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https://www.readbyqxmd.com/read/29243981/assessment-of-intracranial-venous-blood-flow-after-subarachnoid-hemorrhage-a-new-approach-to-diagnose-vasospasm-with-transcranial-color-coded-duplex-sonography
#1
Florian Connolly, Stephan J Schreiber, Christoph Leithner, Georg Bohner, Peter Vajkoczy, José M Valdueza
OBJECTIVE Transcranial color-coded duplex sonography (TCCS) is a reliable tool that is used to assess vasospasm in the M1 segment of the middle cerebral artery (MCA) after subarachnoid hemorrhage (SAH). A distinct increase in blood flow velocity (BFV) is the principal criterion for vasospasm. The MCA/internal carotid artery (ICA) index (Lindegaard Index) is also widely used to distinguish between vasospasm and cerebral hyperperfusion. However, extracranial ultrasonography assessment of the neck vessels might be difficult in an intensive care unit...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29243506/macrocognition-in-the-healthcare-built-environment-mhcbe-a-focused-ethnographic-study-of-neighborhoods-in-a-pediatric-intensive-care-unit
#2
Susan O'Hara, Robin Toft Klar, Emily S Patterson, Nancy Morris, Judy Ascenzi, James C Fackler, Donna J Perry
OBJECTIVES: The objectives of this research were to describe the interactions (formal and informal), in which macrocognitive functions occur and their location on a pediatric intensive care unit, to describe challenges and facilitators of macrocognition using space syntax constructs (openness, connectivity, and visibility), and to analyze the healthcare built environment (HCBE) using those constructs to explicate influences on macrocognition. BACKGROUND: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/29241891/cost-effectiveness-of-candida-polymerase-chain-reaction-detection-and-empirical-antifungal-treatment-among-patients-with-suspected-fungal-peritonitis-in-the-intensive-care-unit
#3
Arnaud Pagès, Xavier Iriart, Laurent Molinier, Bernard Georges, Antoine Berry, Patrice Massip, Blandine Juillard-Condat
BACKGROUND: Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. OBJECTIVES: To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29241421/the-effect-of-zinc-supplementation-on-sleep-quality-of-icu-nurses-a-double-blinded-randomized-controlled-trial
#4
Afshin Gholipour Baradari, Abbas Alipour, Ali Mahdavi, Hassan Sharifi, Seyed Mahmood Nouraei, Amir Emami Zeydi
This study examined the effect of zinc supplementation on the sleep quality (SQ) of intensive care unit (ICU) nurses. In a double-blind, randomized controlled trial, 54 ICU nurses were randomly assigned to the intervention group ( n = 27) that received 220 mg zinc sulfate capsules every 72 hours for 1 month and the control group ( n = 26) that received placebo. Sleep quality of ICU nurses was measured by calculating the total quality sleep score using the Pittsburgh Sleep Quality Index (PSQI). The serum zinc level was a secondary outcome...
December 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/29237289/safely-converting-an-entire-academic-medical-center-from-sliding-scale-to-basal-bolus-insulin-via-implementation-of-the-eglycemic-management-system
#5
Rosalina Newsom, Christopher Patty, Emma Camarena, Regina Sawyer, Raymie McFarland, Thomas Gray, Melanie Mabrey
OBJECTIVE: Hyperglycemia is common in the inpatient setting and providers frequently rely on sliding scale insulin. This case study reviews the experience of one hospital moving from high utilization of sliding scale to basal bolus insulin therapy. METHOD: This Retrospective Quality Improvement Study describes the journey of clinicians at a 580-bed hospital to convert from high usage of SSI to BBI. Hyperglycemic adult patients prescribed insulin, with/without a diagnosis of diabetes, were included...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29235738/twenty-year-trends-of-survival-after-in-hospital-cardiac-arrest
#6
Jad Khatib, Naama Schwartz, Naiel Bisharat
BACKGROUND: In 2006, the Israeli Ministry of Health distributed guidelines for improving cardiopulmonary resuscitation (CPR) knowledge among hospital staff. The impact of these guidelines on survival after in-hospital cardiac arrest (IHCA) is unclear. OBJECTIVES: To compare rates of incidence and survival to discharge after IHCA, preceding and subsequent to issuance of the guidelines: 1995-2005 and 2006-2015. METHODS: Data were retrieved from the computerized records of patients who had an IHCA and underwent CPR...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29234148/quality-improvement-to-reduce-chronic-lung-disease-rates-in-very-low-birth-weight-infants-high-compliance-with-a-respiratory-care-bundle-in-a-small-nicu
#7
Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A Feldman, John Fiascone
OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29232263/can-the-critically-ill-patient-generate-sufficient-energy-to-facilitate-exercise-in-the-icu
#8
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
December 9, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29229889/admission-of-term-infants-to-the-neonatal-intensive-care-unit-in-a-saudi-tertiary-teaching-hospital-cumulative-incidence-and-risk-factors
#9
Heidi Al-Wassia, Mafaza Saber
BACKGROUND: An increasing number of term infants of appropriate birthweight receive care in neonatal intensive care units (NICUs). OBJECTIVES: This study assessed the prevalence, patterns, and risk factors for admission of term infants to a NICU to identify areas for quality improvement. DESIGN: Cross-sectional analytical study. SETTING: An academic and referral center in Jeddah, Saudi Arabia. PATIENTS AND METHODS: The cases were all term infants (>=37 weeks gestational age) admitted to the NICU between 1 January and 31 December 2015...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#10
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29219799/-characteristics-and-healthcare-utilization-of-patients-with-highest-costs-of-care
#11
J J G Wammes, M Tanke, W Jonkers, G P Westert, P J van der Wees, P P T Jeurissen
OBJECTIVE: To determine characteristics and healthcare utilization of high-cost patients in the Netherlands. DESIGN: Cross-sectional study, using claim data for 2013 from one Dutch health insurer. Analyses were limited to the curative health system (care that falls under the Health Insurance Act), including voluntary supplementary insurance. METHOD: We established total healthcare costs per beneficiary by summing all claims with a starting date in 2013...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29218814/knowledge-compliance-with-good-clinical-practices-and-barriers-to-effective-control-of-postoperative-pain-among-nurses-from-hospitals-with-and-without-a-hospital-without-pain-certificate
#12
Lucyna Tomaszek, Grażyna Dębska
AIMS AND OBJECTIVES: (1) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate. (2) To identify the determinants of nurses' knowledge. (3) To define barriers to effective control of postoperative pain. BACKGROUND: Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses...
