keyword
MENU ▼
Read by QxMD icon Read
search

Quality improvement intensive care

keyword
https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#1
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#2
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28806982/software-guided-versus-nurse-directed-blood-glucose-control-in-critically-ill-patients-the-logic-2-multicenter-randomized-controlled-clinical-trial
#3
Dieter Mesotten, Jasperina Dubois, Tom Van Herpe, Roosmarijn T van Hooijdonk, Ruben Wouters, Domien Coart, Pieter Wouters, Aimé Van Assche, Guy Veraghtert, Bart De Moor, Joost Wauters, Alexander Wilmer, Marcus J Schultz, Greet Van den Berghe
BACKGROUND: Blood glucose control in the intensive care unit (ICU) has the potential to save lives. However, maintaining blood glucose concentrations within a chosen target range is difficult in clinical practice and holds risk of potentially harmful hypoglycemia. Clinically validated computer algorithms to guide insulin dosing by nurses have been advocated for better and safer blood glucose control. METHODS: We conducted an international, multicenter, randomized controlled trial involving 1550 adult, medical and surgical critically ill patients, requiring blood glucose control...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#4
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28803624/the-quality-of-primary-care-provided-by-nurse-practitioners-to-vulnerable-medicare-beneficiaries
#5
Catherine M DesRoches, Sean Clarke, Jennifer Perloff, Monica O'Reilly-Jacob, Peter Buerhaus
BACKGROUND: Studies suggest nurse practitioners are heavily represented among primary care providers for vulnerable Medicare beneficiaries. PURPOSE: The purpose of this study was to compare quality indicators among three groups of vulnerable beneficiaries managed by MDs and nurse practitioners (NPs). METHODS: The methods include retrospective cohort design examining 2012 and 2013 Medicare claims for three beneficiary groups: (a) initially qualified for the program due to disability, (b) dually eligible for Medicare and Medicaid, and (c) both disabled and dually eligible...
June 15, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28802772/effectiveness-of-a-combined-exercise-training-and-home-based-walking-programme-on-physical-activity-compared-with-standard-medical-care-in-moderate-copd-a-randomised-controlled-trial
#6
P de Roos, C Lucas, J H Strijbos, E van Trijffel
OBJECTIVE: To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD). DESIGN: Randomised controlled trial. SETTING: Primary care physiotherapy. PARTICIPANTS: Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale...
July 14, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28802347/using-quality-improvement-tools-to-reduce-chronic-lung-disease
#7
REVIEW
Alan Peter Picarillo, Waldemar Carlo
Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic. A specific QI project for CLD must be based on best available evidence in the medical literature, expert recommendations, or based on work by previous QI initiatives...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#8
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802342/improving-value-in-neonatal-intensive-care
#9
REVIEW
Timmy Ho, John A F Zupancic, DeWayne M Pursley, Dmitry Dukhovny
Work within the US health care system has sought to improve outcomes, decrease costs, and improve the patient experience. Combining those three elements leads to value-added care. Quality improvement within neonatology has focused primarily on the improvement of clinical outcomes without explicit consideration of cost. Future improvement efforts in neonatology should consider opportunities to decrease or eliminate waste, and improve outcomes. Consideration of how a change affects all stakeholders reveals potential cost-saving opportunities, and developing aims with value in mind facilitates understanding and goal-setting with senior administrative leaders...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802339/family-involvement-in-quality-improvement-from-bedside-advocate-to-system-advisor
#10
REVIEW
Joanna F Celenza, Denise Zayack, Madge E Buus-Frank, Jeffrey D Horbar
Family involvement in newborn intensive care quality improvement dates back to the 1980s. In recent years, there has been an evolution of support for family partnerships at the bedside, transforming parents from being passively present to being active and engaged caregivers and team members. Through those same efforts, a transformational understanding of the power of the family perspective in system design and improvement has occurred. Even with the progression and deepening of this involvement, opportunities exist to learn from families and to improve the quality of neonatal care as a result of the unique family perspective...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802334/has-quality-improvement-really-improved-outcomes-for-babies-in-the-neonatal-intensive-care-unit
#11
REVIEW
Alan R Spitzer
During the past decade, the emergence of outcome measurement and quality improvement in the neonatal intensive care unit, far more than the introduction of new research approaches or novel therapies, has had a profound effect on improving outcomes for premature neonates. Collection of outcome data, review of those data, and strategies to identify and resolve problems using continuous quality improvement methods can dramatically improve patient outcomes. It is likely that further initiatives in quality improvement will continue to have additional beneficial effects for the neonate...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28800804/intensive-care-and-its-discontents-psychiatric-illness-in-the-critically-ill
#12
REVIEW
Ali M Hashmi, Jin Y Han, Vishal Demla
Critically ill patients can develop a host of cognitive and psychiatric complaints during their intensive care unit (ICU) stay, many of which persist for weeks or months following discharge from the ICU and can seriously affect their quality of life, including their ability to return to work. This article describes some common psychiatric problems encountered by clinicians in the ICU, including their assessment and management. A comprehensive approach is needed to decrease patient suffering, improve morbidity and mortality, and ensure that critically ill patients can return to the highest quality of life after an ICU stay...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28797590/antibiotic-stewardship-programs-in-nursing-homes-a-systematic-review
#13
REVIEW
Diana Feldstein, Philip D Sloane, Cynthia Feltner
INTRODUCTION: Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. METHODS: PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines)...
