complement the recently published Carter report. The Intensive Care Society (ICS) introduced recommendations for infusion concentrations of 16 medications commonly used in critical care areas. The importance being improvement in patient safety and rationalised use of available critical care resources. Five years after publication of these recommendations, a further audit has been undertaken to assess the level of acceptance and application...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28979513/paediatric-electronic-infusion-calculator-an-intervention-to-eliminate-infusion-errors-in-paediatric-critical-care
#7
Aishwarya Venkataraman, Emily Siu, Kalaimaran Sadasivam
INTRODUCTION: Medication errors, including infusion prescription errors are a major public health concern, especially in paediatric patients. There is some evidence that electronic or web-based calculators could minimise these errors. AIMS: To evaluate the impact of an electronic infusion calculator on the frequency of infusion errors in the Paediatric Critical Care Unit of The Royal London Hospital, London, United Kingdom. METHOD: We devised an electronic infusion calculator that calculates the appropriate concentration, rate and dose for the selected medication based on the recorded weight and age of the child and then prints into a valid prescription chart...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28976916/the-use-of-electronic-medical-records-in-jordanian-hospitals-a-nationwide-survey
#8
Ahmad Tubaishat, Omar M Al-Rawajfah
No previous nationwide study has estimated to what extent electronic health records have been implemented in Jordanian hospitals. The purpose of this descriptive, cross-sectional study was to explore the level of adoption and use of electronic health records in Jordanian hospitals across all major healthcare service providers. The standardized American Hospital Association annual survey was used. The level of use of electronic functionalities of electronic health records was determined. The association of certain hospital characteristics with the adoption of electronic health records was examined...
October 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28976485/incongruence-in-perceptions-identifying-barriers-to-patient-satisfaction-in-the-intensive-care-unit
#9
Sarah Thomas, Lindsay Quirk, Cheri Blevins, Beth Quatrara, Lisa Letzkus
BACKGROUND: Patient satisfaction is at the forefront of quality care and patient outcomes. The literature identifies the discrepancy between nurse and patient perceptions in a variety of care settings; few studies have investigated the perceptions of care in a critical care unit. Understanding the perceptions in a critical care unit is necessary to optimize organizational performance related to quality, safety, patient-centered care, and efficiency. OBJECTIVE: The purpose of the study was to determine whether a discrepancy exists between what patients and families perceive as satisfaction with their care as compared with the nurses' perception of what constitutes positive patient satisfaction in a medical critical care unit...
November 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28976345/-impact-of-a-goal-directed-therapy-in-the-implementation-of-an-eras-enhanced-recovery-after-surgery-protocol-in-laparoscopic-radical-cystectomy
#10
Rafael Uña Orejón, Ivan Huercio Martinez, Estrella Mateo Torres, Cristina Jofré Escudero, Juan Gomez Rivas, Jesús Diez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVES: The intraoperative goaldirected fluid therapy (GDT) has become the base of perioperative management in the fast-track protocols. This program using technology to estimate cardiac output, with the aim of minimizing splanchnic hypoperfusion. However, there is insufficient evidence to confirm its application in radical laparoscopic cystectomy. METHODS: In a retrospective study, we have included 52 patients that were scheduled for radical cystectomy. In group A (n=32) patients were treated following GDT...
October 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28974161/consistent-condom-use-with-paying-and-nonpaying-partners-among-female-sex-workers-in-iran-findings-of-a-national-biobehavioral-survey
#11
Mohammad Karamouzian, Behnam Sadeghirad, Hamid Sharifi, Abbas Sedaghat, Ali Akbar Haghdoost, Ali Mirzazadeh
OBJECTIVES: Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. METHODS: A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. RESULTS: Overall, 33...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28962761/one-pot-production-of-chitin-with-high-purity-from-lobster-shells-using-choline-chloride-malonic-acid-deep-eutectic-solvent
#12
Ping Zhu, Zhongji Gu, Shu Hong, Hailan Lian
For the first time in this study, chitin was solely extracted from lobster shells through a fast, easy and eco-friendly method using deep eutectic solvents (DESs), consisting of mixtures of choline chloride-thiourea (CCT), choline chloride-urea (CCU), choline chloride-glycerol (CCG) and choline chloride-malonic acid (CCMA). The physiochemical properties of the isolated chitins were compared with those of the chemically prepared one and commercial one from shrimp shells. Results showed that CCT, CCU and CCG DESs had no important effect on the elimination of proteins and minerals, while chitin obtained by CCMA DES showed a high purity...
December 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28955660/challenges-of-postgraduate-critical-care-nursing-program-in-iran
#13
Nahid Dehghan Nayeri, Esmaeil Shariat, Zahra Tayebi, Majid Ghorbanzadeh
Background: The main philosophy of postgraduate preparation for working in critical care units is to ensure the safety and quality of patients' care. Increasing the complexity of technology, decision-making challenges and the high demand for advanced communication skills necessitate the need to educate learners. Within this aim, a master's degree in critical care nursing has been established in Iran. Current study was designed to collect critical care nursing students' experiences as well as their feedback to the field critical care nursing...
