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https://www.readbyqxmd.com/read/28545535/electronic-audit-and-feedback-intervention-with-action-implementation-toolbox-to-improve-pain-management-in-intensive-care-protocol-for-a-laboratory-experiment-and-cluster-randomised-trial
#1
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Evert de Jonge, Niels Peek, Dave A Dongelmans, Nicolette F de Keizer
BACKGROUND: Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28544787/analysis-of-adults-with-congenital-heart-disease-presenting-to-pediatric-emergency-departments-with-arrhythmias
#2
Shaun Mohan, Brady S Moffett, Wilson Lam, Caridad de la Uz, Christina Miyake, Santiago O Valdes, Jeffrey J Kim
OBJECTIVE: As survivors of congenital heart disease (CHD) continue to age, healthcare utilization by this population has increased. It is unknown how often these patients utilize the emergency department (ED) at children's hospitals and how arrhythmias play a role in their utilization of care. DESIGN: Using a retrospective cohort design, the Pediatric Hospital Information System (PHIS) database was investigated and we studied adults (≥18 years) with CHD (ACHD) who presented to pediatric EDs from 2004 to 2014...
May 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28538643/immature-patients-in-a-mature-system-regional-analysis-of-florida-s-pediatric-trauma-system
#3
Christopher W Snyder, Nicole M Chandler, Cristen N Litz, Etienne E Pracht, Paul D Danielson, David J Ciesla
BACKGROUND: The state of Florida's trauma system is organized into seven regions, two of which lack designated pediatric trauma centers. Injured children residing in these regions often require transfer out of their home region for definitive care. The purpose of this study was to evaluate the effectiveness and efficiency of the current regionalization approach, focusing on variations between regions. METHODS: Using the Florida Agency for Health Care Administration database, we identified all trauma patients 15 years old or younger admitted between 2009 and 2014...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28528623/organizational-perspectives-of-nurse-executives-in-15-hospitals-on-the-impact-and-effectiveness-of-rapid-response-teams
#4
Patricia L Smith, Jean McSweeney
BACKGROUND: Many hospitals use rapid response teams (RRTs) to respond to deteriorating patients, but it remains unclear what organizations actually monitor. Understanding what organizations value in an RRT may help clarify measurement choices. Interviews were conducted to determine how organizational leaders perceived and evaluated their hospitals' RRTs. METHODS: The study used a descriptive, qualitative design. Participants were nurse executives and key informants in 300- to 500-bed hospitals in the south-central United States and were recruited using purposive and snowball sampling...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28506741/evaluation-of-a-sound-environment-intervention-in-an-icu-a-feasibility-study
#5
Lotta Johansson, Berit Lindahl, Susanne Knutsson, Mikael Ögren, Kerstin Persson Waye, Mona Ringdal
BACKGROUND: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes. OBJECTIVES: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms...
May 12, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28494815/association-between-fluid-intake-and-mortality-in-critically-ill-patients-with-negative-fluid-balance-a-retrospective-cohort-study
#6
Yanfei Shen, Xinmei Huang, Weimin Zhang
BACKGROUND: Compared to positive fluid balance (FB), negative FB is associated with improved clinical outcomes in critically ill patients. However, as to whether achieving more negative FB can further improve outcomes has not been investigated. This study aimed to investigate whether more negative FB and restricted fluid intake were associated with improved outcomes in critically ill patients. METHOD: Data were extracted from the Multi-parameter Intelligent Monitoring in Intensive Care III Database...
May 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28492404/trend-and-outcomes-of-video-laryngoscope-use-across-picus
#7
Jocelyn R Grunwell, Pradip P Kamat, Michael Miksa, Ashwin Krishna, Karen Walson, Dennis Simon, Conrad Krawiec, Ryan Breuer, Jan Hau Lee, Eleanor Gradidge, Keiko Tarquinio, Asha Shenoi, Justine Shults, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Video (indirect) laryngoscopy is used as a primary tracheal intubation device for difficult airways in emergency departments and in adult ICUs. The use and outcomes of video laryngoscopy compared with direct laryngoscopy has not been quantified in PICUs or cardiac ICUs. DESIGN: Retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from July 2010 to June 2015...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28483444/critical-care-clinician-perceptions-of-factors-leading-to-medical-emergency-team-review
#8
Judy Currey, Josh Allen, Daryl Jones
BACKGROUND: The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. OBJECTIVE: To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review...
