Articles: checklist.
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Drug courts, therapeutic justice programs for individuals charged with drug offenses, have sub-optimal completion rates. The Courtroom Behavior Checklist (CRBCL), an assessment that quantifies readiness for drug court and drug court behaviors, was developed to predict female offenders who may be at-risk for non-compliance and termination. Data derived from 264 mainly urban women recruited from a Municipal Drug Court System in St. ⋯ Other factors significantly associated with unfavorable drug court behaviors included greater lifetime arrests, lower education, and being less religious or spiritual. Our findings suggest that the CRBCL may have added utility in identifying women in drug court with recent substance use and risky sexual behaviors. However, further studies on other samples of offenders are needed to support these findings.
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Although the overall safety of blood transfusion is high, adverse events do still occur. Much research on transfusion reactions was done in nonperioperative patients. Fortunately, important contributions to the perioperative literature have been made in the last several years, specifically in the areas of transfusion-associated circulatory overload and transfusion-related acute lung injury (TRALI). ⋯ The current article explores new research on the topics of transfusion-associated circulatory overload and transfusion-related lung injury.
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Acta Anaesthesiol Scand · Mar 2019
Delirium assessment in neuro-critically ill patients: A validation study.
Delirium is underinvestigated in the neuro-critically ill, although the harmful effect of delirium is well established in patients in medical and surgical intensive care units (ICU).To detect delirium, a valid tool is needed. We hypothesized that delirium screening would be feasible in patients with acute brain injury and we aimed to validate and compare the Confusion Assessment Method for the ICU and the Intensive Care Delirium Screening Checklist against clinical International Classification of Diseases-10 criteria as reference. ⋯ Our findings suggest that the Intensive Care Delirium Screening Checklist may be a valid tool and the Confusion Assessment Method for the ICU is less suitable for delirium detection for patients in the Neuro-ICU. In the neuro-critically ill, delirium screening is challenged by limited feasibility.
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Jt Comm J Qual Patient Saf · Mar 2019
Bringing Perioperative Emergency Manuals to Your Institution: A "How To" from Concept to Implementation in 10 Steps.
Emergency manuals (EMs) are context-relevant sets of crisis checklists or cognitive aids designed to enable professional teams to deliver optimal care during critical events. Evidence from simulation and other high-risk industries have proven that use of these types of checklists can significantly improve event management and decrease omissions of key steps. However, simply printing and placing tools in operating rooms (ORs) is unlikely to be effective. How interventions are implemented influences whether clinicians actually change practice and whether patient care is affected. This article provides an in-depth description of a rigorous implementation plan with three goals: (1) place EMs in every anesthetizing location, (2) create interprofessional engagement, and (3) demonstrate that a majority of anesthesia clinicians would use the new tool in some way within the first year. ⋯ This article presents a framework and detailed description of the steps a large academic institution followed in successfully implementing EMs. In conjunction with other available resources, those interested in introducing OR EMs at large, complex institutions may benefit from the experience shared in anticipating challenges and overcoming barriers to adoption.