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https://www.readbyqxmd.com/read/28642309/long-term-volume-targeted-pressure-controlled-ventilation-sense%C3%A2-or%C3%A2-nonsense
#1
REVIEW
Maria Paola Arellano-Maric, Cesare Gregoretti, Marieke Duivermann, Wolfram Windisch
The technology underlying the development of novel ventilatory modes for long-term noninvasive ventilation of patients with chronic hypercapnia is continuously evolving. Volume-targeted pressure-controlled ventilation is a hybrid ventilation mode designed to combine the advantages of conventional ventilation modes, while avoiding their drawbacks. However, manufacturers have created different names and have patented algorithms and set-up variables, which can result in confusion for physicians and respiratory therapists...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28639161/moral-distress-and-its-contribution-to-the-development-of-burnout-syndrome-among-critical-care-providers
#2
Renata Rego Lins Fumis, Gustavo Adolpho Junqueira Amarante, Andréia de Fátima Nascimento, José Mauro Vieira Junior
BACKGROUND: Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28636452/epidemiology-of-niv-for-acute-respiratory-failure-in-copd-patients-results-from-the-international-surveys-vs-the-real-world
#3
Aylin Ozsancak Ugurlu, Mehmet Ali Habesoglu
Non-invasive ventilation (NIV) has been recommended as the  first-line ventilation modality for acute respiratory failure (ARF) due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on strong evidence. However, everyday clinical practice may differ from findings of multiple randomized controlled trials. Physicians and respiratory therapists involved in NIV management have been queried about its utilization and effectiveness. In addition to these estimates, cohort studies and analysis of large inpatient dataset of patients with AECOPD and ARF managed with NIV have been extensively published over the last two decades...
June 21, 2017: COPD
https://www.readbyqxmd.com/read/28627936/the-microorganisms-on-nurses-and-health-care-workers-uniforms-in-the-intensive-care-units
#4
Maha Abu Radwan, Muayyad Ahmad
The objective of this study was to identify the types of microorganisms present on uniforms of nurses, physicians, respiratory therapist, students, and housekeepers in intensive care units (ICUs). A convenience sampling was used to recruit the participants ( N = 115) who work at military hospital in Jordan. Environmental cultures ( N = 305) were taken from the participants who were nurses, physicians, students, respiratory therapists, and housekeepers. The number of participating nurses was 58 (50.43%). There were 24 types of microorganisms found on the participants' uniforms...
June 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28588118/clinical-management-strategies-for-airway-pressure-release-ventilation-a-survey-of-clinical-practice
#5
Andrew G Miller, Michael A Gentile, John D Davies, Neil R MacIntyre
BACKGROUND: Airway pressure release ventilation (APRV) is a commonly used mode of ventilation designed to increase mean airway pressure and thus oxygenation. Different strategies for clinical management have been described in the literature but are largely based on physiologic concepts, animal data, and small clinical trials. The purpose of this study was to determine how APRV is currently managed by surveying practicing respiratory therapists with experience using APRV. METHODS: A 15-item survey was developed by the authors and posted on the AARConnect online media platform in January 2016 after being declared exempt by our institution's institutional review board...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28581689/the-physical-deterioration-of-dialysis-patients-ignored-ill-reported-and-ill-treated
#6
EDITORIAL
Paul N Bennett, Nicole Capdarest-Arest, Kristen Parker
The progressive physical deterioration of dialysis patients is apparent to all who are involved in their care. Exercise can help stem this decline, yet exercise uptake in chronic and end-stage kidney disease is low. The involvement of exercise professionals has been shown to significantly increase patients' physical function and improve their quality of life. However, exercise professionals are scarce in renal programs, far less than dietetic and social work services. A review of 10 years of renal exercise publications in the physical therapy and rehabilitation literature found that only 0...
June 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28562401/using-a-standardized-patient-to-improve-collaboration-and-problem-solving-skills-with-cpap-usage-in-the-home
#7
Margaret G Williams, Joan Ruhs
A review of literature revealed a lack of research pertaining to nurses' or student nurses' knowledge of continuous positive airway pressure (CPAP) and the ability to troubleshoot CPAP malfunction. This study sought to answer the following questions: What are associate degree nursing (ADN) students' knowledge, interdisciplinary communication, and problem-solving skills regarding patients' home use of CPAP? Is there a change after participation in a simulation with a patient on CPAP in home setting? Twenty-one ADN students enrolled in small Midwest college participated...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28557756/factors-associated-with-provider-burnout-in-the-nicu
#8
Daniel S Tawfik, Ciaran S Phibbs, J Bryan Sexton, Peiyi Kan, Paul J Sharek, Courtney C Nisbet, Joseph Rigdon, Mickey Trockel, Jochen Profit
BACKGROUND: NICUs vary greatly in patient acuity and volume and represent a wide array of organizational structures, but the effect of these differences on NICU providers is unknown. This study sought to test the relation between provider burnout prevalence and organizational factors in California NICUs. METHODS: Provider perceptions of burnout were obtained from 1934 nurse practitioners, physicians, registered nurses, and respiratory therapists in 41 California NICUs via a validated 4-item questionnaire based on the Maslach Burnout Inventory...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28552547/spirometry-assisted-high-resolution-chest-computed-tomography-in-children-is-it-worth-the-effort
#9
Jeffrey Parke Otjen, Jonathan Ogden Swanson, Assaf Oron, Robert M DiBlasi, Tim Swortzel, Jade Adriana Marie van Well, Eva Anna Elisabeth Gommers, Margaret Rosenfeld
BACKGROUND: Image quality of high resolution chest computed tomographies (HRCTs) depends on adequate breath holds at end inspiration and end expiration. We hypothesized that implementation of spirometry-assisted breath holds in children undergoing HRCTs would improve image quality over that obtained with voluntary breath holds by decreasing motion artifact and atelectasis. METHODS: This is a retrospective case-control study of HRCTs obtained at a tertiary care children's hospital before and after implementation of a spirometry-assisted CT protocol, in which children ≥8 years of age are first trained in supine slow vital capacity maneuvers and then repeat the maneuvers in the CT scanner, coached by a respiratory therapist...
