American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
A simplified score for transfer of patients requiring mechanical ventilation to a long-term care hospital.
Long-term care hospitals are Medicare providers of postacute care that have a mean length of stay of 25 days or more. Early identification and timely transfer of patients requiring mechanical ventilation to such hospitals may improve the efficiency of inpatient care. ⋯ Efforts to aid discharge decision making and optimize hospital resource planning could take advantage of our predictive model and the simplified scoring tool.
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Discharge from critical care to a general care unit is a difficult period, and more effective information is needed to support patients and their families at this time. ⋯ This focus group study provides unique user insight into what influences successful and unsuccessful information giving. Based on real experiences, it adds to the limited international body of current evidence. Findings will be of value in designing future critical care discharge information and identifying the related resource implications.
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Randomized Controlled Trial
Use of a noninvasive electromagnetic device to place transpyloric feeding tubes in critically ill children.
The start of transpyloric feedings is often delayed because of challenges in reliably placing tubes blindly at the bedside. ⋯ Placement of transpyloric feeding tubes with the guidance of a noninvasive electromagnetic device significantly increases the time required for accurate placement. Because placement of transpyloric feeding tubes in critically ill children is common practice in many pediatric intensive care units, technology that delays satisfactory placement may be counterproductive in experienced hands.
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Inpatients may be at risk of cardiopulmonary instability during radiologic testing. Calling the medical emergency team is one rescue intervention that brings a team of critical care providers to the unstable patient. Little is known, however, about patients' instability and activations of the medical emergency team in the radiology department (RD-MET). ⋯ RD-MET patients with comorbid conditions, from a general care unit, and at risk for neurological deterioration arrive in the radiology department with potentially underestimated support needs. Greater support in specific time frames and locations may be warranted to improve outcomes.