Articles: intensive-care-units.
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Failure to deal effectively and promptly with high medical intensive care unit (MICU) staff turnover can cause severe problems. This study demonstrates how monitoring turnover indices might have anticipated a critical shortage of experienced staff that forced this hospital to shut down needed MICU beds. Determinative attitudinal factors are identified from a survey of nurses and supervisors. The authors identify critical problem components and recommends measures to increase staff retention.
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Critical care medicine · Jul 1988
Case ReportsAutopsy as quality assurance in the intensive care unit.
A prospective study of 100 autopsies was carried out. The clinical and pathologic diagnoses were made independently by intensivists and pathologists; at the end of the study, the differences were determined. There were seven Class I errors (which if detected before death, would probably have led to a change in management that might have resulted in cure or prolonged survival), six of these relating to the basic disease and one to the cause of death. ⋯ In 61% of the patients, the major and minor diagnoses coincided. In 77% of the patients, the major diagnoses coincided. No relationship was found between the incidence of Class I and Class II errors and the length of the patients' stay in the ICU.
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Burn trauma is the most devastating injury the body can sustain. Each year, 100,000 victims will sustain burn injuries serious enough to require hospitalization; 35% of these victims are children. ⋯ The primary nurse and physician collaborate with the rest of the health care team to manage all aspects of care. This approach assures that coordination of care occurs and allows the family the opportunity to maintain a unique role as the primary caregiver.