August 7, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28797281/the-efficacy-of-transcutaneous-electrical-nerve-stimulation-on-the-improvement-of-walking-distance-in-patients-with-peripheral-arterial-disease-with-intermittent-claudication-study-protocol-for-a-randomised-controlled-trial-the-tens-pad-study
#14
Florent Besnier, Jean-Michel Sénard, Vincent Grémeaux, Mélanie Riédel, Damien Garrigues, Thibaut Guiraud, Marc Labrunée
BACKGROUND: In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking...
August 10, 2017: Trials
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#15
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
August 10, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28794694/quality-indicators-in-intensive-care-medicine-for-germany-third-edition-2017
#16
REVIEW
Oliver Kumpf, Jan-Peter Braun, Alexander Brinkmann, Hanswerner Bause, Martin Bellgardt, Frank Bloos, Rolf Dubb, Clemens Greim, Arnold Kaltwasser, Gernot Marx, Reimer Riessen, Claudia Spies, Jörg Weimann, Gabriele Wöbker, Elke Muhl, Christian Waydhas
Quality improvement in medicine is depending on measurement of relevant quality indicators. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI) from the year 2013 underwent a scheduled evaluation after three years. There were major changes in several indicators but also some indicators were changed only minimally. The focus on treatment processes like ward rounds, management of analgesia and sedation, mechanical ventilation and weaning, as well as the number of 10 indicators were not changed...
2017: German Medical Science: GMS E-journal
https://www.readbyqxmd.com/read/28789670/patient-centered-boundary-mechanisms-to-foster-intercultural-partnerships-in-health-care-a-case-study-in-guatemala
#17
Martin Hitziger, Mónica Berger Gonzalez, Eduardo Gharzouzi, Daniela Ochaíta Santizo, Regina Solis Miranda, Andrea Isabel Aguilar Ferro, Ana Vides-Porras, Michael Heinrich, Peter Edwards, Pius Krütli
BACKGROUND: Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration...
August 8, 2017: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/28780683/title-v-workforce-development-in-the-era-of-health-transformation
#18
Lewis Margolis, Amy Mullenix, Alexsandra A Apostolico, Lacy M Fehrenbach, Dorothy Cilenti
Purpose The National Maternal and Child Health Workforce Development Center at UNC Chapel Hill (the Center), funded by the Maternal and Child Health Bureau, provides Title V state/jurisdiction leaders and staff and partners from other sectors with opportunities to develop skills in quality improvement, systems mapping and analysis, change management, and strategies to enhance access to care to leverage and implement health transformation opportunities to improve the health of women and children. Description Since 2013, the Center has utilized a variety of learning platforms to reach state and jurisdiction Title V leaders...
August 5, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28777116/emergency-airway-response-team-simulation-training-a-nursing-perspective
#19
Janet T Crimlisk, Gintas P Krisciunas, Gregory A Grillone, R Mauricio Gonzalez, Michael R Winter, Susan C Griever, Eduarda Fernandes, Ron Medzon, Joseph S Blansfield, Adam Blumenthal
BACKGROUND: Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. METHOD: Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28777112/the-relationship-between-professional-quality-of-life-and-caring-ability-in-critical-care-nurses
#20
Marzieh Mohammadi, Hamid Peyrovi, Mahmood Mahmoodi
BACKGROUND: Critical care nursing has some features that may affect the ability of critical care nurses to provide care. Professionals as critical care nurses who deal with peoples' health and life often experience some levels of stress that affects their quality of life. OBJECTIVE: This study examined the relationship between professional quality of life and caring ability of critical care nurses. METHOD: In this descriptive correlational study, 253 critical care nurses working in the medical and surgical intensive care units of Tehran University of Medical Sciences were recruited by convenience sampling method...
September 2017: Dimensions of Critical Care Nursing: DCCN
keyword
keyword
62030
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"