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Academic literature on the topic 'Critical care units'

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Published: 4 June 2021
Last updated: 20 February 2023

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Journal articles on the topic "Critical care units"

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Harrell, Michelle F. "Designing critical care units." Critical Care Nursing Quarterly 14, no. 1 (May 1991): 1–8. http://dx.doi.org/10.1097/00002727-199105000-00003.

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Winet, Elisabeth, Gail Lukasiewicz, Elizabeth Hess, and Monica Cates. "Merging Critical Care Units." Dimensions of Critical Care Nursing 15, no. 5 (September 1996): 264–70. http://dx.doi.org/10.1097/00003465-199609000-00006.

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Sevransky, Jonathan E., and Henry E. Fessler. "Excellence in Critical Care Units." Critical Care Medicine 44, no. 1 (January 2016): 1–2. http://dx.doi.org/10.1097/ccm.0000000000001490.

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Sax, Frederic L. "Utilization of Critical Care Units." Archives of Internal Medicine 147, no. 5 (May 1, 1987): 929. http://dx.doi.org/10.1001/archinte.1987.00370050125021.

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Massanari, R. Michael. "Nosocomial infections in critical care units." Critical Care Nursing Quarterly 11, no. 4 (March 1989): 45–57. http://dx.doi.org/10.1097/00002727-198903000-00006.

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Burdette-Taylor, Shelly R., and Jan Kass. "Heel Ulcers in Critical Care Units." Critical Care Nursing Quarterly 25, no. 2 (August 2002): 41–53. http://dx.doi.org/10.1097/00002727-200208000-00005.

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Honkus, Vicky L. "Sleep Deprivation in Critical Care Units." Critical Care Nursing Quarterly 26, no. 3 (July 2003): 179–91. http://dx.doi.org/10.1097/00002727-200307000-00003.

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Hurst, Sue, and Mike McMillan. "Innovative Solutions in Critical Care Units." Dimensions of Critical Care Nursing 23, no. 3 (2004): 125–28. http://dx.doi.org/10.1097/00003465-200405000-00009.

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Torrego Fernández, A. "Flexible bronchoscopy in critical care units." Medicina Intensiva (English Edition) 36, no. 6 (August 2012): 385–86. http://dx.doi.org/10.1016/j.medine.2012.08.002.

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López-Pueyo, M. J., F. Barcenilla-Gaite, R. Amaya-Villar, and J. Garnacho-Montero. "Antibiotic multiresistance in critical care units." Medicina Intensiva (English Edition) 35, no. 1 (January 2011): 41–53. http://dx.doi.org/10.1016/s2173-5727(11)70008-x.

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Dissertations / Theses on the topic "Critical care units"

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Almansour, Issa Mohammad Ali. "Transitioning towards end-of-life care in Jordanian critical care units : health care professionals' perspectives." Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/29464/.

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This study explored the experiences of Jordanian critical care staff about the transition to, and provision of, end of life care. It examined the difficulties they encountered, and how they sought to care for and communicate with the families of patients who were approaching the end of life. The study took place in two University hospitals in different cities. A mixed methods design in two phases was adopted. The first phase employed the “National Survey of Critical Care Nurses' Perceptions of End-of-Life Care” (adapted with permission) to elicit the views of critical care staff (N=104) about the obstacles and facilitators to providing end of life care for critically ill patients and their families. In the second phase, qualitative interviews were conducted with staff (15 nurses; 10 junior doctors; 5 head nurses). The key overarching finding from the study is that staff experience moral distress when working with critically ill patients whom they perceive to be dying. There were three main dimensions to the experience of moral distress: First, nurses experience moral distress when they are aware when the patients are likely to die, know that continuing life sustaining treatment is futile and yet are expected to continue to provide treatment as normal to the patients. Aggressive modalities of treatments are usually pursued for most terminally ill patients, with both nurses and doctors perceiving there to be no planned, clear or distinct transition from curative focused care to end of life care. Second, with regard to their relationship with patients’ families, the staff found themselves to be in a problematic and paradoxical situation. One the one hand, they expected patients’ families to take the lead in the care decision making process and perceived that the power in decision-making should lie with patients’ relatives; but on the other hand, they also perceived that it is difficult and sometimes impossible to disclose bad news openly to families meaning that families are not fully informed in a way that would enable them to take the lead in the care decision making process. Third, staff have an appreciation of the principles of end of life decision making as a team activity and as a collaborative venture, but they are not able to put these principles into practice for many reasons, ranging from difficulties in their relationships with each other to health care system factors. This study sheds light on two central ethical problems in end of life decision-making in Jordan: the problem of disclosure of terminal prognosis at the end of life and limited involvement of nurses and junior doctors in the process of end of life communication and decision making. The study recommendations focus on developing practice in and disseminating understanding of ethically sound end of life decision-making.
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Singleton, Alsy R. "Patient satisfaction with nursing care : a comparison analysis of critical care and medical units." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1061875.

