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noise in critical care

Angela Jones, Megan-Jane Johnstone
BACKGROUND: Failure to identify and respond to clinical deterioration is an important measure of patient safety, hospital performance and quality of care. Although studies have identified the role of patient, system and human factors in failure to rescue events, the role of 'inattentional blindness' as a possible contributing factor has been overlooked. OBJECTIVES: To explore the nature and possible patient safety implications of inattentional blindness in critical care, emergency and perioperative nursing contexts...
October 5, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Vincent S Staggs, Emily Cramer
Reliability-the extent to which multiple measurements of a target yield similar results-is critical in comparing healthcare provider quality. Hospital unit fall rates are widely tracked and used for benchmarking, but their reliability is not well-studied. Our twofold purpose was to estimate fall rate reliability, both in terms of signal (between-unit variability) relative to noise (within-unit variability) and in terms of the accuracy with which units can be classified as high-fall units; and to assess reliability as a function of the number of quarters of data used to compute fall rates...
September 30, 2016: Research in Nursing & Health
Lioudmila V Karnatovskaia, Margaret M Johnson, Travis J Dockter, Ognjen Gajic
PURPOSE: Survivors of critical illness are frequently unable to return to their premorbid level of psychocognitive functioning following discharge. Therefore, we aimed to evaluate the burden of psychological trauma experienced by patients in the intensive care unit (ICU) as perceived by clinicians to assess factors that can impede its recognition and treatment in the ICU. MATERIALS AND METHODS: Two distinct role-specific Web-based surveys were administered to critical care physicians and nurses in medical and surgical ICUs of 2 academic medical centers...
September 14, 2016: Journal of Critical Care
Yuliya Boyko, Poul Jennum, Miki Nikolic, René Holst, Helle Oerding, Palle Toft
PURPOSE: To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients. MATERIALS AND METHODS: Randomized controlled trial, crossover design. The night intervention "quiet routine" protocol was directed toward improving ICU environment between 10pm and 6am. Noise levels during control and intervention nights were recorded. Patients on mechanical ventilation and able to give consent were eligible for the study...
September 10, 2016: Journal of Critical Care
Sapna R Kudchadkar, M Claire Beers, Judith A Ascenzi, Ebaa Jastaniah, Naresh M Punjabi
BACKGROUND: The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. OBJECTIVES: To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Vadim Krivitsky, Marina Zverzhinetsky, Fernando Patolsky
The detection of biomolecules is critical for a wide spectrum of applications in life sciences and medical diagnosis. Nonetheless, biosamples are highly complex solutions, which contain an enormous variety of biomolecules, cells, and chemical species. Consequently, the intrinsic chemical complexity of biosamples results in a significant analytical background noise and poses an immense challenge to any analytical measurement, especially when applied without prior efficient separation and purification steps. Here, we demonstrate the application of antigen-dissociation regime, from antibody-modified Si-nanowire sensors, as a simple and effective direct sensing mechanism of biomarkers of interest in complex biosamples, such as serum and untreated blood, which does not require ex situ time-consuming biosample manipulation steps, such as centrifugation, filtering, preconcentration, and desalting, thus overcoming the detrimental Debye screening limitation of nanowire-based biosensors...
October 12, 2016: Nano Letters
Brittany Lynn White, Meg Zomorodi
PURPOSE: To compare the noise levels perceived by critical care nurses in the Intensive Care Unit (ICU) to actual noise levels in the ICU. METHODS: Following a pilot study (n=18) and revision of the survey tool, a random sample of nurses were surveyed twice in a 3-day period (n=108). Nurses perception of noise was compared to the actual sound pressure level using descriptive statistics. MAJOR RESULTS: Nurses perceived the ICUs to be noisier than the actual values...
August 23, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Kate Kynoch, Anne Chang, Fiona Coyer, Annie McArdle
BACKGROUND: Attending to the needs of family members of critically ill patients is an important and necessary step in providing appropriate holistic care for both the patient and the family. Family interaction can significantly impact on the experience of critical illness, notwithstanding the challenge of meeting families' needs for many clinicians in the intensive care unit (ICU). Family needs have been extensively researched; however, a previous Joanna Briggs Institute (JBI) systematic review was the first published systematic review recommending effective interventions for addressing family needs of critically ill patients in an acute intensive care setting...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Gonzalo Garcia Guerra, Ari R Joffe, Dominic Cave, Jonathan Duff, Shannon Duncan, Cathy Sheppard, Gerda Tawfik, Lisa Hartling, Hsing Jou, Sunita Vohra
BACKGROUND: Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists. METHODS: The survey was conducted after a literature review and initial focus groups. The survey was then pretested and validated...
September 2016: Pediatric Critical Care Medicine
Gari D Clifford, Ikaro Silva, Benjamin Moody, Qiao Li, Danesh Kella, Abdullah Chahin, Tristan Kooistra, Diane Perry, Roger G Mark
High false alarm rates in the ICU decrease quality of care by slowing staff response times while increasing patient delirium through noise pollution. The 2015 PhysioNet/Computing in Cardiology Challenge provides a set of 1250 multi-parameter ICU data segments associated with critical arrhythmia alarms, and challenges the general research community to address the issue of false alarm suppression using all available signals. Each data segment was 5 minutes long (for real time analysis), ending at the time of the alarm...
