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https://www.readbyqxmd.com/read/29154953/correlation-between-cefepime-utilization-and-pseudomonas-aeruginosa-resistance-rate-to-beta-lactams-and-carbapenems-in-patients-with-healthcare-associated-infections
#1
Zorana M Djordjevic, Marko M Folic, Slobodan M Jankovic
OBJECTIVES: There is direct link between overutilization or abuse of antibiotics and P.aeruginosa resistance rate, but other factors could influence the resistance rate, too. The study aim was to observe changes of P.aeruginosa resistance rate in patients with hospital acquired infections (HAIs) after a period of cefepime unavailability in an intensive care unit (ICU). METHODS: The study was designed as retrospective observational analysis of trends in utilization of antibiotics and density of resistance to antibiotics...
November 14, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29153827/compassion-satisfaction-and-fatigue-a-cross-sectional-survey-of-australian-intensive-care-nurses
#2
Samantha Jakimowicz, Lin Perry, Joanne Lewis
BACKGROUND: Compassion satisfaction and compassion fatigue influence nurses' intention to stay or leave nursing. Identification of compassion satisfaction or fatigue in critical care nurses is important in this high turnover workforce. OBJECTIVES: The aim of this study was to examine factors predicting and contributing to compassion satisfaction and compassion fatigue experienced by critical care nurses in Australian intensive care units. METHODS: A self-reported cross-sectional survey using an established tool collected data from critical care nurses of two adult Australian intensive care units...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29151000/implementing-clinical-practice-changes-in-critical-care-lessons-learned-in-a-national-collaborative-of-over-60-icu-teams
#3
Ruth Kleinpell, Jerry J Zimmerman
Improving care in the intensive care unit (ICU) is a global area of focus for clinicians worldwide. The complexity of the ICU environment, compounded by multiple patient comorbidities and high acuity levels, makes the ICU a unique and challenging area of clinical practice. The essence of quality improvement - designing and implementing strategies to enhance care - fit well with the ICU setting. However, implementing clinical change is challenging, regardless of the clinical setting. A national collaborative targeting ICU settings was initiated which provided a number of lessons learned regarding implementing quality of care initiatives in critical care...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#4
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149460/the-impact-of-a-prolonged-stay-in-the-icu-on-patients-fundamental-care-needs
#5
Claire Minton, Lesley Batten, Annette Huntington
AIM: To explore patients', families', and health professionals' experiences of a long-stay patient in an intensive care unit. BACKGROUND: The fast-paced technologically driven intensive care unit environment, designed for a short patient stay, supports the provision of complex physiologically-focused care for those with life-threatening illnesses. Long stay patients with pronounced fundamental care needs fall outside predicted patient pathways, and nurses can find caring for these patients challenging...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29143704/identification-of-clostridium-difficile-reservoirs-in-the-patient-environment-and-efficacy-of-aerial-hydrogen-peroxide-decontamination
#6
Samuel Yui, Shanom Ali, Monika Muzslay, Annette Jeanes, A Peter R Wilson
OBJECTIVE To identify, using a novel enhanced method of recovery, environmental sites where spores of Clostridium difficile persist despite cleaning and hydrogen peroxide aerial decontamination. DESIGN Cohort study. SETTING Tertiary referral center teaching hospital. METHODS In total, 16 sites representing high-frequency contact or difficult-to-clean surfaces in a single-isolation room or bed area in patient bed bays were sampled before and after terminal or hydrogen peroxide disinfection using a sponge swab...
November 16, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29141664/prevalence-and-prognosis-of-acutely-ill-patients-with-organ-failure-at-arrival-to-hospital-protocol-for-a-systematic-review
#7
Peter Bank Pedersen, Asbjorn Hrobjartsson, Daniel Lykke Nielsen, Daniel Pilsgaard Henriksen, Mikkel Brabrand, Annmarie Touborg Lassen
BACKGROUND: Acutely ill patients are a heterogeneous group, and some of these suffer from organ failure. As the prognosis of organ failure improves with early treatment, it is important to identify these patients as early as possible. Most studies on organ failure have been performed in intensive care settings, or on selected groups of patients, where a high prevalence and mortality have been reported. Before patients arrive to the intensive care unit, or the general ward, most of them have passed through the emergency department (ED), where diagnosis and treatment has been initiated...
