Articles: intensive-care-units.
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The purpose of the paper is to study methods for costing hospital services specifically in relation to multi-unit studies of activity, case-mix, severity-of-illness, outcome, and resource use in adult intensive care units. The article reviews 20 published cost studies of adult intensive care units. The studies are all published in English and are both European and American. ⋯ In addition, the costing methodology applied in the majority of the studies has been wrongly specified in relation to the purpose and the viewpoint of the studies. The article concludes that the methodologies for costing intensive care unit therapy are flawed and fail to provide correct answers. In addition, the study question is in most studies not adequately specified and the cost concept used in the studies is not tailored to the purposes of the studies.
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Swiss medical weekly · Sep 1996
Continuous quality improvement in the ICU and the role of a data management system.
Quality improvement may be defined as the effort to improve the level of performance of key processes in the ICU. Based on knowledge of the current level of performance and on systematic analysis of organizational aspects of the ICU, quality improvement will include the implementation of standards, the formulation and analysis of quality indicators (e.g. scores, rate of complications such as nosocomial infections) and the possible introduction of data management systems.
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Multicenter Study
The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators.
To examine the association between the use of right heart catheterization (RHC) during the first 24 hours of care in the intensive care unit (ICU) and subsequent survival, length of stay, intensity of care, and cost of care. ⋯ In this observational study of critically ill patients, after adjustment for treatment selection bias, RHC was associated with increased mortality and increased utilization of resources. The cause of this apparent lack of benefit is unclear. The results of this analysis should be confirmed in other observational studies. These findings justify reconsideration of a randomized controlled trial of RHC and may guide patient selection for such a study.
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit.
To determine the efficacy of the use of gloves and gowns compared with that of the use of gloves alone for the prevention of nosocomial transmission of vancomycin-resistant enterococci. ⋯ Universal use of gloves and gowns was no better than universal use of gloves only in preventing rectal colonization by vancomycin-resistant enterococci in a medical intensive care unit of a hospital in which vancomycin-resistant enterococci are endemic. Because the use of gowns and gloves together may be associated with better compliance and may help prevent transmission of other infectious agents, this finding may not be applicable to outbreaks caused by single strains or hospitals in which the prevalence of vancomycin-resistant enterococci is low.