Articles: checklist.
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Interact Cardiovasc Thorac Surg · Apr 2014
Clinical TrialEffects of a screening and treatment protocol with haloperidol on post-cardiotomy delirium: a prospective cohort study.
Post-cardiotomy delirium is common and associated with increased morbidity and mortality. No gold standard exists for detecting delirium, and evidence to support the choice of treatment is needed. Haloperidol is widely used for treating delirium, but indication, doses and therapeutic targets vary. Moreover, doubt has been raised regarding overall efficacy. The purpose of this study was to assess the effect of a combination of early detection and standardized treatment with haloperidol on post-cardiotomy delirium, with the hypothesis that the proportion of delirium- and coma-free days could be increased. Length of stay (LOS), complications and 180-day mortality are reported. ⋯ We observed no increase in the proportion of delirium- and coma-free days after introduction of a combination of early detection and standardized treatment with haloperidol on post-cardiotomy delirium. Most patients were not severely affected, and the few who were, proved difficult to treat, indicating that a simple treatment protocol with haloperidol was ineffective.
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Enfermería intensiva · Apr 2014
Observational Study[Analysis of adverse events associated with interhospital transfer of critically ill patients. Safety checklist].
Mobilization entails a risk for critically ill patients. It is therefore important to design and apply the tools to detect any safety lapses and to improve the quality of patient healthcare. ⋯ Before each hospital transfer, a risk-benefit assessment is recommended in order to avoid potential alterations in the patient's pathophysiologic condition. Both the protocol and the safety checklist are key to detect underlying factors and improve security during interhospital transfers.
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Journal of critical care · Apr 2014
Comparative StudyComparative evaluation of the content and structure of communication using two handoff tools: Implications for patient safety.
Handoffs vary in their structure and content, raising concerns regarding standardization. We conducted a comparative evaluation of the nature and patterns of communication on 2 functionally similar but conceptually different handoff tools: Subjective, Objective, Assessment and Plan, based on a patient problem-based format, and Handoff Intervention Tool (HAND-IT), based on a body system-based format. ⋯ The HAND-IT's body system-based structure afforded physicians the ability to better organize and comprehend patient information and led to an interactive and streamlined communication, with limited external input. Our results also emphasize the importance of information organization using a medical knowledge hierarchical format for fostering effective communication.
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Randomized Controlled Trial
Improving ATLS performance in simulated pediatric trauma resuscitation using a checklist.
To develop a checklist for use during pediatric trauma resuscitation and test its effectiveness during simulated resuscitations. ⋯ Implementing a checklist during simulated pediatric trauma resuscitation improves adherence to the ATLS protocol without increasing the workload of trauma team members.
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Pleural procedures such as tube thoracostomy and chest aspirations are commonly performed and carry potential risks of visceral organ injury, pneumothorax and bleeding. In this context limited information exists on the complication rates when non-pulmonologists perform ultrasound-guided bedside pleural procedures. Bedside pleural procedures in our university hospital were audited to compare complication rates between pulmonologists and non-pulmonologists. ⋯ Results from this study support pleural procedural practice by both pulmonologists and non-pulmonologists in an academic medical centre setting. This is possible with a standard training program, pleural safety checklists and relatively high utilization rates of ultrasound guidance for pleural effusions. Nonetheless, additional vigilance is needed when patients with COPD undergo pleural procedures.