Articles: intensive-care-units.
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Intensive Crit Care Nurs · Apr 1995
A qualitative study to establish the self-perceived needs of family members of patients in a general intensive care unit.
Admission to an intensive care unit (ICU) invariably causes a considerable degree of distress and anxiety to both patient and family. If we profess to deliver holistic care then it is essential that intensive care nurses are able to identify the specific needs of family members and provide appropriate supportive interventions. This small study was designed to gain the perspectives of the families. ⋯ Interviews were tape-recorded with permission and subsequently transcribed. Thematic content analysis adapted from Glaser & Strauss' 'grounded theory' approach (1967) by Burnard (1991) occurred, with formation of six categories, exemplified by verbatim quotations. The study may contribute towards a framework for preventative, supportive and therapeutic intervention with family members in the intensive care setting.
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Randomized Controlled Trial Clinical Trial
A randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit.
A randomized, double-blind, placebo-controlled trial of selective decontamination of the oropharynx and gastrointestinal tract was conducted on 61 intubated patients in a medical-surgical intensive care unit (ICU) to determine the impact on nosocomial pneumonia, other infections, and emergence of colonization or infection with antibiotic-resistant bacteria. Over 8 months, 30 patients received an oral paste and solution containing polymyxin, gentamicin, and nystatin; 31 patients received a placebo paste and solution. ⋯ There was no difference in infections caused by antibiotic-resistant gram-negative bacilli, although a trend towards more frequent infection with gentamicin-resistant enterococci was found for study patients. Selective decontamination did not appear to be effective in our very ill medical-surgical ICU patients, although the number of patients in our trial was sufficient to detect only a 50% or greater reduction in pneumonia rates.
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Critical care medicine · Apr 1995
Comparative StudyAfrican-American and white patients admitted to the intensive care unit: is there a difference in therapy and outcome?
To evaluate variations in patient characteristics, hospital mortality, intensive care unit (ICU) length of stay, and treatment among African-American and white patients admitted to the ICU. ⋯ After adjusting for variations in patient characteristics at ICU admission, race has no significant effect on hospital survival. The small but statistically significant differences in adjusted ICU length of stay and resource use could indicate undertreatment for African-Americans or overtreatment for whites.
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An exploratory descriptive survey was conducted to determine the size and character of high dependency units (HDUs) in the UK. A telephone survey and subsequent postal questionnaire was sent to the 39 general HDUs in the UK determined by a recent survey from the Royal College of Anaesthetists; replies were received from 28. Most HDUs (82%, n = 23) were geographically distinct from the intensive care unit and varied in size from three to 13 beds, although only 64% (n = 18) reported that all beds were currently open. ⋯ Provision of facilities and levels of monitoring varied between these units. Few HDUs exist in the UK and they are variable in size and in the facilities and monitoring procedures which they provide. Future studies are urgently required to determine cost-effectiveness and outcome benefit of this intermediate care facility.