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https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#1
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
#2
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
#3
James M Walter, James J Walter
On a fall day in Chicago, a middle-aged man stepped out of a northbound train, appeared to choke, and collapsed. Paramedics arrived within minutes and administered several rounds of defibrillation and intravenous epinephrine. The patient was rapidly transported to an academic medical center, resuscitated in the Emergency Department (ED), and was soon surrounded by a multidisciplinary team of doctors, nurses, and respiratory therapists in the Intensive Care Unit (ICU). This article is protected by copyright...
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
#4
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...
March 22, 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
#5
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
#6
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
https://www.readbyqxmd.com/read/28316266/differing-perspectives-on-parent-access-to-their-child-s-electronic-medical-record-during-neonatal-intensive-care-hospitalization-a-pilot-study
#7
Rebecca K Chung, Una Olivia Kim, Mir Abdul Basir
OBJECTIVE: To improve informed medical decision-making, principles for family-centered neonatal care recommends that parents have access to their child's medical record on an ongoing basis during neonatal intensive unit care (NICU) hospitalization. Currently many NICUs do not allow independent parent access to their child's electronic medical record (EMR) during hospitalization. We undertook a cross-sectional survey pilot study of medical professionals and parents to explore opinions regarding this practice...
March 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28306684/implementation-and-outcomes-of-a-community-based-pulmonary-rehabilitation-program-in-rural-appalachia
#8
Daniel Doyle, Chaffee Tommarello, Mike Broce, Mary Emmett, Cecil Pollard
PURPOSE: To report on the implementation and clinical outcomes of a community-based pulmonary rehabilitation program in rural Appalachia. METHODS: Three rural health centers and a large referral hospital worked together to establish pulmonary rehabilitation services based on AACVPR guidelines. Each site hired at least 1 respiratory therapist. To measure clinical outcomes, a retrospective medical record study compared pre- and post-program values for the modified Medical Research Council dyspnea level, 6-minute walk test (6MWT), negative inspiratory force (NIF), respiratory disease knowledge, St George Respiratory Questionnaire (SGRQ), BODE index (body mass index, airflow obstruction, dyspnea and exercise capacity), and smoking status...
March 16, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28291484/post-traumatic-stress-symptoms-in-united-states-air-force-aeromedical-evacuation-nurses-and-technicians
#9
Julie M Swearingen, Tanya M Goodman, Wayne L Chappelle, William T Thompson
Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28267119/prevention-of-medical-device-related-pressure-injuries-associated-with-respiratory-equipment-use-in-a-critical-care-unit-a-quality-improvement-project
#10
Cynthia A Padula, Heidi Paradis, Robert Goodwin, Judith Lynch, Deborah Hegerich-Bartula
Medical devices have been identified as an extrinsic risk factor for development of pressure injuries, with as many as 30% to 70% of medical device-related pressure injuries resulting from respiratory equipment. This article describes a quality improvement project undertaken to reduce the occurrence of respiratory device-related pressure injuries in a critically care unit. Multiple actions were implemented to achieve this goal. Respiratory therapists were trained to document occurrences on a daily basis, and apparent cause analyses were conducted on each occurrence...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28265153/comparison-of-differences-in-respiratory-function-and-pressure-as-a-predominant-abnormal-movement-of-children-with-cerebral-palsy
#11
Hae-Yeon Kwon
[Purpose] The purpose of this study was to determine differences in respiratory function and pressure among three groups of children with cerebral palsy as a predominant abnormal movement which included spastic type, dyskinetic type, and ataxic type. [Subjects and Methods] Forty-three children with cerebral palsy of 5-13 years of age in I-III levels according to the Gross Motor Function Classification System, the study subjects were divided by stratified random sampling into three groups of spastic type, dyskinetic type, and ataxic type...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28260561/challenges-of-treating-adenovirus-infection-application-of-a-deployable-rapid-assembly-shelter-hospital
#12
Song Bai, Bao-Guo Yu, Yong-Zhong Zhang, Hui Ding, Zhou-Wei Wu, Bin Fan, Hao-Jun Fan, Shi-Ke Hou, Feng Chen
This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment...
March 6, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28254070/computer-tool-to-evaluate-the-cue-reactivity-of-chemically-dependent-individuals
#13
Meire Luci da Silva, Annie France Frère, Henrique Jesus Quintino de Oliveira, Helio Martucci Neto, Terigi Augusto Scardovelli
BACKGROUND AND OBJECTIVE: Anxiety is one of the major influences on the dropout of relapse and treatment of substance abuse treatment. Chemically dependent individuals need (CDI) to be aware of their emotional state in situations of risk during their treatment. Many patients do not agree with the diagnosis of the therapist when considering them vulnerable to environmental stimuli related to drugs. This research presents a cue reactivity detection tool based on a device acquiring physiological signals connected to personal computer...
March 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28246139/emergency-medical-services-responders-perceptions-of-the-effect-of-stress-and-anxiety-on-patient-safety-in-the-out-of-hospital-emergency-care-of-children-a-qualitative-study
#14
Jeanne-Marie Guise, Matthew Hansen, Kerth O'Brien, Caitlin Dickinson, Garth Meckler, Phil Engle, William Lambert, Jonathan Jui
OBJECTIVE: Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. SETTING: This was a nationwide study of EMS providers from 44 of 50 (88%) US states. PARTICIPANTS: A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28223463/impact-of-a-respiratory-therapy-assess-and-treat-protocol-on-adult-cardiothoracic-icu-readmissions
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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