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Patient satisfaction is an outcome of care that represents the patient's judgment on the quality of care. An important aspect of quality affecting patient's judgment can be attributed to patients' expectations and experiences regarding nursing care according to type of unit. The purpose of this study was to examine differences between patients' perceptions of satisfaction with nursing care in critical care units and medical units in one Midwestern hospital.The conceptual framework was "A Framework of Expectation" developed by Oberst in 1984, which asserted that patients have expectations of hospitals and health care professionals regarding satisfaction and dissatisfaction with care. The instrument used to measure patient satisfaction was Risser's Patient Satisfaction Scale, with three dimensions of patient satisfaction: (a) Technical-Professional, (b) Interpersonal-Educational, (c) Interpersonal-Trusting. The convenience sample included 99 patients50 from critical care units and 49 from medical wards. Participation was voluntary. The study design was comparative descriptive and data was analyzed using a t-test.The demographic data showed that the majority of patients had five or more admission. About one-third of the patients were 45-55, 56-65, 66-75, respectively. Findings related to the research questions were that: (a) 84 percent of the respondents rated overall satisfaction in the satisfactory to excellent range, (b) results of a t-test showed significant differences in overall patient satisfaction with patients being more satisfied with care in critical care units. Significant differences were found in three subscales with critical care being more satisfied. No relationship was found between patient satisfaction and age/and/or type of unit.Conclusions were that in both medical and critical care units patients were more satisfied with Technical-Professional and Interpersonal-Trusting than with Interpersonal-Educational. Also noted was that patients in the units where nurse-to-patient ratio was higher participants perceived that nurses had more time, energy and ability to meet patient expectation. Implications call for analysis of nurse/patient ratio in relation to patient satisfaction and nurses in relation to patient education as well as patient's perceptions of getting their needs met.
School of Nursing
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Anthonie, Ramona F. G. "The experiences of critical nurses regarding staffing management in critical care units in private hospitals of the Cape Metropole." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71776.

