Journal of critical care
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Journal of critical care · Aug 2015
Barriers and supportive conditions to improve quality of care for critically ill patients: A team approach to quality improvement.
Despite the fact that Quality Improvement (QI) teams are widespread tools for improving performance in medical settings, little is known about what makes teams effective and successful. The goal of this study was to identify barriers and supportive conditions for QI teams to implement an effective and successful QI project to improve quality of care. ⋯ Using a grounded theory-based qualitative approach, we identified a framework of conditions supportive of QI-related change, which can help project initiators to create environments that are supportive of change.
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Journal of critical care · Aug 2015
Long-term mortality and quality of life in intensive care patients treated for pneumonia and/or sepsis: Predictors of mortality and quality of life in patients with sepsis/pneumonia.
The purpose of this study is to evaluate long-term mortality and quality of life (QoL) of intensive care patients with pneumonia and/or sepsis 1 year after discharge and to identify potential predictors for these outcome measures. ⋯ One-year mortality of ICU pneumonia patients is equally high as in sepsis patients. Simplified Acute Physiology Score II cannot predict long-term mortality but can predict QoL.
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Journal of critical care · Aug 2015
ReviewNormal saline instillation before endotracheal suctioning: "What does the evidence say? What do the nurses think?": Multimethod study.
This study aimed to systematically review studies that investigated the effects of normal saline instillation before endotracheal suctioning and to determine the views of nurses concerning this procedure. ⋯ Although the effects of normal saline instillation on hemodynamics and pneumonia incidence remain controversial, this procedure significantly decreases the oxygenation. Therefore, the use of this procedure is not recommended. However, normal saline instillation is used frequently by nurses to manage thick and tenacious secretions in clinical practice. Additional studies are needed to determine the effectiveness of applications that may be alternatives to normal saline instillation in the management of these secretions.
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Journal of critical care · Aug 2015
Clinical TrialPrehospital oral chlorhexidine does not reduce the rate of ventilator-associated pneumonia among critically ill trauma patients: A prospective concurrent-control study.
The purpose of the study was to test the hypothesis that prehospital oral chlorhexidine administered to intubated trauma patients will decrease the Clinical Pulmonary Infection Score (CPIS) during the first 2 days of hospitalization. ⋯ The prehospital administration of oral chlorhexidine does not reduce the CPIS score over the first 48 hours of admission for intubated trauma patients. Further study should explore other prehospital strategies of reducing complications of critical illness.