April 7, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28546377/respiratory-care-considerations-in-the-childhood-cancer-patient
#10
Lama Elbahlawan, K Jason Rains, Dennis C Stokes
This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations in this specialized population, including patients receiving chemotherapy, radiation, and hematopoietic stem cell transplantation. Although infections cause the most significant complications in this population, non-infectious complications, including acute lung injury from chemotherapy or radiation, idiopathic interstitial pneumonia, diffuse alveolar hemorrhage, bronchiolitis obliterans, and cryptogenic organizing pneumonia, also occur commonly...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28491303/self-evaluation-of-tobacco-exposure-by-allied-health-students-in-a-community-college-setting
#11
Fiona Geiser, Meredith Much, Karen Beyer
OBJECTIVE: Tobacco education is among the initiatives encouraged for health professionals to help them appreciate the significance of addressing tobacco use among their patients. In this pilot study, a nicotine biomarker (cotinine) study was introduced to an applied microbiology course required of all allied health students. Participants assessed their own smoking status in the previous 24 h using a two-dimensional experimental design of a questionnaire and rapid urinary cotinine immunoassay...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28484823/-prolonged-weaning-during-early-neurological-and-neurosurgical-rehabilitation-s2k-guideline-published-by-the-weaning-committee-of-the-german-neurorehabilitation-society-dgnr
#12
REVIEW
J D Rollnik, J Adolphsen, J Bauer, M Bertram, J Brocke, C Dohmen, E Donauer, M Hartwich, M D Heidler, V Huge, S Klarmann, S Lorenzl, M Lück, M Mertl-Rötzer, T Mokrusch, D A Nowak, T Platz, L Riechmann, F Schlachetzki, A von Helden, C W Wallesch, D Zergiebel, M Pohl
Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e...
May 8, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28483242/prevention-of-post-operative-pediatric-tracheotomy-wounds-a-multidisciplinary-team-approach
#13
Timothy P McEvoy, Nolan B Seim, Abdullah Aljasser, Charles A Elmaraghy, Brenda Ruth, Leslie Justice, Sarah Begue, Kris R Jatana
OBJECTIVE: Tracheotomy-related pressure wounds have been reported as high as 29%. All advanced stage (stage 3 or 4) wounds are reported by hospitals, and CMS will no longer reimburse healthcare costs to manage them. We present the results of an intensive, multidisciplinary wound prevention strategy starting in the operating room at the time of tracheotomy placement. METHODS: Prospective analysis of a tracheostomy wound care protocol at an academic, tertiary-care pediatric hospital from September 2012 to February 2016...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483010/pharmacist-managed-diabetes-center-interventions-ensure-quality-and-safety-in-elderly-patients
#14
Geoffrey Twigg, John Motsko, Jennifer Thomas, Tosin David
OBJECTIVES: This quality-improvement study aimed to replicate historical Patient Safety Clinical Pharmacy Services Collaborative results in high-risk Medicare beneficiaries with diabetes to achieve reductions in A1C, adverse drug events (ADEs), and potential ADEs (pADEs). DESIGN: The model included an interdisciplinary team led by a pharmacist located inside a community pharmacy to provide disease state management and medication therapy management (MTM) to the study population...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#15
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#16
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28401616/searching-for-staircases-strengthening-the-connections-between-the-emergency-department-and-the-intensive-care-unit
#17
James M Walter, James J Walter
No abstract text is available yet for this article.
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28371889/development-and-implementation-of-a-risk-identification-tool-to-facilitate-critical-care-transitions-for-high-risk-surgical-patients
#18
Rebecca L Hoffman, Jason Saucier, Serena Dasani, Tara Collins, Daniel N Holena, Meghan Fitzpatrick, Boris Tsypenyuk, Niels D Martin
Quality problem: Patients recently discharged from the intensive care unit (ICU) are at high risk for clinical deterioration. Initial assessment: Unreliable and incomplete handoffs of complex patients contributed to preventable ICU readmissions. Respiratory decompensation was responsible for four times as many readmissions as other causes. Choice of solution: Form a multidisciplinary team to address care coordination surrounding the transfer of patients from the ICU to the surgical ward...
June 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28355933/interprofessional-survey-of-perceived-barriers-and-facilitators-to-early-mobilization-of-critically-ill-patients-in-montreal-canada
#19
David E Anekwe, Karen Kin-Yue Koo, Michel de Marchie, Peter Goldberg, Dev Jayaraman, Jadranka Spahija
OBJECTIVE: Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization. DESIGN: Cross-sectional survey. SETTING: Intensive care units of 3 university-affiliated hospitals in Montreal, Canada...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#20
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
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