Critical care nursing quarterly
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Review Comparative Study
Two decades (1993-2012) of adult intensive care unit design: a comparative study of the physical design features of the best practice examples.
In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. ⋯ In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical design of these award-winning ICUs may help design better ICUs.
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Comparative Study
Changes after transformation from a specialized surgical unit to a general mixed intensive care unit.
We report the transition of a specialized surgical intensive care unit to a general mixed intensive care unit (ICU) and its influence on immediate outcome and performance data of the surgical population before and after the reorganization. ⋯ Organizational changes from a surgical ICU to a general mixed unit can have profound influences on performance data. Crude ICU outcome improved after the reorganization. Nevertheless, ICU standardized mortality ratio did not change.
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Observational Study
Patient outcomes can be associated with organizational changes: a quality improvement case study.
We report the results of a university surgical intensive care (SICU), which are influenced by a reorganization of the department because of a downsizing of beds with the corresponding reduction of personnel resulting in a decrease in nurse-to-bed ratio. Moreover, we report the subsequent interventions and adjustments resulting in favorable results. ⋯ Interventions in ICU structures, communication, work ethics, and organization have a positive impact in conflict management.