Articles: intensive-care-units.
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To evaluate the relationship between inadequate antimicrobial treatment of infections (both community-acquired and nosocomial infections) and hospital mortality for patients requiring ICU admission. ⋯ Inadequate treatment of infections among patients requiring ICU admission appears to be an important determinant of hospital mortality. These data suggest that clinical efforts aimed at reducing the occurrence of inadequate antimicrobial treatment could improve the outcomes of critically ill patients. Additionally, prior antimicrobial therapy should be recognized as an important risk factor for the administration of inadequate antimicrobial treatment among ICU patients with clinically suspected infections.
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Critical care medicine · Feb 1999
Comparative StudyThe relationship of pre mortem diagnoses and post mortem findings in a surgical intensive care unit.
To evaluate pre- and post mortem diagnoses and determine their relationship and the discrepancy rate. ⋯ The overall discrepancy rate as well as the infectious discrepancy rate between pre mortem clinical diagnoses and post mortem findings were substantially higher in a surgical ICU compared with a hospital-wide population. The majority of these discrepancies were undiagnosed infections. The length of time spent in the ICU before death appeared to influence the rate of errors uncovered at the post mortem examination, suggesting that a longer ICU course, as well as the particular type of surgical patient population, may increase the chance of developing an infectious process, only to be uncovered at post mortem examination.
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Critical care medicine · Feb 1999
GuidelineCritical care services and personnel: recommendations based on a system of categorization into two levels of care. American College of Critical Care Medicine of the Society of Critical Care Medicine.
To recommend hospital services and personnel requirements for the provision of optimal care to critically ill patients. Requirements for hospitals with comprehensive resources, as well as for hospitals with limited resources, are addressed. ⋯ By combining the strengths and expertise of multidisciplinary critical care specialists, these guidelines provide a framework in which hospitals of varying resources may optimize the care of critically ill patients.
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To evaluate the clinical, financial, and parent/patient satisfaction impact of critical pathways on the postoperative care of pediatric cardiothoracic patients with simple congenital heart lesions. ⋯ Implementation of critical pathways reduced resource utilization and costs after repair of three simple congenital heart lesions, without obvious complications or patient dissatisfaction.
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Intensive Crit Care Nurs · Feb 1999
Comparative StudyWorkforce dilemmas: a comparison of staffing in a generalist and a specialist intensive care unit.
Intensive care units are arguably one of the most costly resources a hospital has to maintain in terms of nursing staff, skills and technology. Given that the Government's agenda on quality remains one of obtaining cost-effective healthcare, it is imperative that nursing managers consider the implications of the new policy shift for how they currently provide services. The purpose in this paper is to compare the different staffing levels adopted by managers in generalized and neurosurgical intensive care in an acute hospital trust. The dilemmas facing managers making staffing decisions without any definitive guidelines for resourcing these specialized units are examined.