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https://www.readbyqxmd.com/read/28223463/impact-of-a-respiratory-therapy-assess-and-treat-protocol-on-adult-cardiothoracic-icu-readmissions
#1
Robert T Dailey, Thomas Malinowski, Mitchel Baugher, Daniel D Rowley
BACKGROUND: The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28216177/introduction-of-tele-icu-in-rural-hospitals-changing-organisational-culture-to-harness-benefits
#2
Cassie Cunningham Goedken, Jane Moeckli, Peter M Cram, Heather Schacht Reisinger
OBJECTIVE: This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. METHODS: We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013...
February 16, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#3
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28151783/organizational-learning-in-a-cardiac-intensive-care-unit-a-learning-history
#4
Bret Lyman, Kalene M Ethington, Carly King, Jonathan D Jacobs, Hayley Lundeen
INTRODUCTION: Providing high-quality care to every patient is challenging, particularly in critical care units (CCUs). However, this standard can be achieved through organizational learning. Unfortunately, the process of organizational learning in CCUs is not well understood. OBJECTIVE: The objective of this study is to describe the developmental progression of a cardiac intensive care unit (CICU) to reach its current state of reliably excellent clinical performance...
March 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28126152/impact-of-a-multidisciplinary-team-approach-including-an-intensivist-on-the-outcomes-of-critically-ill-patients-in-the-cardiac-care-unit
#5
Zaher Fanari, Armin Barekatain, Roger Kerzner, Sumaya Hammami, William S Weintraub, Vinay Maheshwari
OBJECTIVE: To investigate the impact of integrating a medical intensivist into a cardiac care unit (CCU) multidisciplinary team on the outcomes of CCU patients. PATIENTS AND METHODS: We conducted a retrospective cohort study of 2239 CCU admissions between July 1, 2011, and July 1, 2013, which constituted patients admitted in the 12 months before and 12 months after the introduction of intensivists into the CCU multidisciplinary team. This team included a cardiologist, a medical intensivist, medical house staff, nurses, a pharmacist, a dietitian, and physical and respiratory therapists...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28116021/novel-airway-training-tool-that-simulates-vomiting-suction-assisted-laryngoscopy-assisted-decontamination-salad-system
#6
James DuCanto, Karen D Serrano, Ryan J Thompson
INTRODUCTION: We present a novel airway simulation tool that recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation. METHODS: We modified a standard difficult-airway mannequin head (Nasco, Ft. Atkinson, WI) with hardware-store equipment to enable simulation of vomiting or hemorrhage during intubation...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28098671/the-effects-of-effleurage-hand-massage-on-anxiety-and-pain-in-patients-undergoing-chemotherapy
#7
Monica E Gensic, Brandy R Smith, Dawn M LaBarbera
OBJECTIVE: To determine the effectiveness of effleurage hand massage performed by trained volunteers on reducing anxiety and pain in patients receiving treatment at a chemotherapy center in Fort Wayne, Ind., as measured by heart rate, respiratory rate, BP, visual analogue scale for anxiety (VAS-A), and visual analogue scale for pain (VAS-P). METHODS: Volunteers trained in effleurage massage gave 10-minute hand massages to 24 patients at the beginning of their chemotherapy session...
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28096477/the-future-of-respiratory-care-results-of-a-new-york-state-survey-of-respiratory-therapists
#8
Stephen G Smith, Lisa M Endee, Lisa A Benz Scott, Pamela L Linden
BACKGROUND: In the current health-care environment, respiratory care may need to make significant changes to academic preparation and clinical practice. The purpose of this research was to assess current needs of respiratory therapists (RTs) in New York State and to understand how RTs perceive their future clinical and academic roles. METHODS: This study employed a descriptive, cross-sectional non-experimental design. Between October and December 2014, a 32-item online survey was distributed via e-mail to the 2,170 members of the New York State Society of Respiratory Care...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28079970/categorizing-the-magnitude-and-frequency-of-exposure-to-uncivil-behaviors-a-new-approach-for-more-meaningful-interventions
#9
Dena Evans
PURPOSE: To examine turnover intentions, as well as the prevalence and frequency of uncivil behaviors, from the perspective of registered nurses, respiratory therapists, and imaging professionals, using a new method to categorize exposure magnitude. DESIGN AND METHODS: Data were collected using the 22-item Negative Acts Questionnaire-Revised (NAQ-R). Additional items, informed by Price and Mueller's causal model of turnover, were included, as were select demographic variables...
January 12, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#10
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVES: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
February 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28060549/characterization-of-spirituality-in-maternal-child-caregivers
#11
Katherine Coughlin, Amy Mackley, Rachel Kwadu, Vanessa Shanks, Wendy Sturtz, David Munson, Ursula Guillen
OBJECTIVE: To characterize spiritual beliefs and support provided by maternal-child staff at three academic hospitals. BACKGROUND: Parents in neonatal intensive care units (NICUs) believe that addressing spirituality is important. The spiritual beliefs and the support provided by NICU staff are currently unknown. METHODS: This prospective study surveyed all maternal-child staff (NICU and Obstetrics): physicians, neonatal nurse practitioners, physician assistants, nurses, respiratory therapists, and social workers...
