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https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#1
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737545/the-perinatal-neonatal-care-journey-for-parents-of-preterm-infants-what-is-working-and-what-can-be-improved
#2
Linda S Franck, Alison McNulty, Fiona Alderdice
Preterm birth is traumatic for parents, but there are few reports of parents' views on how the healthcare journey can be improved. This secondary thematic analysis used focus group data from parent consultation on proposed neonatal services standards for Northern Ireland to discover parents' experiences and recommendations for the perinatal, neonatal, and home care phases. Parents of preterm infants (n = 40) described their healthcare journey as positive overall and were grateful for the caring and competent care providers they encountered...
July 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28731659/neonatal-intensive-care-unit-lighting-update-and-recommendations
#3
Roberto G Rodríguez, Andrea E Pattini
Achieving adequate lighting in neonatal intensive care units is a major challenge: in addition to the usual considerations of visual performance, cost, energy and aesthetics, there appear different biological needs of patients, health care providers and family members. Communicational aspects of light, its role as a facilitator of the visual function of doctors and nurses, and its effects on the newborn infant physiology and development were addressed in order to review the effects of light (natural and artificial) within neonatal care with a focus on development...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28725854/improving-the-patient-experience-by-implementing-an-icu-diary-for-those-at-risk-of-post-intensive-care-syndrome
#4
K Taylor A Blair, Sarah D Eccleston, Hannah M Binder, Mary S McCarthy
The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS) are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay...
March 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28725847/the-process-and-impact-of-stakeholder-engagement-in-developing-a-pediatric-intensive-care-unit-communication-and-decision-making-intervention
#5
Kelly N Michelson, Joel Frader, Lauren Sorce, Marla L Clayman, Stephen D Persell, Patricia Fragen, Jody D Ciolino, Laura C Campbell, Melanie Arenson, Danica Y Aniciete, Melanie L Brown, Farah N Ali, Douglas White
Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews...
December 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#6
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28716040/the-communication-between-patient-relatives-and-physicians-in-intensive-care-units
#7
Faruk Cicekci, Numan Duran, Bunyamin Ayhan, Sule Arican, Omur Ilban, Iskender Kara, Melda Turkoglu, Fatma Yildirim, Ismail Hasirci, Adnan Karaibrahimoglu, Inci Kara
BACKGROUND: Patients in intensive care units (ICUs) are often physically unable to communicate with their physicians. Thus, the sharing of information about the on-going treatment of the patients in ICUs is directly related to the communication attitudes governing a patient's relatives and the physician. This study aims to analyze the attitudes displayed by the relatives of patients and the physician with the purpose of determining the communication between the two parties. METHODS: For data collection, two similar survey forms were created in context of the study; one for the relatives of the patients and one for the ICU physicians...
July 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28708689/improving-medical-icu-outcomes-promoting-respect-and-ongoing-safety-through-patient-engagement-communication-and-technology-study
#8
Judith Gedney Baggs
No abstract text is available yet for this article.
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28707029/-traumatized-relatives-of-intensive-care-patients
#9
REVIEW
A Niecke, G Schneider, C S Hartog, G Michels
Relatives are not only visitors in the intensive care unit, but provide support and care for patients at the end of life, and serve as an important source of information for clinicians. They are confronted, often unexpectedly and unprepared, with life-threatening illness, death and dying and life-threatening decisions to limit therapy. Thus, they are often substantially burdened themselves and are in need of support. It is undisputed that communication with relatives can have an adaptive or also traumatic influence on the experience gained...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28705527/reducing-stat-portable-chest-radiograph-turnaround-times-a-pilot-study
#10
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
#11
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/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#12
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28699268/an-integrative-review-of-supports-facilitators-and-barriers-to-patient-centred-nursing-in-the-intensive-care-unit
#13
REVIEW
Samantha Jakimowicz, Lin Perry, Joanne Lewis
AIM: To systematically review the literature describing factors perceived by nurses as impacting the provision of patient-centred nursing in the intensive care unit. BACKGROUND: Patient-centred nursing in critical care differs from other healthcare areas, and the aggressive curative environment of the ICU has potential to compromise some of its elements. Understanding critical care nurses' perceptions of promoting and deterrent factors may inform development of strategies to support effective patient-centred nursing and job satisfaction in this workforce...
