Articles: intensive-care-units.
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To determine what data are currently being collected at the critical care bedside, the role of flow sheets in storing these data, and what other forms and locations are used to store critical care data. ⋯ The lack of standardization regarding key information that should be collected and archived in critical care units identifies important risk management and quality assurance issues. There is a need for agreement on what information should be collected and maintained at the bedside in order to provide quality patient care.
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Comparative Study
Cross infection in an intensive care unit by Klebsiella pneumoniae from ventilator condensate.
Klebsiella pneumoniae serotype K28 was cultured from six patients over 5 weeks in a general Intensive Care Unit. Colonized condensate in the ventilator expiratory water traps was the probable source of the organism, and hand carriage the vehicle of transmission. Although the cross-infection hazard of ventilator tubing condensate is recognized, there is no report in the literature of an outbreak caused by such fluid. Ventilator tubing condensate should be viewed as contaminated clinical waste and dealt with accordingly.
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The frequency of adult surgical and medical intensive care unit (ICU) admissions related to substance abuse was determined at a large community, trauma, and tertiary referral hospital. Of 435 ICU admissions, 14 percent (95 percent confidence interval [CI], 5 to 23 percent) were tobacco related generating 16 percent of costs, 9 percent (95 percent CI, 0 to 18 percent) were alcohol related generating 13 percent of costs, and 5 percent (95 percent CI, 0 to 14 percent) were illicit drug related generating 10 percent of costs. In all, 28 percent (95 percent CI, 20 to 36 percent) of ICU admissions generating 39 percent of costs were substance abuse related. ⋯ Frequency of substance abuse-related admission was linked with the patient's insurance status (Medicare, private insurance, uninsured). In the uninsured group, 44 percent of admissions were substance abuse related (95 percent CI, 35 to 52 percent), significantly higher than in the private insurance and Medicare groups, and generating 61 percent of all ICU costs in the uninsured group. Large fractions of adult ICU admissions and costs are substance abuse related, particularly in uninsured patients.
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Revista médica de Chile · Jan 1993
Comparative Study[Mortality in an intensive care unit: predictive value of APACHE II severity score versus maximum APACHE].
Patients admitted to intensive care units (ICU) experience constant changes in their general condition. Therefore, the determination of Apache score within the first 24 hours of admission may not be a reliable index of severity. The aim of this study was to measure daily Apache scores in ICU patients, and to determine if the maximum score (Maximum Apache) attained during hospitalization had a better prognostic value than that of admission. ⋯ Only 78.3% of patients attained their maximum apache score during the first 24 hours of admission, whereas 21.7% attained it during the rest of ICU hospitalization. Excluding subjects with less than one day of ICU stay, 33% of patients attained maximum Apache score after 24 hours of ICU admission. Statistical analysis showed that maximum Apache score was a better predictor of mortality than that of admission.