Journal of critical care
-
Journal of critical care · Feb 2021
ReviewTelemedicine in the intensive care unit: A vehicle to improve quality of care?
The high demand for intensive care, which is predicted to further increase in the future, is contrasted by a shortage of trained intensivists and specialized nurses. Telemedicine has been heralded as a promising solution. ⋯ In a new model of telemedicine for the ICU, telemedicine could be used to increase adherence to best practice guidelines and indicators of process quality. Further, indicators of process quality, functional outcomes and quality of life measures should be incorporated in the evaluation of outcomes, as patients frequently value those higher than mere survival.
-
Journal of critical care · Feb 2021
Consequences of suboptimal communication for patients with limited English proficiency in the intensive care unit and suggestions for a way forward: A qualitative study of healthcare team perceptions.
To understand the healthcare team's perceptions of the negative consequences of suboptimal communication and their recommendations to improve communication with patients and families who have Limited English Proficiency (LEP) in the Intensive Care Unit (ICU). ⋯ Patients with LEP are at risk of experiencing suboptimal communication with the healthcare team in the ICU. There are several educational and quality improvement strategies that ICUs and institutions can take to mitigate these issues.
-
Journal of critical care · Feb 2021
ReviewA mixed methods study to effectively utilize trigger tools in the ICU.
This study aimed to create a trigger tool for our intensive care units (ICUs) to support our departmental quality improvement efforts. ⋯ We used the modified Delphi process to derive consensus-selected triggers to identify ICU specific adverse events with opportunity for improvement in local care. This methodology can be adopted by other centers looking to introduce trigger tools in a manner selective to their practice needs.
-
Journal of critical care · Feb 2021
Observational StudyMicrocirculation alterations in severe COVID-19 pneumonia.
To assess the presence of sublingual microcirculatory and skin perfusion alterations in COVID-19 pneumonia. ⋯ COVID-19 patients showed an altered tissue perfusion. Sublingual microcirculation was characterized by decreases in the proportion of perfused vessel and flow velocity along with high vascular densities. This last finding might be related to enhanced angiogenesis or hypoxia-induced capillary recruitment.
-
Journal of critical care · Feb 2021
A simplified critical illness severity scoring system (CISSS): Development and internal validation.
To create a simplified critical illness severity scoring system with high prediction accuracy for 30-day mortality using only commonly available variables. ⋯ CISSS has very good performance and requires only commonly used variables that can be easily extracted by electronic health records.