July 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28682859/multidisciplinary-interventions-and-continuous-quality-improvement-to-reduce-unplanned-extubation-in-adult-intensive-care-units-a-15-year-experience
#14
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Chung-Han Ho, Chin-Ming Chen, Willy Chou
We conduct a retrospective study of patients with unplanned extubation (UE) in adult intensive care units (ICU) at a medical center. In 2001, a multidisciplinary team of intensivists, senior residents, nurses, and respiratory therapists was established at Chi Mei Medical Center. The improvement interventions, implemented between 2001 and 2015, were organized around 8 key areas: standardizing procedures, improving communication skills, revising sedation and weaning protocols, changing strategies for restraints, establishing a task force for identifying and managing high-risk patients, using new quality-improvement models as breakthrough series and team resource management, using the strategy of accountability without assigning blame, and changing a new method to secure endotracheal tube...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28679836/effects-of-the-i-pass-nursing-handoff-bundle-on-communication-quality-and-workflow
#15
Amy J Starmer, Kumiko O Schnock, Aimee Lyons, Rebecca S Hehn, Dionne A Graham, Carol Keohane, Christopher P Landrigan
BACKGROUND AND OBJECTIVE: Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses. METHODS: We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 2011-2012. The I-PASS Nursing Handoff Bundle intervention consisted of educational training, verbal handoff I-PASS mnemonic implementation, and visual materials to provide reinforcement and sustainability...
July 5, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28677173/handing-over-patients-from-the-icu-to-the-general-ward-a-focused-ethnographical-study-of-nurses-communication-practice
#16
Gitte Bunkenborg, Tina Bitsch Hansen, Bibi Hølge-Hazelton
AIM: To explore nursing practice and perception of engaging in communicative interaction when handing over multi morbid patients from the ICU to general medical or surgical wards. BACKGROUND: Communication failures impose risks to patient safety. ICU and general ward nurses communicate in writing and verbally when handing over patients from one setting to another. A deeper understanding of nurses' communicative interaction and of nurses' perception of their interaction is crucial to facilitate clinical interventions focusing to improve patient safety...
July 5, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28674611/reducing-the-number-of-unnecessary-liver-function-tests-requested-on-the-paediatric-intensive-care-unit
#17
Lynn Sinitsky, Joe Brierley
Between January and October 2014, Great Ormond Street Hospital Paediatric Intensive Care Unit (PICU) was spending an average £23,392 on blood tests per month. Blood tests should be requested based on previous results and the patient's clinical condition, medication and nutritional status. However, more blood tests were being ordered than clinically indicated: an audit in October 2014 showed liver function tests (LFTs) were requested daily on most patients, even with previous normal results. A driver diagram identified three primary drivers for blood test requesting: decision-making, situational awareness and computer-based ordering...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28668920/communication-and-decision-making-about-end-of-life-care-in-the-intensive-care-unit
#18
Laura Anne Brooks, Elizabeth Manias, Patricia Nicholson
BACKGROUND: Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. OBJECTIVES: To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. METHODS: The study was conducted in a 24-bed intensive care unit in Melbourne, Australia...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28660168/spontaneous-intraventricular-rupture-of-a-craniopharyngioma-cyst-a-case-report
#19
Kunal Vakharia, Ioannis Dimitrios Siasios, Alexander B Dorsch, Jody Leonardo
Intraventricular rupture of craniopharyngioma cysts is an unusual event which is associated with a high risk of loculated or communicating hydrocephalus. A 75-year-old woman presented at the Emergency Department of our hospital with mental status deterioration due to chemical ventriculitis and acute hydrocephalus following the intraventricular rupture of a craniopharyngioma cyst. The patient was treated with stress-dose steroid therapy. In addition, she underwent placement of an external ventricular drain and endoscopy-assisted intra-cystic placement of an Ommaya reservoir for the aspiration of the cystic fluid...
April 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28659433/effect-of-communication-skills-training-on-outcomes-in-critically-ill-patients-with-life-limiting-illness-referred-for-intensive-care-management-a-before-and-after-study
#20
Neil R Orford, Sharyn Milnes, Nicholas Simpson, Gerry Keely, Tania Elderkin, Allison Bone, Peter Martin, Rinaldo Bellomo, Michael Bailey, Charlie Corke
OBJECTIVES: To describe the effect of a communication skills training programme on patient-centred goals of care documentation and clinical outcomes in critically ill patients with life-limiting illnesses (LLI) referred for intensive care management. METHODS: Prospective before-and-after cohort study in a tertiary teaching hospital in Australia. The population was 222 adult patients with LLI referred to the intensive care unit (ICU). The study was divided into two periods, before (1 May to 31 July 2015) and after (15 September to 15December 2015) the intervention...
June 28, 2017: BMJ Supportive & Palliative Care
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