Articles: intensive-care-units.
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Issues Compr Pediatr Nurs · Jan 1995
Comparative StudyFamily functioning following pediatric intensive care unit hospitalization.
The purpose of this cross-sectional study was to compare two groups of families on measures of current family functioning and to explore factors related to current family functioning. Surveys were mailed to parents from families (n = 27) whose child aged 1 to 5 years had been hospitalized in a pediatric intensive care unit (PICU) and parents from families (n = 25) whose child aged 1 to 5 years had been hospitalized on a general care unit (GCU) in a large Midwestern children's hospital within 3 years of their child's discharge. Time since discharge ranged from 16 to 158 weeks (M = 84.9, SD = 36.0). ⋯ Length of stay and PRISM scores were significant predictors of fathers' cohesion ratings; PRISM and location (PICU vs. GCU) were significant predictors of mothers' adaptability ratings. The findings suggest that it is not a PICU admission alone that has negative effects on the family; rather, the additive effects of how sick the child is on admission, where the child is hospitalized, and how long the child stays in the hospital may have negative consequences for the family.
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Clin Intensive Care · Jan 1995
Comparative StudyComparison of APACHE III, II and the Glasgow Coma Scale for prediction of mortality in a neurosurgical intensive care unit.
This study examined the efficacy of predicting power for hospital mortality of three different scoring systems in a neurosurgical intensive care unit (NICU). ⋯ The APACHE III system seems to be the most reliable. The results reveal that the APACHE III system is better in predicting power for hospital mortality than either the GCS or APACHE II systems in our NICU patients.
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Comparative Study
The identification of ICU-specific outcome predictors: a comparison of medical, surgical, and cardiothoracic ICUs from a single institution.
To identify ICU-specific predictors of mortality. ⋯ We identified the presence of ICU-specific predictors of mortality amongst the three ICUs examined. These data suggest that ICU-specific interventions could be developed to improve the quality of patient care and potentially to reduce patient mortality.
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Int J Technol Assess Health Care · Jan 1995
Is there a relationship between the volume of work carried out in intensive care and its outcome?
This paper reports the results of a study of the association between volume of activity and patient outcome in 26 intensive care units in the United Kingdom. Hospital fatality rates showed a statistically significant (p = .016) negative association with volume. ⋯ Thus, one explanation of the lower death rates at higher volumes is that larger units admit less severely ill patients. For patients admitted immediately after surgery, the correlation between severity standardized mortality ratios and volume (while not significant, p < .1) suggests there may be a volume-output effect unexplained by severity.
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The introduction of new medical technology needs to be associated with the assessment of the value of this technology in patient care. Traditional outcome measures of quality in health care (such as survival, cost, and "quality of life") may be of little value in assessing quality of patient care at the bedside. A model of quality in bedside patient care is presented and used in the assessment of the impact of introducing a bedside information system on patient care quality.