December 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29216816/acute-kidney-injury-in-low-and-middle-income-countries-investigations-management-and-prevention
#13
Mohamed B Abdelraheem
Acute kidney injury (AKI) is a relatively common condition, encountered in everyday paediatric clinical practice. It is an important cause of morbidity and mortality in children both inside and outside intensive care units. It is associated with prolonged hospital stay and progression to chronic kidney disease. The burden of AKI is particularly high in low- and middle-income countries where rural areas and smaller cities in the countryside predominate. Most of these areas suffer from poverty, poor sanitation, water quality and hygiene, lack of education and poor access to health care...
November 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29212480/the-effect-of-nursing-participation-in-the-design-of-a-critical-care-information-system-a-case-study-in-a-chinese-hospital
#14
Yanhong Qin, Ranyun Zhou, Qiong Wu, Xiaodi Huang, Xinli Chen, Weiwei Wang, Xun Wang, Hua Xu, Jing Zheng, Siyu Qian, Changqing Bai, Ping Yu
BACKGROUND: Intensive care information systems (ICIS) are continuously evolving to meet the ever changing information needs of intensive care units (ICUs), providing the backbone for a safe, intelligent and efficient patient care environment. Although beneficial for the international advancement in building smart environments to transform ICU services, knowledge about the contemporary development of ICIS worldwide, their usage and impacts is limited. This study aimed to fill this knowledge gap by researching the development and implementation of an ICIS in a Chinese hospital, nurses' use of the system, and the impact of system use on critical care nursing processes and outcomes...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29211195/impact-of-two-bundles-on-central-catheter-related-bloodstream-infection-in-critically-ill-patients
#15
Cristobal Felipe Padilla Fortunatti
OBJECTIVE: To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. METHOD: This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29211187/the-epimed-monitor-icu-database%C3%A2-a-cloud-based-national-registry-for-adult-intensive-care-unit-patients-in-brazil
#16
Fernando Godinho Zampieri, Márcio Soares, Lunna Perdigão Borges, Jorge Ibrain Figueira Salluh, Otávio Tavares Ranzani
OBJECTIVE: To describe the Epimed Monitor Database®, a Brazilian intensive care unit quality improvement database. METHODS: We described the Epimed Monitor® Database, including its structure and core data. We presented aggregated informative data from intensive care unit admissions from 2010 to 2016 using descriptive statistics. We also described the expansion and growth of the database along with the geographical distribution of participating units in Brazil...
November 30, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29210925/frequency-of-desaturation-and-association-with-hemodynamic-adverse-events-during-tracheal-intubations-in-picus
#17
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
November 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29209982/adherence-to-inhaled-medications-and-its-effect-on-healthcare-utilization-and-costs-among-high-grade-chronic-obstructive-pulmonary-disease-patients
#18
Jee-Ae Kim, Min Kyoung Lim, Kunil Kim, JuHee Park, Chin Kook Rhee
BACKGROUND: Adherence to inhaled medication regimens affects chronic obstructive pulmonary disease (COPD) prognosis and quality of life, and reduces the use of healthcare services, resulting in cost savings. OBJECTIVES: To examine the effects of adherence to inhaled medication regimens on healthcare utilization and costs in high-grade COPD patients. METHODS: We performed an observational retrospective cohort study using a longitudinal data set from the Korean Health Insurance Review and Assessment Service (2008-2013) containing healthcare services' information for 50 million beneficiaries...
December 5, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#19
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29200209/-nursing-sensitive-outcomes-and-staffing-a-review-on-healthcare-associated-infection
#20
Matteo Seligardi, Erika Bassi, Maria Mongardi
. Nursing sensitive outcomes and staffing: a review on healthcare associated infection. INTRODUCTION: Healthcare associated infections (HAI) continue to be an unresolved problem in hospital settings. AIM: To assess the relationship between nurse staffing and healthcare associated infections in different settings. METHODS: From April to May 2015 a review of literature was conducted consulting PubMed, CINAHL and Cochrane Library. RESULTS: An increased amount of Registered Nurse Hours Per Patient Day (RNHPPD) and nurse-to-patient ratio was associated to a decreased occurrence of HAI...
October 2017: Assistenza Infermieristica e Ricerca: AIR
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