Critical care clinics
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Many clinicians are concerned that protocol supported care will become rote or "cookbook" care and will be generated without attention to the specific and changing needs of the individual critically ill patient. This article addresses that concern. In addition, the author discusses the potential advantages that this decision-support approach, with bedside computerized protocols, brings to the healthcare delivery system, and what contributions to clinical care and to clinical research might be anticipated from its widespread application.
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The demands of today's health care arena have forced the issue of automation and computerization. Nursing, as the major stakeholder in the collecting, managing, processing, transforming, and communicating of information regarding the patient, has developed a new approach to these tasks. ⋯ Critical care is a data-rich environmental that can benefit from better management and processing of the data derived from the critically ill patient. Nursing and medical informatics joining together to organize the data, coupled with the introduction of good DSS and the addition of information retrieval systems at the bedside and the on-line medical record, will have a positive effect on the critical care environment and on the critical care patient outcomes.
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Critical care clinics · Jul 1999
ReviewPoint of care testing informatics. The critical care-hospital interface.
Point of care testing (POCT), a new paradigm in laboratory testing, has recently been introduced to the critical care setting. In this model, laboratory testing is performed in the critical care vicinity by local bedside personnel. ⋯ Currently, critical care physicians are not educated and trained in the intricacies of laboratory data management and device interfacing. This article addresses the technical, political, and implementation issues surrounding POCT data management and interfacing as well as the philosophical and practical differences in laboratory data management between the central laboratory and POCT sites.
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Critical care clinics · Jul 1999
ReviewUsing large-scale databases to measure outcomes in critical care.
The major intent of this article is to describe the availability and potential use of large-scale databases; however, it is first essential to know and understand the basic principles involved in the conduct and interpretation of observational outcomes studies. In this article, the authors briefly overview the design of observational outcomes studies as applied to critical care medicine. Then, criteria for evaluating data sources and for in-depth reviewing of the available data sources from which these observational studies can be conducted are discussed.
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Decision analysis, a quantitative approach to problem solving, has been applied to many clinical scenarios and has applications for the intensivist and for problems in the critically ill. This article provides a brief overview of the fundamental features of decision analysis along with an overview of its application to problems in critical care medicine and related fields.