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Thesis (MCurr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Nurse managers are responsible to staff different hospital units and departments with sufficient, trained and experienced personnel. Most critical care units in the private healthcare in South Africa are staffed below maximum workload levels and additional staff is supplemented when needed. Current staffing management strategies comprises the application of the patient acuity score, the utilisation of contracted agency staff and ward staff who assist occasionally in the critical care unit (CCU). The aim of the study was to explore the experiences of critical care nurses regarding staffing management within critical care units in private health care institutions in the Western Cape. The following objectives were set to: - explore the experiences of CCNs regarding staffing management strategies such as o the patient acuity score o the employment of ad hoc agency staff and o the utilization of ward staff A descriptive design with a qualitative approach was applied. A sample size of n=15 was drawn from a total population of N=377, using purposive sampling technique. A pilot-test was also completed. The trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability. All ethical principles were met. The findings of the study demonstrated that nurses perceive the workload in critical care units as heavy. The utilisation of the acuity score does not really assist in relieving the workload as managers tend not to consider the staffing requirements as predicted by the acuity score due to budget constraints. The enrolled nurses who assist occasionally in the critical care unit require supervision as well as ongoing development to ensure safe and quality patient care. Yet agency nurses were perceived as either extraordinary good or incompetent.
AFRIKAANSE OPSOMMING: Verpleegbestuurders het die verantwoordelik om verskillende hospitaaleenhede en departemente met voldoende opgeleide en ervare personeel te voorsien. Die meeste kritieke sorgeenhede in Suid-Afrika word met minder as dan die maksimum werkladingsvlak beman en addisionele personeel word aangevul wanneer nodig. Huidige personeelbestuurstrategieë behels die toepassing van die pasiënt akuïteit telling, die gebruik van ingekontrakteerde agentskap-personeel en saalpersoneel wat per geleentheid in die kritiekesorgeenheid help. Die doel van die studie was om die ervaringe van kritieke-sorgverpleegsters ten opsigte van personeel bestuur binne die kritiekesorgeenhede in die privaat gesondheidsorginstellings in die Weskaap, te ondersoek. Die volgende doelwitte is gestel: - Om die ervaringe van kritieke-sorgverpleegsters aangaande personeelbestuur-strategieë te ondersoek, soos: o die pasiënt akuïteit telling o die gebruik van agentskapverpleegpersoneel en o die gebruik van saal personeel, te ondersoek ’n Beskrywende kwalitatiewe studie is toegepas. ’n Steekproef van n=15 is uit ’n totale populasie van N=377 getrek deur die doelgerigte steekproeftegniek te gebruik. ’n Loodstoetsing van die semi-gestruktureerde vraelys is ook gedoen. Die betroubaarheid van hierdie studie was verseker deur van Lincoln en Guba se kriteria vir geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid gebruik te maak. Daar is aan alle etiese vereistes voldoen. Die bevindings van die studie toon dat die verpleegpersoneel die werklading in die kritiekesorgeenheid as veeleisend ervaar. Die aanwending van die pasiënt akuïteit-telling dra nie werklik by tot verligting van die werklading nie, aangesien bestuurders weens begrotingsbeperkings neig om nie die personeelbenodigdhede soos deur die akuïteit-telling voorspel in ag neem nie. Die ingeskrewe verpleegsters wat per geleentheid in die kritieke-sorgeenheid hulp verleen, benodig toesig asook volgehoue ontwikkeling ten einde veilige en kwaliteit pasiëntsorg te verseker. Die agentskapverpleegpersoneel is egter as baie bekwaam of onbevoeg beskou.
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Mallory, Caitlin Brook. "Critical Care Nurses' Experiences of Family Behaviors as Obstacles in End-of-Life Care." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6903.

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Background: Critical care nurses (CCNs) frequently provide end-of-life care for critically ill patients. CCNs may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care. Objective: What are the predominant themes noted when CCNs share their experiences of common obstacles, relating to families in providing EOL care? Methods: A random geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses was surveyed. Responses from a qualitative question on the questionnaire were analyzed. Results: Sixty-seven EOL obstacle experiences surrounding issues with families' behavior were analyzed for this study. Experiences were categorized into 8 themes. Top three common obstacle experiences included families in denial, families going against patient wishes and advance directives, and families directing care which negatively impacted patients. Conclusions: In overcoming EOL obstacles, it may be beneficial to have proactive family meetings to align treatment goals and to involve palliative care earlier in the ICU stay.
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Pretorius, Ronel. "Positive practice environments in critical care units : a grounded theory / Ronel Pretorius." Thesis, North-West University, 2009. http://hdl.handle.net/10394/4005.

