Journal of critical care
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Journal of critical care · Feb 2012
Effect of an antibiotic algorithm on the adequacy of empiric antibiotic therapy given by a medical emergency team.
Delayed administration of effective antimicrobial therapy increases mortality in patients with septic shock. Empiric antibiotic selection in this setting can be inaccurate. The objective of this study was to determine whether an antibiotic algorithm (AA) tailored to institutional resistance patterns improves the adequacy of antimicrobial therapy. ⋯ The use of an AA significantly improves the adequacy of empiric antimicrobial therapy.
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Journal of critical care · Feb 2012
Time spent in the emergency department and mortality rates in severely injured patients admitted to the intensive care unit: An observational study.
The aim of this study was to identify the determinants of a shorter emergency department time (EDt) in patients with severe trauma (STPs) admitted to the intensive care unit and determine whether EDt influences mortality. ⋯ Patients in the ED with indicators of high trauma severity have a reduced EDt but a higher mortality rate. Advanced age increases both mortality and EDt. With the factors included in the model, EDt was not an independent factor for mortality in STPs.
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Journal of critical care · Feb 2012
Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy.
With the advent of highly active antiretroviral therapy (HAART), sepsis has become a more frequent ICU diagnosis for patients with HIV infections. Yet, little is known about the etiologies of acute infections in critically ill patients with HIV and the factors that affect in-hospital mortality. ⋯ In this large cohort study, nosocomial/health care-associated infections were common in ICU patients with HIV and severe sepsis. Hospital mortality was associated with acute illness severity, but not clearly associated with variables related to HIV infection. Interventions that aim to prevent or more effectively treat nosocomial infections in critically ill patients with HIV may favorably impact clinical outcomes.
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Journal of critical care · Feb 2012
Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International Nosocomial Infection Control Consortium's (INICC) findings.
The aim of this study was to determine device-associated health care-associated infections (DA-HAI) rates, microbiologic profile, bacterial resistance, and length of stay in one intensive care unit (ICU) of a hospital member of the International Nosocomial Infection Control Consortium (INICC) in Poland. ⋯ Most DA-HAI rates are lower in Poland than in INICC, but higher than in the National Healthcare Safety Network, expressing the feasibility of lowering infection rates and increasing patient safety.
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Journal of critical care · Feb 2012
Organizational and safety culture in Canadian intensive care units: relationship to size of intensive care unit and physician management model.
The objectives of this study are to describe organizational and safety culture in Canadian intensive care units (ICUs), to correlate culture with the number of beds and physician management model in each ICU, and to correlate organizational culture and safety culture. ⋯ Differences in perceptions between staff in larger and smaller ICUs highlight the importance of teamwork across units in larger ICUs.