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nursing intensive care

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https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#1
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28816063/acute-cardiovascular-care-association-position-paper-on-intensive-cardiovascular-care-units-an-update-on-their-definition-structure-organisation-and-function
#2
Eric Bonnefoy-Cudraz, Hector Bueno, Gianni Casella, Elia De Maria, Donna Fitzsimons, Sigrun Halvorsen, Christian Hassager, Zaza Iakobishvili, Ahmed Magdy, Toomas Marandi, Jorge Mimoso, Alexander Parkhomenko, Susana Price, Richard Rokyta, Francois Roubille, Pranas Serpytis, Avi Shimony, Janina Stepinska, Diana Tint, Elina Trendafilova, Marco Tubaro, Christiaan Vrints, David Walker, Doron Zahger, Endre Zima, Robert Zuckerman, Maddalena Lettino
Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28812946/nurse-researchers-perspectives-on-research-ethics-in-china
#3
Can Gu, Man Ye, Xiaomin Wang, Min Yang, Honghong Wang, Kaveh Khoshnood
BACKGROUND: In China, research ethics is a subject of increasingly formal regulation. However, little is known about how nursing researchers understand the concept of research ethics and the ways in which they can maintain ethical standards in their work. AIM: The aim of this study is to examine nursing researchers' perspectives on research ethics in China. RESEARCH DESIGN: We conducted a descriptive qualitative study. Qualitative research methods enabled us to gain an in-depth understanding of nursing researchers' views on research ethics...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#4
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
#5
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/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#6
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#7
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
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
#8
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/28801406/speak-up-culture-in-an-intensive-care-unit-in-hong-kong-a-cross-sectional-survey-exploring-the-communication-openness-perceptions-of-chinese-doctors-and-nurses
#9
George Wing Yiu Ng, Jack Kwok Hung Pun, Eric Hang Kwong So, Wendy Wai Hang Chiu, Avis Siu Ha Leung, Yuk Han Stone, Chung Ling Lam, Sarah Pui Wa Lai, Rowlina Pui Wah Leung, Hing Wah Luk, Anne Kit Hung Leung, Kin Wah Au Yeung, Kang Yiu Lai, Diana Slade, Engle Angela Chan
OBJECTIVES: Despite growing recognition of the importance of speaking up to protect patient safety in critical care, little research has been performed in this area in an intensive care unit (ICU) context. This study explored the communication openness perceptions of Chinese doctors and nurses and identified their perceptions of issues in ICU communication, their reasons for speaking up and the possible factors and strategies involved in promoting the practice of speaking up. DESIGN: A mixed-methods design with quantitative and sequential qualitative components was used...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800982/pain-measurement-in-mechanically-ventilated-patients-after-cardiac-surgery-comparison-of-the-behavioral-pain-scale-bps-and-the-critical-care-pain-observation-tool-cpot
#10
Saskia Rijkenberg, Willemke Stilma, Robert J Bosman, Nardo J van der Meer, Peter H J van der Voort
OBJECTIVES: The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for sedated and unconscious critically ill patients. The aim of this study was to compare the reliability, internal consistency, and discriminant validation of the BPS and the CPOT simultaneously in mechanically ventilated patients after cardiac surgery. DESIGN: A prospective, observational cohort study. SETTING: A 20-bed closed-format intensive care unit with mixed medical, surgical, and cardiac surgery patients in a teaching hospital in Amsterdam, The Netherlands...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800580/establishing-a-classification-system-for-high-fall-risk-among-inpatients-using-support-vector-machines
#11
Shinichiroh Yokota, Miyoko Endo, Kazuhiko Ohe
We constructed a model using a support vector machine to determine whether an inpatient will suffer a fall on a given day, depending on patient status on the previous day. Using fall report data from our own facility and intensity-of-nursing-care-needs data accumulated through hospital information systems, a dataset comprising approximately 1.2 million patient-days was created. Approximately 50% of the dataset was used as training and testing data. A multistep grid search was conducted using the semicomprehensive combination of three parameters...
August 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28799197/cost-effectiveness-of-the-family-nurse-partnership-fnp-programme-in-england-evidence-from-the-building-blocks-trial
#12
Belen Corbacho, Kerry Bell, Eugena Stamuli, Gerry Richardson, Sarah Ronaldson, Kerenza Hood, Julia Sanders, Michael Robling, David Torgerson
RATIONAL, AIMS, AND OBJECTIVES: The Family Nurse Partnership (FNP) is a licensed intensive home visiting intervention developed in the United States. It has been provided in England by the Department of Health since 2006. The Building Blocks trial assessed the effectiveness and cost-effectiveness of FNP in England. METHODS: We performed a cost-utility analysis (National Health Service (NHS) perspective) alongside the Building Blocks trial (over 2.5 y). The analysis was conducted in accordance with National Institute for Health and Clinical Excellence (NICE) reference case standards...
