Journal of critical care
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Journal of critical care · Oct 2019
Technology-mediated macrocognition: Investigating how physicians, nurses, and respiratory therapists make critical decisions.
Although intensive care clinicians are expected to make data-driven critical decisions using the technologies available to them, the effect of those technologies on decision-making are not well understood. Using the macrocognitive framework, we studied critical decision-making and technology use to understand how different specialists within teams make decisions and guide the development of decision-making support technologies. ⋯ This exploratory study provides much needed details about the different ways in which specialists use technologies to support decision-making tasks, particularly those involving sensemaking, which are essential to the design and development of decision-support technologies.
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Journal of critical care · Oct 2019
Adhering to the procalcitonin algorithm allows antibiotic therapy to be shortened in patients with ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) increases exposure to antibiotics. Physicians are however reluctant to shorten treatment, arguing this could lead to failures and worse outcome. Monitoring procalcitonin (PCT) has proven effective for decreasing exposure to antibiotics in randomized controlled trials, but additional "real-life" studies are needed. ⋯ PCT-guided ABT adherence appears safe for patients with VAP and is likely to reduce exposure to antibiotics.
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Journal of critical care · Oct 2019
Sleep quality and daytime sleepiness among Polish anaesthesiologists and intensivists.
We aimed to investigate sleep quality (SQ), daytime sleepiness (DS), and their relation with subject- and work-related factors among Polish anaesthesiologists. ⋯ Poor SQ and excessive DS are frequently occurring phenomena. Since sleep disturbances are also related to the nature of their profession, the problem could be reduced by introducing organisational changes at work.
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Journal of critical care · Oct 2019
Observational StudyMoral distress in intensive care unit personnel is not consistently associated with adverse medication events and other adverse events.
To examine the association between moral distress in ICU personnel, and medication errors and adverse events, and other adverse events. ⋯ Moral distress in ICU personnel is generally not associated with medication errors or adverse events, or other adverse events, but it may be associated with both hyper-vigilance and distraction.
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Journal of critical care · Oct 2019
Review Meta AnalysisDiarrhea and patient outcomes in the intensive care unit: Systematic review and meta-analysis.
We aimed to determine whether diarrhea experienced by patients in the intensive care unit (ICU) is related to their clinical outcomes. ⋯ The diarrhea experienced by patients may be associated with higher mortality and prolonged length of stay in the ICU and hospital.