2017: Medical Journal of the Islamic Republic of Iran
https://www.readbyqxmd.com/read/28952972/acute-opiate-overdose-an-update-on-management-strategies-in-emergency-department-and-critical-care-unit
#14
Rukma Parthvi, Abhinav Agrawal, Sameer Khanijo, Adey Tsegaye, Arunabh Talwar
BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide...
September 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28946897/undetectable-haptoglobin-is-associated-with-major-adverse-kidney-events-in-critically-ill-burn-patients
#15
François Dépret, Chloé Dunyach, Christian De Tymowski, Maïté Chaussard, Aurélien Bataille, Axelle Ferry, Nabila Moreno, Alexandru Cupaciu, Sabri Soussi, Mourad Benyamina, Alexandre Mebazaa, Kevin Serror, Marc Chaouat, Jean-Pierre Garnier, Romain Pirracchio, Matthieu Legrand
BACKGROUND: Intravascular haemolysis has been associated with acute kidney injury (AKI) in different clinical settings (cardiac surgery, sickle cell disease). Haemolysis occurs frequently in critically ill burn patients. The aim of this study was to assess the predictive value of haptoglobin at admission to predict major adverse kidney events (MAKE) and AKI in critically ill burn patients. METHODS: We conducted a retrospective, single-centre cohort study in a burn critical care unit in a tertiary centre, including all consecutive severely burned patients (total burned body surface > 20% and/or shock and/or mechanical ventilation at admission) from January 2012 to April 2017 with a plasmatic haptoglobin dosage at admission...
September 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28941748/impact-of-triggering-events-on-outcomes-of-acute-heart-failure
#16
Yasuyuki Shiraishi, Shun Kohsaka, Takayuki Abe, Kazumasa Harada, Tetsuro Miyazaki, Takamichi Miyamoto, Kiyoshi Iida, Shuzou Tanimoto, Mayuko Yagawa, Makoto Takei, Yuji Nagatomo, Toru Hosoda, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
BACKGROUND: The onset of acute heart failure is known to be associated with increased physical activity and other specific behaviors that can trigger hemodynamic deterioration. This analysis aimed to describe the distribution of triggers in patients hospitalized for acute heart failure, and investigate their effects on in-hospital outcomes. METHODS: Consecutive patients hospitalized for acute heart failure between 2010-2014 were registered in a multicenter data registration system (72 institutions within Tokyo, Japan)...
September 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28929601/conversion-of-benzoic-acid-into-phenol-in-an-itms-under-ci-ms-n-conditions-recognition-of-ortho-chlorobenzoyl-derivatives
#17
Michela Begala
Isomeric chlorobenzoyl cations (m/z 139), under collision induced experiments, fragment identically. Chlorobenzoyl cations can be efficiently converted into cholorophenol radical cations by the reaction with methanol in the ion trap analyser under CI-MS(n) conditions. The substitution of the carbonyl group with a hydroxyl moiety is able to induce an ortho effect, which is absent in the starting ortho-chlorobenzoyl cation. This transformation could be useful to recognize ortho-chlorinated benzoyl derivatives without the need of MS spectra comparison of the whole set of isomers...
September 19, 2017: Journal of Mass Spectrometry: JMS
https://www.readbyqxmd.com/read/28928729/high-throughput-genetic-screen-reveals-that-early-attachment-and-biofilm-formation-are-necessary-for-full-pyoverdine-production-by-pseudomonas-aeruginosa
#18
Donghoon Kang, Natalia V Kirienko
Pseudomonas aeruginosa is a re-emerging, multidrug-resistant, opportunistic pathogen that threatens the lives of immunocompromised patients, patients with cystic fibrosis, and those in critical care units. One of the most important virulence factors in this pathogen is the siderophore pyoverdine. Pyoverdine serves several critical roles during infection. Due to its extremely high affinity for ferric iron, pyoverdine gives the pathogen a significant advantage over the host in their competition for iron. In addition, pyoverdine can regulate the production of multiple bacterial virulence factors and perturb host mitochondrial homeostasis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28927193/timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-myocardial-infarction-a-swedeheart-study
#19
Daniel Lindholm, Joakim Alfredsson, Oskar Angerås, Felix Böhm, Fredrik Calais, Sasha Koul, Bo Lagerqvist, Henrik Renlund, Giovanna Sarno, Christoph Varenhorst
Aims: Although routine invasive management is recommended in NSTEMI patients, the optimal timing of the procedure is not defined. The aim of this study was to assess outcomes in relation to timing of PCI in NSTEMI patients. Methods and results: This was an observational, prospective, multicentre cohort study from the SWEDEHEART registry including all Swedish PCI centres. We included 40 494 consecutive PCI-treated patients who were admitted to any coronary care unit from 2006 to 2013...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#20
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
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