May 5, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28473010/reduction-of-environmental-contamination-with-multidrug-resistant-bacteria-by-copper-alloy-coating-of-surfaces-in-a-highly-endemic-setting
#9
Maria Souli, Anastasia Antoniadou, Ioannis Katsarolis, Irini Mavrou, Elisabeth Paramythiotou, Evangelos Papadomichelakis, Maria Drogari-Apiranthitou, Theofano Panagea, Helen Giamarellou, George Petrikkos, Apostolos Armaganidis
OBJECTIVE To evaluate the efficacy of copper-coating in reducing environmental colonization in an intensive-care unit (ICU) with multidrug-resistant-organism (MDRO) endemicity DESIGN Interventional, comparative crossover trial SETTING The general ICU of Attikon University hospital in Athens, Greece PATIENTS Those admitted to ICU compartments A and B during the study period METHODS Before any intervention (phase 1), the optimum sampling method using 2 nylon swabs was validated. In phase 2, 6 copper-coated beds (ie, with coated upper, lower, and side rails) and accessories (ie, coated side table, intravenous [i...
May 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28470134/standardized-icu-to-or-handoff-increases-communication-without-delaying-surgery
#10
Thomas J Caruso, Juan Luis Sandin Marquez, Melanie S Gipp, Stephen P Kelleher, Paul J Sharek
Purpose No studies have examined preoperative handoffs from the intensive care unit (ICU) to OR. Given the risk of patient harm, the authors developed a standardized ICU to OR handoff using a previously published handoff model. The purpose of this paper is to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness. Design/methodology/approach The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28470131/implementation-strategies-for-guidelines-at-icus-a-systematic-review
#11
Portia Jordan, Ferestas Mpasa, Wilma Ten Ham-Baloyi, Candice Bowers
Purpose The purpose of this paper is to critically analyze empirical studies related to the implementation strategies for clinical practice guidelines (CPGs) in intensive care units (ICUs). Design/methodology/approach A systematic review with a narrative synthesis adapted from Popay et al.'s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August)...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28460438/early-outcome-of-early-goal-directed-therapy-for-patients-with-sepsis-or-septic-shock-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Xiaofan Chen, Weifeng Zhu, Jing Tan, Heyun Nie, Liangming Liu, Dongmei Yan, Xu Zhou, Xin Sun
Various trials and meta-analyses have reported conflicting results concerning the application of early goal-directed therapy (EGDT) for sepsis and septic shock. The aim of this study was to update the evidence by performing a systematic review and meta-analysis. Multiple databases were searched from initial through August, 2016 for randomized controlled trials (RCTs) which investigated the associations between the use of EGDT and mortality in patients with sepsis or septic shock. Meta-analysis was performed using random-effects model and heterogeneity was examined through subgroup analyses...
April 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28459497/assessment-of-delirium-in-intensive-care-unit-patients-educational-strategies
#13
Judith M Smith, M Nancy Van Aman, Mary Elizabeth Schneiderhahn, Robin Edelman, Patrick M Ercole
BACKGROUND: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently. METHOD: A pretest-posttest design was used to evaluate the success of a multimodal educational strategy (i...
May 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28450765/effect-of-body-mass-index-on-postoperative-complications-in-beating-coronary-artery-surgery
#14
Feridoun Sabzi, Reza Faraji
BACKGROUND: Body Mass Index (BMI) is considered as an important risk factor in cardiovascular surgery. We designed a historical cohort study for the evaluation of perioperative complications related to BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB). METHODS: We studied 1120 consecutive patients who underwent OPCAB between January 2008 and December 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groups according to BMI: underweight/low BMI (< 18...
