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https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#1
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28640023/preventing-harm-in-the-icu-building-a-culture-of-safety-and-engaging-patients-and-families
#2
Kevin C Thornton, Jennifer J Schwarz, A Kendall Gross, Wendy G Anderson, Kathleen D Liu, Mark C Romig, Hildy Schell-Chaple, Peter J Pronovost, Adam Sapirstein, Michael A Gropper, Angela K M Lipshutz
OBJECTIVE: Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#3
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28627241/neonatal-intensive-care-unit-layout-and-nurses-work
#4
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/28625267/-application-of-quality-control-chart-in-quality-control-for-nosocomial-infection-in-intensive-care-unit
#5
Yumei Cheng, Yuanyi Liu, Difen Wang
OBJECTIVE: To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infections in ICU. METHODS: From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28619038/the-experiences-of-women-with-maternal-near-miss-and-their-perception-of-quality-of-care-in-kelantan-malaysia-a-qualitative-study
#6
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Ab Razak Asrenee, Zaharah Sulaiman
BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia...
June 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28618038/open-visitation-and-nurse-job-satisfaction-an-integrative-review
#7
Marissa Monroe, Linda Wofford
AIMS AND OBJECTIVES: To explore the effect of open visitation on critical care nurse job satisfaction. BACKGROUND: Open visitation has many benefits for ICU patients and families. However, ICU open visitation affects nurses' work environment too. Because nurse satisfaction is crucial to overall patient satisfaction, nurses' perceptions, experiences, and opinions about open visitation should be considered. DESIGN: A literature search was performed through CINAHL Complete, MEDLINE Complete, PubMed, ScienceDirect, Academic Search Premier and PsychINFO...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28617421/a-targeted-noise-reduction-observational-study-for-reducing-noise-in-a-neonatal-intensive-unit
#8
S Chawla, P Barach, M Dwaihy, D Kamat, S Shankaran, B Panaitescu, B Wang, G Natarajan
BACKGROUND: Excessive noise in neonatal intensive care units (NICUs) can interfere with infants' growth, development and healing.Local problem:Sound levels in our NICUs exceeded the recommended levels by the World Health Organization. METHODS: We implemented a noise reduction strategy in an urban, tertiary academic medical center NICU that included baseline noise measurements. We conducted a survey involving staff and visitors regarding their opinions and perceptions of noise levels in the NICU...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28615274/detecting-organisational-innovations-leading-to-improved-icu-outcomes-a-protocol-for-a-double-blinded-national-positive-deviance-study-of-critical-care-delivery
#9
Howard Chiou, Jeffrey K Jopling, Jennifer Yang Scott, Meghan Ramsey, Kelly Vranas, Todd H Wagner, Arnold Milstein
INTRODUCTION: There is substantial variability in intensive care unit (ICU) utilisation and quality of care. However, the factors that drive this variation are poorly understood. This study uses a novel adaptation of positive deviance approach-a methodology used in public health that assumes solutions to challenges already exist within the system to detect innovations that are likely to improve intensive care. METHODS AND ANALYSIS: We used the Philips eICU Research Institute database, containing 3...
June 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615010/internet-based-perioperative-exercise-program-in-patients-with-barrett-s-carcinoma-scheduled-for-esophagectomy-ipep-study-a-prospective-randomized-controlled-trial
#10
Daniel Pfirrmann, Suzan Tug, Oana Brosteanu, Matthias Mehdorn, Martin Busse, Peter P Grimminger, Florian Lordick, Torben Glatz, Jens Hoeppner, Hauke Lang, Perikles Simon, Ines Gockel
BACKGROUND: Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy...
June 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28604159/spiritual-care-in-the-intensive-care-unit-a-narrative-review
#11
Jim Q Ho, Christopher D Nguyen, Richard Lopes, Stephen C Ezeji-Okoye, Ware G Kuschner
Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#12
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28599676/a-randomized-trial-of-supplemental-parenteral-nutrition-in-underweight-and-overweight-critically-ill-patients-the-top-up-pilot-trial
#13
Paul E Wischmeyer, Michel Hasselmann, Christine Kummerlen, Rosemary Kozar, Demetrios James Kutsogiannis, Constantine J Karvellas, Beth Besecker, David K Evans, Jean-Charles Preiser, Leah Gramlich, Khursheed Jeejeebhoy, Rupinder Dhaliwal, Xuran Jiang, Andrew G Day, Daren K Heyland
BACKGROUND: Nutrition guidelines recommendations differ on the use of parenteral nutrition (PN), and existing clinical trial data are inconclusive. Our recent observational data show that amounts of energy/protein received early in the intensive care unit (ICU) affect patient mortality, particularly for inadequate nutrition intake in patients with body mass indices (BMIs) of <25 or >35. Thus, we hypothesized increased nutrition delivery via supplemental PN (SPN) + enteral nutrition (EN) to underweight and obese ICU patients would improve 60-day survival and quality of life (QoL) versus usual care (EN alone)...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28596289/paediatric-sepsis-the-under-recognised-killer-quality-improvement-initiative-of-outreach-teaching-in-paediatric-sepsis
#14
Claire Elizabeth Stewart, Trisha Radia, Kazim Ghafoor
Sepsis is the leading cause of child's death, yet it is well known that the rapid initiation of simple, timely interventions reduces morbidity and mortality. This paper shares our findings on the barriers doctors in training have identified to delivering such care. We also share the results of a pilot paediatric intensive care unit outreach teaching programme designed to directly address these highlighted concerns.
