Journal of critical care
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One major risk to patients in the preoperative period is that of myocardial ischemia or infarction and cardiovascular death in high-risk patients. Historically, attempts to decrease the incidence of perioperative cardiac complications have focused on preoperative evaluation and identification of patients at risk for complications with referral for additional testing and/or revascularization. ⋯ The Agency for Healthcare Research and Quality has identified that the use of perioperative beta-blockers can reduce perioperative morbidity and mortality. The focus of this article is to describe the evidence supporting perioperative beta-blocker use, to discuss potential barriers to their use, and to propose a strategy to improve their use.
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Journal of critical care · Jun 2002
ReviewApplying the science to the prevention of catheter-related infections.
Catheter-related bloodstream infection (CR-BSI) remains a leading cause of nososcomial infection, despite the fact that many CR-BSIs are preventable. Simple principles of infection control and the use of novel devices to reduce these infections are not uniformly implemented. ⋯ Simple interventions can reduce the risk for serious catheter-related infection. Health care provider awareness and adherence to these prevention strategies is critical to reducing the risk for CR-BSI, improving patient safety, and promoting quality health care.
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Intensive care is one of the largest and most expensive components of American health care. Studies suggest that errors and resulting adverse events are common in intensive care units (ICUs). The incidence may be as high as 2 errors per patient per day; 1 in 5 ICU patients may sustain a serious adverse event, and virtually all are exposed to serious risk for harm. ⋯ The analysis and feedback of reports will inform the design of interventions to improve patient safety. The effort is aided substantially by collaboration with the 30 participating ICUs and important stakeholders including the Society of Critical Care Medicine, the American Society for Health-care Risk Management, the Food and Drug Administration Center for Devices and Radiological Health, the Foundation for Accountability, and the Leapfrog Group. A demonstration and evaluation of the system is underway, funded by the Agency for Healthcare Re-search and Quality.