November 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28449530/quality-improvement-in-the-icu-treat-first-what-kills-first
#15
EDITORIAL
Peter H J van der Voort
Professionals in the ICU, like nurses and doctors, are constantly working on quality improvement by developing protocols and monitoring the implementation with indicators. Protocols and quality indicators are usually based on evidence. Studies on quality improvement often measure the effect of protocols after implementation but frequently cannot replicate the results of the previously performed RCTs in clinical practice. Amongst other reasons, this is due to the selection of patients that are included in RCTs...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28442306/evaluation-of-a-real-time-pcr-assay-for-rectal-screening-of-oxa-48-producing-enterobacteriaceae-in-a-general-intensive-care-unit-of-an-endemic-hospital
#16
J Fernández, S A Cunningham, A Fernández-Verdugo, L Viña-Soria, L Martín, M R Rodicio, D Escudero, F Vazquez, J N Mandrekar, R Patel
Carbapenemase-producing Enterobacteriaceae are increasing worldwide. Rectal screening for these bacteria can inform the management of infected and colonized patients, especially those admitted to intensive care units (ICUs). A laboratory developed, qualitative duplex real-time polymerase chain reaction assay for rapid detection of OXA-48-like and VIM producing Enterobacteriaceae, performed on rectal swabs, was designed and evaluated in an intensive care unit with endemic presence of OXA-48. During analytical assay validation, no cross-reactivity was observed and 100% sensitivity and specificity were obtained for both blaOXA-48-like and blaVIM in all spiked clinical samples...
April 6, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28434804/nurses-knowledge-and-perception-of-delirium-screening-and-assessment-in-the-intensive-care-unit-long-term-effectiveness-of-an-education-based-knowledge-translation-intervention
#17
Sharon L Hickin, Sandra White, Jennifer Knopp-Sihota
OBJECTIVES: To determine the impact of education on nurses' knowledge of delirium, knowledge and perception of a validated screening tool, and delirium screening in the ICU. METHODS: A quasi-experimental single group pretest-post-test design. SETTING: A 16 bed ICU in a Canadian urban tertiary care centre. MAIN OUTCOME MEASURES: Nursing knowledge and perception were measured at baseline, 3-month and 18-month periods. Delirium screening was then assessed over 24-months...
April 20, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#18
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28427132/-influences-of-abar-gene-on-biofilm-formation-of-acinetobacter-baumannii
#19
H N Guo, J Xiang
Objective: To detect drug-resistant phenotype and abaR gene of Acinetobacter baumannii (AB) and investigate influences of abaR gene on biofilm formation of AB. Methods: From February to July 2014, 159 strains AB were collected from Department of Clinical Microbiology of Ruijin Hospital of School of Medicine of Shanghai JiaoTong University and numbered starting from 1 according time when they were collected. (1) The above-mentioned 159 strains of AB were identified by detecting gene sequence of 16S ribosomal DNA...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28419884/fish-oil-supplementation-for-primary-prevention-of-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery-a-randomized-clinical-trial
#20
Ali Vasheghani Farahani, Awat Yousefi Azar, Hamid Reza Goodarzynejad, Elnaz Khorrami, Mohammad Javad Hosseinzadeh-Attar, Sima Oshnouei, Alireza Alizadeh Ghavidel, Elham Golfeshan, Fateme Ghourban Pour
BACKGROUND: Atrial fibrillation (AF) after cardiac surgery is a common complication that may influence patients' early and long term outcomes and hospital costs. The purpose of this study was to assess the effect of fish oil on occurrence of AF following coronary artery bypass graft surgery (CABG). METHODS: This study was a single-center, randomized, double blinded, placebo-controlled clinical trial. Four-hundred and one patients undergoing coronary artery bypass graft surgery were randomly assigned to receive 2 g/d fish oil or placebo (olive oil) for at least 5 days before surgery...
April 15, 2017: International Journal of Surgery
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