Articles: intensive-care-units.
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Little research was found to indicate that pain is managed well in hospitalized patients and few studies were found regarding pain management for critical care patients. ⋯ Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects. Patients who experience pain expect to have their pain controlled. Efforts must be made to change nurses' pain management behaviors.
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Our objective is to determine the opinions and knowledge of intensive care unit physicians toward organ donation. All physicians working in all 13 hospitals of Curitiba with intensive care unit for adults participated of the study. Of a total of 81 physicians, 75 (92.6%) answered the questionnaire. ⋯ Most physicians did not know the patient survival after transplantation of several organs. It is concluded that almost all intensive care unit physicians in Curitiba are favorable to organ donation and are willing to participate actively in obtaining consent of family members for donation. The basic knowledge of Brazilian law and several medical subjects on organ transplantation is unsatisfactory.
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Infections are a major cause of death in critically ill patients. As gram-positive organisms are more widespread and methicillin-resistant staphylococci (MRSA, MRSE) are easily distributed in overcrowded Intensive Care Units (ICU), extended hygienic procedures for infection control are most important. We hypothesize that strict regulations and educational programs for medical and nursing personnel are able to control the spread of resistant bacteria. ⋯ MRSA and MRSE isolated from surveillance cultures of bronchial secretions were reduced from an annual rate of 60.0% to 37.7% and 36.4% to 6.2% respectively between the years 1991 and 1992. Accordingly, the number of lower respiratory tract infections and the crude mortality could be reduced. We conclude that prompt implementation of control measures and continuous education of medical personnel are able to control an outbreak of infection with resistant staphylococci in an ICU setting.