August 11, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28798876/the-criterion-validity-reliability-and-feasibility-of-an-instrument-for-assessing-the-nursing-intensity-in-perioperative-settings
#13
Satu Rauta, Sanna Salanterä, Tero Vahlberg, Kristiina Junttila
Patient classification systems generate information for staff allocation based on a patient's care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N = 876) representing different fields of surgery. Reliability was tested by parallel classifications (n = 144). Also, the users' (n = 40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument...
2017: Nursing Research and Practice
https://www.readbyqxmd.com/read/28797857/level-of-care-preferences-among-nursing-home-residents-with-advanced-dementia
#14
Susan L Mitchell, Jennifer A Palmer, Angelo E Volandes, Laura C Hanson, Daniel Habtemariam, Michele L Shaffer
CONTEXT: Delivering goal-directed care is a hallmark of high quality palliative care, but requires an understanding of preferences. OBJECTIVES: To describe and identify factors associated with level of care preferences among proxies of nursing home residents with advanced dementia. METHODS: Nursing home residents with advanced dementia and their proxies (N=402 dyads) were recruited from 62 Boston-area facilities as part of an ongoing randomized clinical trial...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797590/antibiotic-stewardship-programs-in-nursing-homes-a-systematic-review
#15
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/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#16
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/28795670/-analysis-of-the-risk-factors-of-cognitive-impairment-in-post-intensive-care-syndrome-patient
#17
Cong Shao, Lixue Gu, Yongxia Mei, Mingjin Li
OBJECTIVE: To investigate the risk factors of cognitive impairment in post-intensive care syndrome patient (PICS-CI). METHODS: A retrospective study was conducted. The patient who transferred from post-intensive care unit (ICU) to the general ward for more than 7 days, and with the age ≥ 18 years old in the First Affiliated Hospital of Jinzhou Medical University from October 2015 to November 2016 were enrolled. The gender, age, marital status, education, occupation, salary, economic income, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28793935/utilization-of-electronic-health-record-events-to-conduct-a-tuberculosis-contact-investigation-in-a-high-risk-oncology-unit
#18
Shauna C Usiak, Fabian A Romero, Patrice Schwegman, Violet Fitzpatrick, MaryAnn Connor, Janet Eagan, Arthur E Brown, Mini Kamboj
OBJECTIVE To describe the utilization of electronic medical data resources, including health records and nursing scheduling resources, to conduct a tuberculosis (TB) exposure investigation in a high-risk oncology unit. SETTING A 42-bed inpatient unit with a mix of surgical and medical patients at a large tertiary-care cancer center in New York City. PARTICIPANTS High-risk subjects and coworkers exposed to a healthcare worker (HCW) with cavitary smear positive lung TB. RESULTS During the 3-month exposure period, 270 patients were admitted to the unit; 137 of these (50...
August 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28793094/therapeutic-nursing-care-transition-in-sexuality-of-the-elderly-caregiving-spouse
#19
Claudia Feio da Maia Lima, Célia Pereira Caldas, Iraci Dos Santos, Liana Amorim Correa Trotte, Bárbara Martins Corrêa da Silva
Objective: To understand the transitions experienced, and the conditions and expected response patterns to changes in sexuality of the spouse-caregiver of the elderly, during progression of the dementia process. Method: A qualitative research study, conducted at the neurogeriatric clinic between May of 2014 and May of 2015. An intensive, individual interview was administered to 12 elderly caregivers. Thematic content analysis was applied, using the theoretical model of Transition Theory...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28792829/mental-health-problems-among-nurses-in-paediatric-cardiac-intensive-care
#20
Renata Santos Tito, Patrícia Campos Pavan Baptista, Fabio José da Silva, Vanda Elisa Andres Felli
At present, there are growing rates of psychiatric symptoms among some occupational categories, with emphasis on health professionals who work in hospitals. This study aimed to identify the occurrence of mental health problems (anxiety and depression) among 92 nursing workers in a paediatric cardiac intensive care unit. This is an exploratory, cross-sectional study, with a quantitative approach. The research was conducted in a public university hospital specialising in cardiology, pneumology, and thoracic and cardiac surgery...
August 10, 2017: British Journal of Nursing: BJN
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