August 2016: Physiological Measurement
C Daluwatte, L Johannesen, L Galeotti, J Vicente, D G Strauss, C G Scully
False and non-actionable alarms in critical care can be reduced by developing algorithms which assess the trueness of an arrhythmia alarm from a bedside monitor. Computational approaches that automatically identify artefacts in ECG signals are an important branch of physiological signal processing which tries to address this issue. Signal quality indices (SQIs) derived considering differences between artefacts which occur in ECG signals and normal QRS morphology have the potential to discriminate pathologically different arrhythmic ECG segments as artefacts...
August 2016: Physiological Measurement
Xilin Liu, Milin Zhang, Tao Xiong, Andrew G Richardson, Timothy H Lucas, Peter S Chin, Ralph Etienne-Cummings, Trac D Tran, Jan Van der Spiegel
Reliable, multi-channel neural recording is critical to the neuroscience research and clinical treatment. However, most hardware development of fully integrated, multi-channel wireless neural recorders to-date, is still in the proof-of-concept stage. To be ready for practical use, the trade-offs between performance, power consumption, device size, robustness, and compatibility need to be carefully taken into account. This paper presents an optimized wireless compressed sensing neural signal recording system...
July 18, 2016: IEEE Transactions on Biomedical Circuits and Systems
Madhavi Mallam, K Chandra Bhutan Rao
In this paper, a new model for adaptive artifact cancelation in impedance cardiography (ICG) signals is presented. It is a hybrid model based on wavelet decomposition and an adaptive filter. A novel feature of this model is the implementation of reference-free adaptive artifact cancellers (AAC). For this implementation, the reference signal is constructed using a wavelet transformation. During critical conditions the filter weights may be negative and cause an imbalance in the convergence. To overcome this problem, we introduce non-negative adaptive algorithms in the proposed artifact canceller...
2016: SpringerPlus
Pouya Farokhnezhad Afshar, Fatemeh Bahramnezhad, Parvaneh Asgari, Mahmoud Shiri
INTRODUCTION: Sleep disorders are a common problem in patients in the critical care unit. The objective of the present study was to determine the effect of white noise on the quality of sleep in patients admitted to the CCU. METHODS: The present study was single-blind, quasi-experimental study. A total of 60 patients were selected using the purposive sampling method. Quality of sleep was measured with PSQI on the first day in admission, then after three nights of admission without any intervention for control group and for the experimental group quality of sleep measured by white noise with intensity of 50-60 dB then Quality of sleep was measured with PSQI...
2016: Journal of Caring Sciences
Gari D Clifford, Ikaro Silva, Benjamin Moody, Qiao Li, Danesh Kella, Abdullah Shahin, Tristan Kooistra, Diane Perry, Roger G Mark
High false alarm rates in the ICU decrease quality of care by slowing staff response times while increasing patient delirium through noise pollution. The 2015 Physio-Net/Computing in Cardiology Challenge provides a set of 1,250 multi-parameter ICU data segments associated with critical arrhythmia alarms, and challenges the general research community to address the issue of false alarm suppression using all available signals. Each data segment was 5 minutes long (for real time analysis), ending at the time of the alarm...
September 2015: Computing in Cardiology
A Luetz, B Weiss, T Penzel, I Fietze, M Glos, K D Wernecke, B Bluemke, A M Dehn, T Willemeit, A Finke, C Spies
Noise is a proven cause of wakefulness and qualitative sleep disturbance in critically ill patients. A sound pressure level reduction can improve sleep quality, but there are no studies showing the feasibility of such a noise reduction in the intensive care unit (ICU) setting. Considering all available evidence, we redesigned two ICU rooms with the aim of investigating the physiological and clinical impact of a healing environment, including a noise reduction and day-night variations of sound level. Within an experimental design, we recorded 96 h of sound-pressure levels in standard ICU rooms and the modified ICU rooms...
July 2016: Physiological Measurement
Vincent S Staggs, Emily Cramer
Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital-acquired pressure ulcer rates and evaluate a standard signal-noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step-down, medical, surgical, and medical-surgical nursing units from 1,299 US hospitals were analyzed...
August 2016: Research in Nursing & Health
Jan Claassen, Shah Atiqur Rahman, Yuxiao Huang, Hans-Peter Frey, J Michael Schmidt, David Albers, Cristina Maria Falo, Soojin Park, Sachin Agarwal, E Sander Connolly, Samantha Kleinberg
High frequency physiologic data are routinely generated for intensive care patients. While massive amounts of data make it difficult for clinicians to extract meaningful signals, these data could provide insight into the state of critically ill patients and guide interventions. We develop uniquely customized computational methods to uncover the causal structure within systemic and brain physiologic measures recorded in a neurological intensive care unit after subarachnoid hemorrhage. While the data have many missing values, poor signal-to-noise ratio, and are composed from a heterogeneous patient population, our advanced imputation and causal inference techniques enable physiologic models to be learned for individuals...
2016: PloS One
Xuelin Bian, Steve W Lockless
There is a growing need to study ligand binding to proteins in native or complex solution using isothermal titration calorimetry (ITC). For example, it is desirable to measure ligand binding to membrane proteins in more native lipid-like environments such as bicelles, where ligands can access both sides of the membrane in a homogeneous environment. A critical step to obtain high signal-to-noise is matching the reaction chamber solution to the ligand solution, typically through a final dialysis or gel filtration step...
May 17, 2016: Analytical Chemistry
Marc Felzen, Jörg C Brokmann, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Miriam Tamm, Rolf Rossaint, Sebastian Bergrath
INTRODUCTION: Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. METHODS: The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014...
April 13, 2016: Journal of Telemedicine and Telecare
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