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INTRODUCTION AND AIM: The current shortage of nurses is a concern shared by the healthcare industry globally. Whilst the reasons for these shortages are varied and complex, a key factor among them seem to involve an unhealthy work environment. The demanding nature of the critical care environment presents a challenge to many nursing professionals and it carries the risk of a high turn over rate due to the stress and intensity of the critical care environment. The critical care nurse is responsible for caring for the most ill patients in hospitals and the acute shortage of critical care nurses contributes to the intensity and pressures of this environment. Little evidence exists of research conducted to explore and describe the practice environment of the critical care nurse in South Africa. The main aim of this research study was to construct a theory for positive practice environments in critical care units in South Africa, grounded in the views and perceptions of critical care nurses working in the private hospital context. In recognition of the fact that a positive practice environment is considered to be the foundation for the successful recruitment and retention of nurses, it was clear that issues related to staff shortages will not be resolved unless the unhealthy work environment of nurses is adequately addressed. RESEARCH DESIGN AND METHOD: A constructivist grounded theory design was selected to address the inquiry at hand. The study was divided into two phases and pragmatic plurality allowed the use of both quantitative and qualitative data collection methods to explore, describe and contextualise the data in order to achieve the overall aim of the study. In phase one, a checklist developed by the researcher was used to describe the demographic profile of the critical care units (n=31) that participated in the study. The perceptions of critical care nurses (n=298) regarding their current practice environment was explored and decribed by using a valid and reliable instrument, the Practice Environment Scale of the Nursing Work Index (PES-NWI). In phase two, the elements of a positive practice environment were explored and described by means of intensive interviews with critical care nurses (n=6) working in the critical care environment. Concepts related to the phenomenon under investigation were identified by means of an inductive analysis of the data through a coding process and memo-writing. One core conceptual category and six related categories emerged out of the data. In the final phase of the theoretical sampling of the literature, a set of conclusions relevant to the phenomenon under study was constructed. The conclusions deduced from the empirical findings in both phases of the research process were integrated with those derived from the literature review to provide the foundation from which the theory was constructed. FINDINGS: The findings from the first phase of the research process provided information about the context in which the participants operate and assisted in discovering concepts considered relevant to the phenomenon under investigation. A grounded theory depicting the core conceptual category of "being in controi" and its relation to the other six categories was constructed from the data in order to explain a positive practice environment for critical care units in the private healthcare sector in South Africa.
Thesis (Ph.D. (Nursing))--North-West University, Potchefstroom Campus, 2010.
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Ezennaya, Chidiogo. "Critical care Nurses Experiences of Taking Reports of Patients From Other Units." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-21489.

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The critical care unit (CCU) is a unit where different health care professionals work together to care for the patient efficiently. A lot of studies in the past have shown that good communication and transfer of information from one health care professional to the other is an essential aspect in the transfer of a patients care. Most of these studies are concentrated on the reporter or informant. Lapses in communication and information transfer could result in unnecessary suffering both for the patient and for the health care worker. There are very few studies on how well the recipient of the information or report understands or comprehends the information passed. The aim of this study was to illuminate the critical care nurses (CCN) experiences of receiving report of patients transferred from other units. A qualitative design was chosen and five CCNs in a particular CCU were interviewed. The analysis was done using the content analysis method. The analysis resulted in four main categories which are: The patient’s situation-a determinant factor, the work environment, communication deficit creates uncertainty and structure enhances report and ten subcategories. The findings showed that CCNs' experience a feeling of uncertainty as a result of lapses in communication and their work environment and its attendant distractions has a great influence on the quality of the report they receive. To ensure a good quality of care that promotes patient’s safety and job satisfaction, it would be necessary to address the factors that hinder effective communication during handover in nurses' education programs and clinical practices.
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Lamoreaux, Nicole. "Critical Care Nurses' Perceptions of End-of-Life Care: Comparative 17-year Data." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6382.

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BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end-of-life (EOL). Providing high quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made over the last 17 years.OBJECTIVE: To determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether or not meaningful changes have occurred since data were first gathered in 1998.METHODS: A quantitative-qualitative mixed methods design was used. A random, geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses was surveyed.RESULTS: Five obstacle items increased in mean score and rank as compared to 1999 data including: (1) family not understanding what the phrase "life-saving measures" really means; (2) providing life-saving measures at families' requests despite patient's advance directive listing no such care; (3) family not accepting patient's poor prognosis; (4) family members fighting about use of life support; and, (5) not enough time to provide EOL care because the nurse is consumed with life-saving measures attempting to save the patient's life. Five obstacle items decreased in mean score and rank compared to 1999 data including (1) physicians differing in opinion about care of the patient; (2) family and friends who continually call the nurse rather than calling the designated family member; (3) physicians who are evasive and avoid families; (4) nurses having to deal with angry families; and, (5) nurses not knowing their patient's wishes regarding continuing with tests and treatments.CONCLUSIONS: Obstacles in EOL care, as perceived by critical care nurses, still exist. Family-related obstacles have increased over time and may not be easily overcome as each family, dealing with a dying family member in an ICU, likely has never experienced a similar situation. Based on the current top five obstacles, recommendations for possible areas of focus may include (1) improved nursing assessment regarding the health literacy of families followed with directed, appropriate, and specific EOL information, (2) improved care coordination between physicians and other health care providers to facilitate sharing care plans, (3) advanced directives that are followed as written by patients, (4) designated family contact communicating with family and friends regarding patient information, and, finally, (5) earlier, transparent discussions of patient prognoses as disease processes advance and patient conditions deteriorate.
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Ramsey, Priscilla W., James Cathelyn, Beverly Gugliotta, and L. Lee Glenn. "Visitor and Nurse Satisfaction With a Visitation Policy Change in Critical Care Units." Digital Commons @ East Tennessee State University, 1999. https://dc.etsu.edu/etsu-works/7530.

