Articles: cations.
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Misclassification bias is introduced into medical claims-based research because of reliance on diagnostic coding rather than full medical record review. We sought to characterize this bias for idiopathic intracranial hypertension (IIH) and evaluate strategies to reduce it. ⋯ An ICD-9 or -10 code for IIH had a PPV of 63% for probable or definite IIH in patients with necessary diagnostic testing performed at a single institution. Coding accuracy was improved in patients with an IIH ICD code assigned by an ophthalmologist. Use of coding algorithms considering treatment providers, number of codes, and treatment is a potential strategy to reduce misclassification bias in medical claims-based research on IIH. However, these are associated with a reduced sample size.
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Critical care nurse · Dec 2021
Using Simulation to Improve Adherence to Get With the Guidelines Time to First Shock.
Evidence demonstrates that shocking patients in ventricular fibrillation or pulseless ventricular tachycardia in 2 minutes or less leads to improved outcomes. At our facility in Orlando, Florida, 4 of 7 time to first shock fallouts occurred in the intensive care unit. No standardization for conducting code situations existed in the intensive care unit. ⋯ Online education and code simulation positively affected time to first shock in code situations and empowered nurses to confidently function in these situations.
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Critical care nurse · Dec 2021
Favorable Outcomes After Implementing a Nurse-Driven Sedation Protocol.
In patients receiving mechanical ventilation, prolonged exposure to sedative and analgesic medications contributes to negative clinical outcomes. ⋯ These preliminary data suggest that implementation of a nurse-driven sedation protocol resulted in favorable outcomes by decreasing duration of mechanical ventilation, intensive care unit length of stay, and duration of continuous sedation and increasing the number of spontaneous awakening trials performed.