June 8, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28592468/improving-health-care-provider-communication-in-end-of-life-decision-making
#15
Tracey Wilson, Cathy Haut, Bimbola Akintade
Critical care providers are responsible for many aspects of patient care, primarily focusing on preserving life. However, nearly 40% of patients who are admitted to an adult critical care unit will not survive. Initiating a conversation about end-of-life decision-making is a daunting task. Often, health care providers are not trained, experienced, or comfortable facilitating these conversations. This article describes a quality improvement project that identified current views on end-of-life communication in the intensive care unit and potential barriers that obstruct open discussion, and offering strategies for improvement...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28591370/relating-family-satisfaction-to-the-care-provided-in-intensive-care-units-quality-outcomes-in-saudi-accredited-hospitals
#16
Mohamed Saad Mahrous
Objectives: This study aims to identify the satisfaction levels of the family members of patients in intensive care units. Methods: This is a cross-sectional analytical study. General intensive care units offer a variety of services to clinical and surgical patients. For the purpose of this study, a trained interviewer communicated with the families of patients, either before or after visiting hours. Results: The study included 208 participants: 119 (57...
June 5, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28591056/epidemiology-and-clinical-analysis-of-critical-patients-with-child-maltreatment-admitted-to-the-intensive-care-units
#17
En-Pei Lee, Shao-Hsuan Hsia, Jing-Long Huang, Jainn-Jim Lin, Oi-Wa Chan, Chia-Ying Lin, Kuang-Lin Lin, Yu-Ching Chang, I-Jun Chou, Fu-Song Lo, Jung Lee, Yi-Chen Hsin, Pei-Chun Chan, Mei-Hua Hu, Cheng-Hsun Chiu, Han-Ping Wu
Children with abuse who are admitted to the intensive care unit (ICU) may have high mortality and morbidity and commonly require critical care immediately. It is important to understand the epidemiology and clinical characteristics of these critical cases of child maltreatment.We retrospectively evaluated the data for 355 children with maltreatments admitted to the ICU between 2001 and 2015. Clinical factors were analyzed and compared between the abuse and the neglect groups, including age, gender, season of admission, identifying settings, injury severity score (ISS), etiologies, length of stay (LOS) in the ICU, clinical outcomes, and mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28591048/effects-of-dexmedetomidine-on-sleep-quality-of-patients-after-surgery-without-mechanical-ventilation-in-icu
#18
Weina Lu, Qinghui Fu, Xiaoqian Luo, Shuiqiao Fu, Kai Hu
Sleep quality of patients in intensive care unit (ICU) has been recently recognized as an important aspect of the intensive care. Dexmedetomidine is one of the most recently introduced for sedation in the ICU. This study was designed to evaluate the effect of dexmedetomidine on sleep quality of patients without mechanical ventilation in ICU.The patients who were included in this study were divided into two groups. In the sedation group, dexmedetomidine was given by a continuous infusion targeting a sedation level -1 to -2 on the score of RASS (Richmond Agitation-Sedation Scale)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#19
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
June 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28589374/-integration-of-palliative-care-into-intensive-care-systematic-review
#20
K Adler, D Schlieper, D Kindgen-Milles, S Meier, J Schwartz, P van Caster, M S Schaefer, M Neukirchen
BACKGROUND: One of the prime aims of intensive care is to cure patients or at least to extend life duration, sometimes to the extent of losing quality of life. Palliative care aims to improve the quality of life of patients with life-limiting conditions; however, some patients need both intensive and palliative care. About 5-10% of all deaths in Germany and 20% of all deaths in the USA occur in an intensive care unit (ICU) and many of those as well as other patients may benefit from palliative care consultation...
June 6, 2017: Der Anaesthesist
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