Articles: intensive-care-units.
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Randomized Controlled Trial Clinical Trial
Effects of critical care unit noise on the subjective quality of sleep.
Nurse researchers have provided evidence that hospital critical care unit (CCU) noise may put patients at risk for sleep problems. Technological advances in this setting have been described as contributing to this problem. Although data on the negative effects of CCU noise on physiological sleep are available, less attention has been given to self-reports of the subjective quality of sleep following exposure to this stressor. ⋯ Data on the quality of dreams yielded no difference between groups. The results provide support for the hypothesis that CCU sound levels impact negatively on subjective sleep. It was recommended, now that CCU sound levels were isolated in the laboratory as a potential stressor, that future research should attempt to replicate this study in a hospital CCU.
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Organizational structure and process are thought to affect patient care outcomes beyond the effects of expert clinical care. ⋯ With experienced critical care practitioners, unit-level structure and process factors were better predictors of organizational outcomes than of clinical outcomes.
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Intensive care medicine · Sep 1996
Infection control practices in intensive care units of 14 European countries. The EURO.NIS Study Group.
To evaluate compliance with recommended patient-care practices for the prevention of hospital-acquired infections (HAI) in the intensive care unit (ICU). ⋯ Interpretation of data is made difficult by the lack of consensus among experts with respect to some of the practices investigated. Nevertheless, the implementation of standard practices for preventing HAIs is far from satisfactory in the hospitals surveyed, even in a high priority hospital area such as intensive care. Documented European guidelines could be worth-while in increasing awareness of the ICU staff. The availability of at least one infection control nurse in each hospital should be strongly advocated.
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Intensive care medicine · Sep 1996
Postal survey on the long-term use of neuromuscular block in the intensive care.
To assess the long-term use of neuromuscular blocking (NMB) agents in intensive care, especially with reference to the potential problems of the long-term use of NMB drugs in the intensive care unit (ICU). ⋯ Most responders agreed that while neuromuscular block in the ICU population may provide advantages, it cannot be considered benign. Indeed, a great majority consider that NMB agents should be used only as a last option and -for as short a period as possible.
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A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. ⋯ The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.