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Studies have addressed the visitation needs of visitors and patients and the impact of visitation policies on nurses, but few studies compare the level of satisfaction between visitors and nurses when visitation policies change. The objectives of this study were to investigate whether a more liberal intensive care unit visitation policy satisfactorily met the needs and expectations of visitors and nurses. © 1999 Lippincott Williams and Wilkins, Inc.
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Raduma-Tomás, Michelle Amondi. "Doctors' shift handovers in acute medical units." Thesis, University of Aberdeen, 2012. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=186875.

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Aim and objectives: To describe the ideal doctors' shift handover process in a systematic fashion, and to identify tasks that should be performed, but are not consistently done. To understand the types of communication problems that may occur during the handover process, their causes, their likelihood of occurrence and their effect on patient safety. Method: Three studies were conducted in two, Scottish Acute Medical Units. A Hierarchical Task Analysis was performed and data was collected by means of interviews and focus groups. Observations of doctors' actual shift handover process were compared against the description of doctors' ideal handover process. To examine potential failures modes, a Healthcare Failure Modes and Effects Analysis was performed using focus group interviews. Results: The handover process entailed the pre-handover, the handover, and the post- handover phases. Multiple critical steps in the process were omitted by outgoing shift doctors. The pre-handover was particularly vulnerable to information omission, with over 50% of its critical tasks not being performed across a total of 62 observations. Nonetheless, most of these omissions were typically caught during the handover meeting, especially if incoming doctors participated in pre-handover activities. Post-handover activities involved prioritizing and delegating clinical tasks. However these were observed not to happen consistently due to multiple interruptions. Thirty-four failure modes were identified, with eight of them posing a significant risk to patient safety. The studies found that interruptions, patient workload, and a lack of standardised procedures were the biggest causes for information loss during the handover process. Conclusions: There are key critical tasks necessary for an ideal doctors' shift handover process. A simple, handover process checklist may ensure critical handover tasks have been achieved prior to any shift change. Interruptions, patient workload, peer trust, and a lack of standard operating procedures are areas that future handover research should examine.
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Fataar, Danielle. "Endotracheal tube verification in the mechanically ventilated patient in a critical care unit." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1008057.

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Critically ill patients often require assistance by means of intubation and mechanical ventilation to support their spontaneous breathing if they are unable to maintain it. Mechanical ventilation is one of the most commonly used treatment modalities in the care of the critically ill patient and up to 90% of patients world-wide require mechanical ventilation during some or most parts of their stay in critical care units Management of a patient’s airway is a critical part of patient care both in and out of hospital. Although there are many methods used in verifying the correct placement of the endotracheal tube, the need and ability to verify placement of an endotracheal tube correctly is of utmost importance, because many complications can occur should the tube be incorrectly placed. Since unrecognized oesophageal intubation can have many disastrous effects on patients, various methods for verifying correct endotracheal tube placement have been developed and considered. Some of these methods include direct visualization, end-tidal carbon dioxide measurement and oesophageal detector devices. This research study aimed to explore and describe the existing literature on the verification of endotracheal tubes in the mechanically ventilated patient in the critical- care unit. A systematic review was done in order to operationalize the primary objective. Furthermore, based on the literature collected from the systematic review, recommendations for the verification of the endotracheal tube in the mechanically ventilated patient in the critical care unit were made. Ethical considerations were maintained throughout the study and the quality of the systematic review was ensured by performing a critical appraisal of the evidence found.
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Books on the topic "Critical care units"

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M, Civetta Joseph, Taylor Robert W. 1949-, and Kirby Robert R, eds. Critical care. Philadelphia: Lippincott, 1988.

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Textbook of critical care. 6th ed. Philadelphia, PA: Elsevier/Saunders, 2011.

