Articles: intensive-care-units.
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Critical care medicine · Sep 1999
Results of a collaborative quality improvement program on outcomes and costs in a tertiary critical care unit.
To demonstrate that by using the knowledge and skills of the primary care provider and by applying statistical and scientific principles of quality improvement, outcomes can be improved and costs significantly reduced. ⋯ A focused quality improvement program in the ICU can have a beneficial impact on care and simultaneously reduce costs.
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To determine factors that contributed to readmissions to the intensive care unit (ICU) from the general wards. ⋯ Preliminary results indicate that the appointment of the follow-up nurse has not only reduced the rate of readmissions to the ICU but also decreased the acuity levels of those readmitted.
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Recent studies combining medical and surgical patients have suggested that mortality is higher for mechanically ventilated women than for men. This study was designed to determine whether there are gender-based differences in outcomes in mechanically ventilated medical ICU (MICU) patients. ⋯ Using univariate and multivariate analyses, we found no differences in hospital mortality rates between mechanically ventilated men and women. Differences in the process of care or gender-based treatment bias may explain previously reported differences in outcomes.
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Critical care medicine · Sep 1999
Mortality and the increase in length of stay attributable to the acquisition of Acinetobacter in critically ill patients.
To determine the impact of Acinetobacter baumannii (AB) acquisition in intensive care unit (ICU) patients on mortality and length of stay (LOS). ⋯ AB acquisition involved an excess LOS in ICU patients and increased risk of death, but the latter could be found only in patients with proven infection.
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Critical care medicine · Sep 1999
Quality, cost, and outcome of intensive care in a public hospital in Bombay, India.
To study the quality, cost, and benefits of intensive care in a public hospital in Bombay, India. ⋯ Intensive care in India is cheaper than in the West; however, mortality is 1.67 times that for patients with similar APACHE II scores in ICUs in the United States. This finding may be attributable to the lesser intensity of care per patient (lower day-1 TISS points), lower nurse-to-patient ratio because of shortage of trained personnel and budgetary constraints, and higher workload per nurse (64.2 TISS points per nurse, compared with 40 points per nurse in the West). In addition, the APACHE II scores may underestimate mortality for Indian patients because of differences in case mix, higher lead time between onset of admission and treatment before ICU admission, and possible inappropriateness of age points derived from American patients for Indian subjects because of a higher burden of diseases at lower ages in Indian patients.