Articles: intensive-care-units.
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To develop, validate, and deploy models for predicting delirium in critically ill adult patients as early as upon intensive care unit (ICU) admission. ⋯ Our early prediction models based on data obtained upon ICU admission could achieve good performance in predicting delirium occurred within 48 h after ICU admission. Our 24-h models can improve delirium prediction for patients discharged >1 day after ICU admission.
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Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. ⋯ Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS.
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The few studies of associations between fever and outcomes in pediatric intensive care unit (PICU) patients have conflicting findings. Associations between hypothermia and patient outcomes have not been studied. ⋯ These findings provide evidence that the manifestation and characteristics of fever and hypothermia are independent predictors of adverse outcomes in PICU patients.
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After an intensive care unit (ICU) admission, nearly 20% of survivors of chronic critical illness require admission to a long-term acute care hospital (LTACH) for continued subspecialty care. The effect of the burden of medical comorbidities on discharge disposition after LTACH admission remains unclear. ⋯ Severity-of-illness scores on admission to an LTACH can be used to predict patients' likelihood of being discharged home.
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Observational Study
Systems-Based Physical Assessments: Earlier Detection of Clinical Deterioration and Reduced Mortality.
Despite efforts to improve early detection of deterioration in a patient's condition, delays in activating the rapid response team remain common. ⋯ When nurses focus on conducting a systems-based physical assessment early in their shift, delays in recognizing a patient's deteriorating condition are reduced, fewer patients are admitted to the intensive care unit, and mortality is significantly reduced.