January 6, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28055027/interdisciplinary-onsite-team-based-simulation-training-in-the-neonatal-intensive-care-unit-a-pilot-report
#12
D J W Reed, R L Hermelin, C S Kennedy, J Sharma
OBJECTIVE: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period. STUDY DESIGN: This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28048892/su-f-j-116-clinical-experience-based-verification-and-improvement-of-a-4dct-program
#13
P Fogg, M West, T Aland
PURPOSE: To demonstrate the role of continuous improvement fulfilled by the Medical Physicist in clinical 4DCT and CBCT scanning. METHODS: Lung (SABR and Standard) patients' 4D respiratory motion and image data were reviewed over a 3, 6 and 12 month period following commissioning testing. By identifying trends of clinically relevant parameters and respiratory motions, variables were tested with a programmable motion phantom and assessed. Patient traces were imported to a motion phantom and 4DCT and CBCT imaging were performed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046750/su-f-j-18-feasibility-of-open-mask-immobilization-with-optical-imaging-guidance-oig-for-h-n-radiotherapy
#14
B Zhao, G Maquilan, M Anders, S Jiang, D Schwartz
PURPOSE: Full face and neck thermoplastic masks provide standard-of-care immobilization for patients receiving H&N IMRT. However, these masks are uncomfortable and increase skin dose. The purpose of this pilot study was to investigate the feasibility and setup accuracy of open face and neck mask immobilization with OIG. METHODS: Ten patients were consented and enrolled to this IRB-approved protocol. Patients were immobilized with open masks securing only forehead and chin...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#15
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28013272/trauma-focused-smoking-cessation-for-smokers-exposed-to-the-world-trade-center-disaster-a-randomized-clinical-trial
#16
Adam Gonzalez, Fred Friedberg, Xiaotong Li, Michael J Zvolensky, Evelyn J Bromet, Brittain L Mahaffey, Anka A Vujanovic, Benjamin J Luft, Roman Kotov
INTRODUCTION: The main objective was to evaluate the efficacy of an 8-session, group-based comprehensive smoking cessation and trauma management (CSC-T) treatment among daily smokers (≥ 5 cigarettes/day) exposed to the WTC disaster with elevated WTC-related PTSD symptoms. METHODS: Participants (N=90) were randomly assigned to CSC-T (N=44; 63.6% White; 27.3% female; mean age = 51.32±7.87) or comprehensive smoking cessation (CSC) alone (N=46; 71.7% White; 28.3% female; mean age=48...
December 24, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28011987/-interprofessional-collaboration-of-physicians-and-respiratory-therapists-it-is-easier-as-a-team
#17
O Karg
No abstract text is available yet for this article.
February 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27999151/endotracheal-intubation-training-and-skill-maintenance-for-respiratory-therapists
#18
Andrew G Miller
BACKGROUND: Endotracheal intubation is commonly performed outside the operating room (OR). Although respiratory therapists (RTs) performing endotracheal intubation is a well-established practice, the optimum way for RTs to be trained and maintain their skills is unspecified. The purpose of this study was to describe training methods and skills maintenance methods and to identify barriers that prevent RTs from intubating in some institutions. METHODS: A survey instrument was developed by the author...
February 2017: Respiratory Care
https://www.readbyqxmd.com/read/27979608/early-mobilization-reduces-duration-of-mechanical-ventilation-and-intensive-care-unit-stay-in-patients-with-acute-respiratory-failure
#19
Chih-Cheng Lai, Willy Chou, Khee-Siang Chan, Kuo-Chen Cheng, Kuo-Shu Yuan, Chien-Ming Chao, Chin-Ming Chen
OBJECTIVE: To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). DESIGN: A retrospective observational study. SETTING: Nineteen-bed ICU at a medical center. PARTICIPANTS: Adults patients with MV (N=153) admitted to a medical ICU. INTERVENTIONS: A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable...
December 13, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27965421/icu-clinicians-underestimate-breathing-discomfort-in-ventilated-subjects
#20
Andrew P Binks, Steven Desjardin, Richard Riker
BACKGROUND: Breathing discomfort (dyspnea) during mechanical ventilation in the ICU may contribute to patient distress and complicate care. Assessment of nonverbal cues may allow caregivers to estimate patient breathing discomfort. This study assesses the accuracy of those caregiver estimates. METHODS: Thirty subjects were identified from ventilated, hemodynamically stable patients in the special care unit of Maine Medical Center. Those with impaired neurological function or too unstable to waken were excluded...
February 2017: Respiratory Care
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