Articles: intensive-care-units.
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To evaluate the long-term mortality and morbidity of critically ill elderly patients requiring intensive care. ⋯ Age alone is not an adequate predictor of long-term survival and quality of life in critically ill elderly patients.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Jun 1993
[Staffing levels and patient needs in the intensive care unit].
The current study sought to utilize a patient classification system to investigate staffing and patient needs along with nursing care distribution in our intensive care units. The study employed a factor type analysis to design a patient need checklist (for our six ICUs) in order to determine staff load and nursing requirements. Snapshot observations were also taken to survey the distribution of nursing care time. ⋯ The understaffed units are all surgical units; the overstaffed ones, internal medicine units. To conclude the study, we examined the nature and complexity of nursing duties in the hopes of returning non-nursing responsibilities to the proper medical organizations. Our ultimate goal is to realize the full potential and improve the quality of our nursing personnel.
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Critical care medicine · Jun 1993
Multicenter StudyPostoperative utilization of critical care services by cardiac surgery: a multicenter study in the Canadian healthcare system.
To describe patterns of critical care services used after cardiac surgery and to evaluate whether variations in the process of care influence outcome. ⋯ Significant differences exist among hospitals in the same healthcare system in the utilization of critical care services for cardiac surgery. In spite of these differences, for similar patient "input," the outcome (mortality and hospital lengths of stay) appeared similar. Assessments of utilization of critical care must focus on more detailed specific issues than unit length of stay, and must include factors such as availability of intermediate care areas, the unit management system, chronic health status, and the operative procedures performed, if a utilization management process is to effect improved resource use in critical care.
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In order to obtain a contemporary view of the visiting hour regimes in intensive care units (ICUs) in the UK, a national telephone survey was performed. 122 geographically representative units were contacted, representing 42% of the total number of units in the UK. 107 units gave consent to participate in the study, of which 66 units allowed visiting at any time of the day. Many of these units however restricted the number or kind of visitors and only 19% could be regarded as having 'true' open visiting, that is, visiting at any time of the day for any age of child, any member of the family, or friends. ⋯ Based on the available research evidence, a more liberated view of hospital visiting is necessary, with relaxation of what often amount to restricted visiting regimes. Several recommendations for further research are made.
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Beside the procedures to ensure adequate ventilatory and circulatory support, analgesia, sedation and even anesthesia are essential parts of the preclinical treatment of patients with multiple injuries. The measures for extrication and positioning must be adjusted to minimize pain and excitation. ⋯ The therapy must take into account the special conditions concerning the patient, material and assisting personnel by choosing suitable techniques. The best results can be obtained if all kinds of measures can be administered from the site of the accident on up to the definitive care in the operating room.