Journal of critical care
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Journal of critical care · Aug 2015
Implementing and sustaining an early rehabilitation program in a medical intensive care unit: A qualitative analysis.
Early rehabilitation programs in a medical intensive care unit can improve patient outcomes, but clinicians face barriers in implementing and sustaining such programs. We sought to describe a multidisciplinary team perspective regarding how to implement and sustain a successful early rehabilitation program. ⋯ This qualitative study of a successful early rehabilitation program highlights the importance of assessing and engaging a multidisciplinary team before implementation and the positive outcomes of early rehabilitation on staff by improving job satisfaction and changing the culture of a hospital unit.
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Journal of critical care · Jul 2015
Pediatric Early Warning Score and unplanned readmission to the pediatric intensive care unit.
Early unplanned Pediatric Intensive Care Unit (PICU) readmission is associated with greater length of stay and mortality. No tools exist to identify children at risk for PICU readmission. The Pediatric Early Warning Score (PEWS) currently identify children at risk for deterioration on the ward. Our primary objective was to evaluate the ability of PEWS to identify children at risk for unplanned PICU readmission. ⋯ Higher PEWS scores were associated with increased risk of unplanned PICU readmission. However, cutoff scores are not sensitive or specific enough to be clinically useful. Adding chronic disease variables may improve the clinical utility of cutoff PEWS scores.
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Journal of critical care · Jul 2015
Gender association with postoperative hemorrhage patient safety indicator in the United States from 2000 to 2012.
Postoperative hemorrhage and hematoma (PHH) is a patient safety indicator (PSI) representing a universal complication for all surgical procedures. This study examined the association between gender and the rates of PHH from 2000 to 2012. ⋯ Contrary to our results, the current literature on PHH largely identifies females as the gender with the greater risk of PHH. Specific to our study, our definition of PHH excludes pregnancy, childbirth, and puerperium patients. This finding suggests that pregnancy-related bleeding complications have influenced the current literature and males are the higher risk gender for PHH in nonobstetric procedures.
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Journal of critical care · Jun 2015
Tele-intensivists can instruct non-physicians to acquire high-quality ultrasound images.
Intensive care unit telemedicine (tele-ICU) uses audiovisual systems to remotely monitor and manage patients. Intensive care unit ultrasound can augment an otherwise limited bedside evaluation. To date, no studies have utilized tele-ICU technology to assess the quality and clinical use of real-time ultrasound images. We assessed whether tele-intensivists can instruct nonphysicians to obtain high-quality, clinically useful ultrasound images. ⋯ Tele-intensivists can guide minimally trained nonphysicians to obtain high-quality, clinically useful ultrasound images. For most anatomic sites, tele-ICU images are of similar quality to those acquired directly by ultrasound.