Articles: intensive-care-units.
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Intensive care medicine · Jan 1998
Multicenter StudyEvaluation of the uniformity of fit of general outcome prediction models.
To compare the performance of the New Simplified Acute Physiology Score (SAPS II) and the New Admission Mortality Probability Model (MPM II0) within relevant subgroups using formal statistical assessment (uniformity of fit). ⋯ Concerning the performance of the models, very large differences were apparent in relevant subgroups, varying from excellent to almost random predictive accuracy. These differences can explain some of the difficulties of the models to accurately predict mortality when applied to different populations with distinct patient baseline characteristics. This study stresses the importance of evaluating multiple diverse populations (to generate the design set) and of methods to improve the validation set before extrapolations can be made from the validation setting to new independent populations. It also underlines the necessity of a better definition of the patient baseline characteristics in the samples under analysis and the formal statistical evaluation of the application of the models to specific subgroups.
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Comparative Study Clinical Trial Controlled Clinical Trial
Effectiveness of a structured communication program for family members of patients in an ICU.
In ICUs, an essential component of caring for patients' families is providing information about the patient's status. Nevertheless, interruptions by family members requesting information create an additional burden for nursing staff. ⋯ The intervention reduced the number of incoming calls from family members, without compromising family members' satisfaction with care or how well their information needs were met.
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Critical care medicine · Jan 1998
Comparative StudyEffect of clinical outcomes data on intensive care unit utilization by bone marrow transplant patients.
To determine if a program to educate referring physicians as to the poor outcome of mechanically ventilated bone marrow transplant patients would result in a change in intensive care unit (ICU) utilization. ⋯ Simple educational interventions are not a powerful mechanism by which to alter the practice of physicians regarding the utilization of scarce and expensive resources, even when the physicians generally agree that the use of those resources results in dismal patient outcomes.
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To assess the utilization of venous thromboembolism (VTE) prophylaxis in a medical-surgical ICU. ⋯ Eighty-six percent of the medical-surgical patients included in this study received VTE prophylaxis. The utilization of VTE prophylaxis described in this study is higher compared to previously published data. The nature of physician coverage in our medical-surgical ICU (closed unit), consistent practice patterns of a designated ICU staff, and a continuing medical education program involving VTE prophylaxis are the factors believed to be responsible for these results.