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https://www.readbyqxmd.com/read/29053532/using-a-complex-patient-management-scenario-to-help-bridge-the-education-practice-gap
#1
Adriane Burgess, Hannah Murphy Buc, Janice M Brennan
Preparing nursing students for transition to practice is challenging in light of the increasing complexity of today's health care environment. A clinical simulation was developed to engage senior-level bachelor of science in nursing students in the management of a critically ill patient whose deterioration warranted timely transfer to an intensive care unit. In this fast-paced, highly charged simulation, students were challenged to implement priority setting, delegation, communication methods, and teamwork...
October 20, 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29051396/facial-transplantation-an-update-of-results-and-perspectives-from-tissue-engineering
#2
Francesco Simonacci, Roberto Toni, Edoardo Raposio
BACKGROUND/AIM: Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29045063/evaluating-manufacturing-process-profile-comparability-with-multivariate-equivalence-testing-case-study-of-cell-culture-small-scale-model-transfer
#3
Yang Cao, Daniel Obeng, Guodong Hui, Luting Xue, Yukun Ren, Xianjie Yu, Fei Wang, Chad Atwell
This paper studies the Generalized Mahalanobis Distance (GMD) approach proposed by Hoffelder(1) which measures the dissimilarity of two multivariate Gaussian distributions with arbitrary covariance matrices and unequal sample sizes. This investigation demonstrated that, with appropriate adjustment, the GMD approach can achieve the targeted nominal Type I error and provide sufficient power for testing equivalence between two profile populations. The adjusted GMD approach was applied to examine the equivalence of harvest profiles between a 12L small scale model and 2000L manufacturing scale in a transfer study performed at Sanofi Speciality Care Framingham Biologics...
October 16, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/29041985/simplified-prognostic-model-for-critically-ill-patients-in-resource-limited-settings-in-south-asia
#4
Rashan Haniffa, Mavuto Mukaka, Sithum Bandara Munasinghe, Ambepitiyawaduge Pubudu De Silva, Kosala Saroj Amarasiri Jayasinghe, Abi Beane, Nicolette de Keizer, Arjen M Dondorp
BACKGROUND: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29020010/assay-optimisation-and-technology-transfer-for-multi-site-immuno-monitoring-in-vaccine-trials
#5
Steven G Smith, Stephanie A Harris, Iman Satti, Donna Bryan, K Barry Walker, Hazel M Dockrell, Helen McShane, Mei Mei Ho
Cellular immunological assays are important tools for the monitoring of responses to T-cell-inducing vaccine candidates. As these bioassays are often technically complex and require considerable experience, careful technology transfer between laboratories is critical if high quality, reproducible data that allows comparison between sites, is to be generated. The aim of this study, funded by the European Union Framework Program 7-funded TRANSVAC project, was to optimise Standard Operating Procedures and the technology transfer process to maximise the reproducibility of three bioassays for interferon-gamma responses: enzyme-linked immunosorbent assay (ELISA), ex-vivo enzyme-linked immunospot and intracellular cytokine staining...
2017: PloS One
https://www.readbyqxmd.com/read/28979518/a-consensus-to-determine-the-ideal-critical-care-transfer-bag
#6
Gezz Van Zwanenberg, Melissa Dransfield, Rohit Juneja
BACKGROUND: Familiarity with environment, processes and equipment reduces the risk inherently associated with critical care transfers. Therefore, the North West London Critical Care Network decided to create a standardised ideal transfer bag and contents to improve patient safety. METHODS: A four-round modified Delphi survey developed a condensed and clinically tested content list. An expert panel then designed an ideal transfer bag based on agreed important principles...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28956788/the-management-of-critically-ill-patients-with-haematological-malignancies
#7
N Kusadasi, M C A Müller, D J van Westerloo, A E C Broers, M G E C Hilkens, N M A Blijlevens On Behalf Of The Hema-Icu Study Group
The management of critically ill patients with haematological malignancy (HM) still shows inter- and intra-regional differences. Our objective in this updated review was to address the evidence supporting the potential treatment options, based on multidisciplinary processes, of critically ill patients with HM. A stepwise approach to the critical care pathway of this patient population from the triage to ICU admission to ICU discharge was chosen to emphasise certain key findings. Our main focus relied on significant issues of decision-making in daily clinical routine...
September 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28943978/impact-of-targeted-educational-interventions-on-appropriateness-of-stress-ulcer-prophylaxis-in-critically-ill-adults
#8
Drayton A Hammond, Catherine A Killingsworth, Jacob T Painter, Rose E Pennick, Kshitij Chatterjee, Bradley Boye, Nikhil Meena
BACKGROUND: Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). OBJECTIVE: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. METHODS: A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU) at an academic medical center between January to June of 2014 (no intervention) and January to June of 2015 (intervention) was conducted...
