Journal of critical care
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Journal of critical care · Jun 2008
Improving communication in a pediatric intensive care unit using daily patient goal sheets.
The aim of the study was to determine if a pediatric intensive care unit (PICU) daily patient goal sheet would improve communication between health care providers and decrease length of stay (LOS). ⋯ Using a PICU daily patient goal sheet can improve communication between health care providers, help nurses identify the in-charge physicians, and be helpful for patient care. By explicitly documenting patient care goals, there is enhanced clarity of patient care plans between health care providers.
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Although rarely thought of as simulations by anesthesia educators, the use of standardized patients to simulate clinical encounters spans 4 decades (Mt Sinai J Med. 1996;63:241-249; J Am Med Assoc. 1997;278:790-791; Int J Dermatol. 1999;38:893-894). Although its efficacy for education and evaluation in the medical community has been well established through extensive research, there is a distinct dearth in the literature in its use for anesthesia trainee education and evaluation. In this article, we discuss this simulation modality via a historic review, its current application in competency assessment, and its use in anesthesiology education and evaluation. We conclude with a "how to guide" to facilitate those considering including standardized patient simulations into their anesthesia training or simulation curriculum.
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Journal of critical care · Mar 2008
Randomized Controlled Trial Multicenter StudyPrevious cultures are not clinically useful for guiding empiric antibiotics in suspected ventilator-associated pneumonia: secondary analysis from a randomized trial.
To examine the predictive validity of prior cultures at predicting the microorganism isolated at the time of suspicion of ventilator-associated pneumonia (VAP). ⋯ There is poor agreement between prior cultures and cultures performed at time of suspicion of VAP. Prior cultures should not be used to narrow the spectrum of empiric antibiotics.
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Journal of critical care · Mar 2008
Meta AnalysisEfficacy of prone ventilation in adult patients with acute respiratory failure: a meta-analysis.
The use of prone ventilation in acute respiratory failure has been investigated by several randomized controlled trials in the recent past. To date, there has been no systematic review or meta-analysis of these trials. ⋯ The use of prone ventilation is associated with improved oxygenation. It is not associated with a reduction in mortality, pneumonia, or ICU stay and may be associated with an increased incidence of pressure sores.
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Journal of critical care · Mar 2008
Randomized Controlled Trial Multicenter StudyThe clinical significance of Candida colonization of respiratory tract secretions in critically ill patients.
Clinical uncertainty exists regarding the significance of colonization confined to respiratory tract secretions with Candida sp in critically ill patients. Our objectives were to describe such colonization, its associated risk factors, and to examine the clinical outcomes in patients with a clinical suspicion of ventilator-associated pneumonia with isolated Candida colonization compared to those without. ⋯ Respiratory tract Candida colonization is associated with worse clinical outcomes and is independently associated with increased hospital mortality. However, it is unclear whether Candida colonization is causally related to poor outcomes or whether it is a marker for increased morbidity and mortality.