November 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29140952/-don-t-lose-hope-early-hemorrhagic-diffuse-axonal-injury-on-head-ct-is-not-associated-with-poor-outcome-in-moderate-severe-tbi-patients
#8
Nils Henninger, Rebecca A Compton, Muhammad W Khan, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel
BACKGROUND: Diffuse axonal injury (DAI) on MRI has been associated with poor functional outcome after moderate-severe traumatic brain injury (msTBI). Yet, DAI assessment with highly-sensitive MRI-techniques is unfeasible in the acute trauma setting, and CT remains the key diagnostic modality despite its lower sensitivity. We sought to determine whether CT-defined-hemorrhagic-DAI (hDAI) is associated with discharge and favorable 3-and 12-month functional outcome (Glasgow Outcome Score ≥4) after msTBI...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29138955/the-impact-of-palliative-care-training-for-oncologists-and-integrative-palliative-service-in-a-public-funded-hospital-cluster-a-retrospective-cohort-study
#9
Pak-Lun Lam, Tai-Chung Lam, Cheuk-Wai Choi, Anne Wing-Mui Lee, Kwok-Keung Yuen, To-Wai Leung
PURPOSE: Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome...
November 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29138206/monitor-ic-study-a-mixed-methods-prospective-multicentre-controlled-cohort-study-assessing-5-year-outcomes-of-icu-survivors-and-related-healthcare-costs-a-study-protocol
#10
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29137860/quality-of-anthropometric-measurements-in-spanish-intensive-care-units-the-camies-study
#11
M A García-Martínez, T Cherednichenko, Y Hidalgo Encinas, A I Catalá Espinosa, A Arrascaeta Llanes, J A Acosta Escribano
INTRODUCTION: Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the clinical practice guides. OBJECTIVE: To describe anthropometric quality in CIP, health professional perception of such quality, and its influencing factors...
November 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29137583/the-effect-of-intensive-care-unit-admission-on-smokers-attitudes-and-their-likelihood-of-quitting-smoking
#12
C M Polmear, H Nathan, S Bates, C French, J Odisho, E Skinner, A Karahalios, F McGain
We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29132912/humanization-in-healthcare-arises-from-the-need-for-a-holistic-approach-to-illness
#13
C de la Fuente-Martos, M Rojas-Amezcua, M R Gómez-Espejo, P Lara-Aguayo, E Morán-Fernandez, E Aguilar-Alonso
Suffering is not only exclusive to patients or their relatives, but also to the health professionals, who feel to be at the center of the depersonalization process. Over-technification and the fact that the disease process is sometimes the only focal point of our activities, together with the ever-increasing influence of institutional power seen in recent times, all cause the health professional to be the first in demanding a change in health institution dynamics. Following initial reflection from one of the most technified medical specialties (Intensive Care Medicine), classically isolated from the rest of the Hospital and from the community, we implemented a project aimed at securing integration and empathy in our approach to patients and their relatives in the Intensive Care Unit (ICU) of Infanta Margarita Hospital...