July 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28939279/patient-safety-incidents-during-interhospital-transport-of-patients-a-prospective-analysis
#9
Cathelijne Lyphout, Jochen Bergs, Willem Stockman, Koen Deschilder, Christophe Duchatelet, Didier Desruelles, Koen Bronselaer
INTRODUCTION: Interhospital transport of critically ill patients is at risk of complications. The objective of the study was to prospectively record patient safety incidents that occurred during interhospital transports and to determine their risk factors. METHODS: We prospectively collected data during a fifteen-month period in 2 hospitals. Patient and transport characteristics were collected using a specifically designed tool. Patient safety incidents were appraised for health-care associated harm, and categorized as technical, operational, and communication problems...
September 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28938179/does-simulation-enhance-nurses-ability-to-assess-deteriorating-patients
#10
Maria Bliss, Leanne M Aitken
Recognising and responding to patient deterioration has been identified as a key skill in nursing care to ensure that care is escalated for prompt, efficient management of the potentially critically ill patient. Simulation is one teaching strategy that has been established in nurse education as a method for enhancing skills. The objective was to explore the experiences of registered nurses to ascertain whether they perceived that simulation enhanced their skills in recognising the deteriorating patient. An exploratory qualitative design was used...
September 12, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#11
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
October 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935343/a-survey-of-next-of-kin-needs-of-trauma-patients-admitted-to-intensive-care-units-in-south-africa
#12
Petra Brysiewicz, Jennifer Chipps
AIM: To conduct a cross-sectional survey of next of kin needs of critically injured trauma patients admitted to Intensive Care Units in South Africa. METHODS: The needs of next of kin of trauma patients (in public and private hospitals) who were critically injured and required admission to Intensive Care Units were surveyed at two points: on admission within first 24hours and on Day 3/day of transfer if earlier. RESULTS: A total of 162 next of kin participated (114 from state and 48 from private) and Critical Care Family Needs Inventory subscale scores obtained at admission and at Day 3/day of transfer if earlier indicated a trend toward reporting increased needs...
September 18, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#13
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#14
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28917604/the-needs-of-the-relatives-in-the-adult-intensive-care-unit-cultural-adaptation-and-psychometric-properties-of-the-chilean-spanish-version-of-the-critical-care-family-needs-inventory
#15
Noelia Rojas Silva, Cristobal Padilla Fortunatti, Yerko Molina Muñoz, Macarena Amthauer Rojas
INTRODUCTION: The admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients. METHODS: The back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts...
September 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28911290/outcomes-of-telemedicine-intervention-in-a-regional-intensive-care-unit-a-before-and-after-study
#16
O M Panlaqui, E Broadfield, R Champion, J P Edington, S Kennedy
Telemedicine consultations in remote intensive care units (ICUs) overseas were found to be effective in reducing mortality and hospital length of stay (LOS). In Australia, there were anecdotal reports of these clinical outcomes. This retrospective before and after study assessed the improvement in patient outcomes with the implementation of a telemedicine program in a regional high dependency unit. Daily virtual consultations were conducted between the rural facility and the intensivists at the regional centre...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28901538/the-impact-of-fatigue-on-the-non-technical-skills-performance-of-critical-care-air-ambulance-clinicians
#17
J A Myers, D M C Powell, S Aldington, D Sim, A Psirides, K Hathaway, M F Haney
BACKGROUND: The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. METHODS: Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design)...
September 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28901207/characterizing-citizens-preferences-for-engagement-in-patient-care-and-research-in-adult-and-pediatric-intensive-care-units
#18
Karen E A Burns, Leena Rizvi, Anna Charteris, Samuel Laskey, Saima B Bhatti, Kamalprit Chokar, Karen L M Choong
RATIONALE: Engagement promotes and supports the active participation of patients and families in health care and research to strengthen their influence on decision-making. We sought to characterize how citizens wish to be engaged in care and research in the intensive care unit (ICU). METHODS: Interviewers administered questionnaires to visitors in 3 adult ICUs and 1 pediatric ICU. RESULTS: We surveyed 202 (adult [n = 130] and pediatric [n = 72]) visitors...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28898327/-transition-from-pediatric-to-adult-health-care-services-for-adolescents-with-chronic-diseases-recommendations-from-the-adolescent-branch-from-sociedad-chilena-de-pediatr%C3%A3-a
#19
Tamara Zubarew, Loreto Correa, Paula Bedregal, Carolina Besoain, Alejandro Reinoso, Macarena Velarde, María Teresa Valenzuela, Carolina Inostroza
The Adolescent Branch from Sociedad Chilena de Pediatría supports the implementation of planned programs for transition from child to adult health centers, oriented to adolescents with chronic diseases, in order to ensure an appropriate follow-up and a high-quality health care. Recommendations for care are set out in the FONIS and VRI PUC project carried out by the Division of Pediatrics of the Universidad Católica de Chile: “Transition process from pediatric to adult services: perspectives of adolescents with chronic diseases, caregivers and health professionals”, whose goal was to describe the experience, barriers, critical points, and facilitators in the transition process...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28890925/on-the-road-to-becoming-a-responsible-leader-a-simulation-based-training-approach-for-final-year-medical-students
#20
Marion Schmidt-Huber, Janine Netzel, Jan Kiesewetter
Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today's medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians' success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews (N=19) with relevant personnel (e...
2017: GMS Journal for Medical Education
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