Articles: intensive-care-units.
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Unbiased, objective evaluations of quality of care are preferred over subjective evaluations. We observed 681 admissions to a pediatric intensive care unit of a community hospital from 1989 through 1990 for outcomes and physiologic profiles of the patients on the admission day using the Pediatric Risk of Mortality score to assess severity of illness. ⋯ The number of outcomes and their distribution according to mortality risk indicated close agreement between observed and predicted results. Thus, a quality-assurance technique developed in tertiary care centers can be used to indicate a comparable level of care in a community hospital.
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Comparative Study
Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units.
Effective hand-washing can prevent nosocomial infections, particularly in high-risk areas of the hospital. There are few clinical studies of the efficacy of specific hand-cleansing agents in preventing the transmission of pathogens from health care workers to patients. ⋯ A hand-disinfection system using an antimicrobial agent (chlorhexidine) reduces the rate of nosocomial infections more effectively than one using alcohol and soap. The improvement may be explained at least in part by better compliance with hand-washing instructions when chlorhexidine was used.
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Critical care, as a specialty in both nursing and medicine, is well recognized and the number of people requiring hospitalization for critical illnesses continues to increase. The purpose of this paper is to examine the future and the changes that lie ahead in critical care. ⋯ A variety of changes in critical care are anticipated that reflect our increasing abilities in biotechnology, basic and clinical research, and data management. These changes are viewed for their obvious impact on cost, ethical controversies, and patient care and outcome.
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Historical Article
New nurses, new spaces: a preview of the AACN History Study.
This article previews selected findings of the American Association of Critical-Care Nurses History Project that is being conducted under the auspices of the Center for the Study of the History of Nursing at the University of Pennsylvania. Using methods of social history research, we reviewed pertinent literature, studied documents of institutions and organizations, and interviewed a broad array of participants. ⋯ We explored the effects of changing public and professional ideas about the nature of critical illness, the effects of technology, and the historical dimensions of critical care nursing. Special attention was given to the events and circumstances that led to the development of AACN and the reciprocal relationships between AACN and the care of critically ill people.