November 10, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29132626/early-hospital-mortality-prediction-of-intensive-care-unit-patients-using-an-ensemble-learning-approach
#14
Aya Awad, Mohamed Bader-El-Den, James McNicholas, Jim Briggs
BACKGROUND: Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29122787/effect-of-daily-antiseptic-body-wash-with-octenidine-on-nosocomial-primary-bacteraemia-and-nosocomial-multidrug-resistant-organisms-in-intensive-care-units-design-of-a-multicentre-cluster-randomised-double-blind-cross-over-study
#15
Anne Meißner, Dirk Hasenclever, Oana Brosteanu, Iris Freya Chaberny
INTRODUCTION: Nosocomial infections are serious complications that increase morbidity, mortality and costs and could potentially be avoidable. Antiseptic body wash is an approach to reduce dermal micro-organisms as potential pathogens on the skin. Large-scale trials with chlorhexidine as the antiseptic agent suggest a reduction of nosocomial infection rates. Octenidine is a promising alternative agent which could be more effective against Gram-negative organisms. We hypothesise that daily antiseptic body wash with octenidine reduces the risk of intensive care unit (ICU)-acquired primary bacteraemia and ICU-acquired multidrug-resistant organisms (MDRO) in a standard care setting...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29118830/a-multicentre-prospective-evaluation-of-alcohol-related-admissions-to-intensive-care-units-in-wales
#16
Ceri Lynch, Richard Pugh, Ceri Battle
Purpose: We conducted a prospective multicentre study in 13 Welsh intensive care units to assess what proportion of intensive care admissions relate to alcohol, and how outcomes among these patients compare with non-alcohol related admissions. Materials and methods: Data were prospectively collected for one month between June and July 2015. Every intensive care admission was screened for alcohol associations based on ICD-10 criteria, using a pre-designed pro-forma...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29116995/prolonged-infusion-piperacillin-tazobactam-decreases-mortality-and-improves-outcomes-in-severely-ill-patients-results-of-a-systematic-review-and-meta-analysis
#17
Nathaniel J Rhodes, Jiajun Liu, J Nicholas O'Donnell, Joel M Dulhunty, Mohd H Abdul-Aziz, Patsy Y Berko, Barbara Nadler, Jeffery Lipman, Jason A Roberts
OBJECTIVE: Piperacillin-tazobactam is a commonly used antibiotic in critically ill patients; however, controversy exists as to whether mortality in serious infections can be decreased through administration by prolonged infusion compared with intermittent infusion. The purpose of this systematic review and meta-analysis was to describe the impact of prolonged infusion piperacillin-tazobactam schemes on clinical endpoints in severely ill patients. DESIGN: We conducted a systematic literature review and meta-analysis searching MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library from inception to April 1, 2017, for studies...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29115949/neurally-adjusted-ventilatory-assist-nava-or-pressure-support-ventilation-psv-during-spontaneous-breathing-trials-in-critically-ill-patients-a-crossover-trial
#18
Juliana C Ferreira, Fabia Diniz-Silva, Henrique T Moriya, Adriano M Alencar, Marcelo B P Amato, Carlos R R Carvalho
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a proportional ventilatory mode that uses the electrical activity of the diaphragm (EAdi) to offer ventilatory assistance in proportion to patient effort. NAVA has been increasingly used for critically ill patients, but it has not been evaluated during spontaneous breathing trials (SBT). We designed a pilot trial to assess the feasibility of using NAVA during SBTs, and to compare the breathing pattern and patient-ventilator asynchrony of NAVA with Pressure Support (PSV) during SBTs...
November 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29113779/hospital-acquired-lower-respiratory-tract-infections-among-high-risk-hospitalized-patients-in-a-tertiary-care-teaching-hospital-in-china-an-economic-burden-analysis
#19
Tianyuan Yan, Yingxia Li, Yu Sun, Haiyan Wang, Jingna Wang, Weili Wang, Yunhong Liu, Xiaohui Wu, Shuhui Wang
BACKGROUND: Data on the economic burden of hospital-acquired lower respiratory tract infection (LRTI) among high risk hospitalized patients are lacking in China. This study aims to fill this knowledge gap. METHODS: We used a prospective matched cohort design, comparing patients with LRTIs and 1:1 matched patients without LRTIs. Study period was from January 2013 to December 2015 analyzing inpatients from high risk wards - intensive care unit (ICU), dialysis, hematology, etc...
November 4, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/29109640/obstetric-critical-care-requirements-felt-by-the-obstetricians-an-experience-based-study
#20
Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians. Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
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