Articles: critical-care.
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The emergency department (ED) provides a substantial amount of critical care. The purpose of this study was to quantitate the critical care provided in an urban ED. The study was performed at a large urban hospital with an annual ED volume of 70,000 patients. ⋯ Overall, 14% of adult critical care, 23% of pediatric critical care, and 15% of all critical care provided in the areas studied occurred in the ED. A significant proportion of critical care is provided in the ED, and triage acuity assignment reflects this need. A significant proportion of critically ill patients was admitted to the floor for lack of bed space, which highlights the financial constraints in urban hospitals such as the one studied.
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Recent changes in UK legislation concerning community care of mentally ill people have initiated comprehensive changes in the delivery of healthcare. The NHS and Community Care Act (Department of Health 1990) added impetus to the run down of residential facilities and the speed of development of community mental health services. A community mental health intensive care team was established in Essex and employed a high ratio of unqualified to qualified staff. At a time of tension within the Health Service around issues such as skill mix and unemployment among qualified nurses, it was perhaps not unreasonable that the introduction of healthcare assistants might be viewed with suspicion, as a way of diluting the workforce with a less expensive alternative. The importance of evaluating new services is self-evident. ⋯ It is self-evident that the clients' expressed satisfaction with the care provided by healthcare assistants argues against the professional ideology of nursing, which proposed that nursing may only be given by those with a statutory qualification. A complementary role for healthcare assistants in the provision of mental health care is proposed.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Intensive care medicine from the viewpoint of patients, their family and nursing personnel].
We wanted to know how our intensive care unit would be graded by the patients, their family members and the staff, as well as the impression that intensive care medicine made on them. A total of 82% of the patients and 90% of the family members were of the opinion that they owed their lives to intensive care medicine, and 100% of the patients and 96% of family members deemed intensive care medicine significant. ⋯ The nursing staff held a contrary opinion and were more critical. Competent explanation and transmission of information represented the most important factor in forming a positive opinion of intensive care medicine.
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The role of the nurse practitioner in the tertiary care or hospital setting has become well established during the course of this decade. With the introduction of a national certifying examination for acute care nurse practitioners in 1995, it is important that the word acute be defined in a way that is acknowledged universally. ⋯ This article presents the conflicting use of these two terms in the literature and provides a rationale for recognizing the differences. It is suggested that the definition of the word acute, as it is used in the title acute care nurse practitioner, be reexamined, and that either the content or the title of the certifying examination for acute care nurse practitioners be reconsidered.