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1929-, Ayres Stephen M., ed. Textbook of critical care. 3rd ed. Philadelphia: Saunders, 1995.

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Critical care emergency medicine. New York: McGraw-Hill Medical, 2012.

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Udwadia, Farokh Erach. Principles of critical care. New Delhi: Oxford University Press, 1999.

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M, Rippe James, ed. Intensive care medicine. 2nd ed. Boston: Little, Brown, 1991.

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Critical care manual: A systems approach method. 3rd ed. New Hyde Park, NY: Medical Examination Pub. Co., 1985.

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R, Cutler Lee, and Robson Wayne P, eds. Critical care outreach. Chichester, West Sussex, England: Wiley, 2006.

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M, Clochesy John, ed. Critical care nursing. Philadelphia: W.B. Saunders Co., 1993.

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Joseph, Layon A., Yu Mihae, and Civetta Joseph M, eds. Civetta, Taylor, and Kirby's manual of critical care. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health, 2012.

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Book chapters on the topic "Critical care units"

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Agarwala, Rita, Ben Singer, and Sreekumar Kunnumpurath. "Palliative Care in Critical Care Units." In Essentials of Palliative Care, 417–39. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-5164-8_24.

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O’Mahony, Michelle, and Tim Wigmore. "Early Warning Systems and Oncological Critical Care Units." In Oncologic Critical Care, 1–12. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74698-2_7-1.

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Booker, Kathy J. "Philosophy and treatment in US critical care units." In Critical Care Nursing, 1–12. Hoboken, NJ: John Wiley & Sons, Inc., 2015. http://dx.doi.org/10.1002/9781118992845.ch1.

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O’Mahony, Michelle, and Tim Wigmore. "Early Warning Systems and Oncological Critical Care Units." In Oncologic Critical Care, 75–86. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_7.

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Cadenhead, Charles D. "Architectural Design of Critical Care Units: A Comparison of Best Practice Units and Design." In Pediatric Critical Care Medicine, 17–32. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6362-6_3.

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Bone, Roger C., James R. Vevaina, and John R. Dunne. "Legal Problems in Critical Care Units." In Legal Aspects of Medicine, 85–97. New York, NY: Springer New York, 1989. http://dx.doi.org/10.1007/978-1-4612-4534-6_13.

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Soomro, Kamran, Elias Pimenidis, and Chris McWilliams. "Supporting Patient Nutrition in Critical Care Units." In Engineering Applications of Neural Networks, 128–36. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-08223-8_11.

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Ostrowky, Belinda E., and William R. Jarvis. "Challenges in Outbreak Investigations in Intensive Care Units." In Critical Care Infectious Diseases Textbook, 377–403. Boston, MA: Springer US, 2001. http://dx.doi.org/10.1007/978-1-4615-1679-8_22.

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Barach, P., M. Potter Forbes, and I. Forbes. "Designing Safe Intensive Care Units of the Future." In Intensive and Critical Care Medicine, 525–41. Milano: Springer Milan, 2009. http://dx.doi.org/10.1007/978-88-470-1436-7_40.

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Le Gall, J. R., and E. Azoulay. "How to Evaluate Performance of Adult Intensive Care Units: A 30Year Experience." In Intensive and Critical Care Medicine, 97–103. Milano: Springer Milan, 2005. http://dx.doi.org/10.1007/88-470-0350-4_9.

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Conference papers on the topic "Critical care units"

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Wallace, David J., Amber E. Barnato, Andrew Kramer, Derek Angus, and Jeremy M. Kahn. "Structures And Processes Of Care In Intensivist-Staffed Critical Care Units." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a1021.

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Egozcue-Dionisi, Monica, Rosangela Fernandez-Medero, Ricardo Fernandez, Gloria M. Rodriguez-Vega, and Raul Reyes-Sosa. "Puerto Rico's Intensive Care Units: An Overview Of Critical Care Medicine." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a3161.

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Bouchillon, Samuel K., Meredith Hackel, Daryl Hoban, Brian Johnson, Robert Badal, Jack Johnson, Stephen Hawser, and Michael Dowzicky. "Evaluating Multi-Drug Resistant Acinetobacter Baumannii In Critical Care Units." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5830.

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Zaidi, G. Z., A. Tsegaye, S. Ahn, and M. Narasimhan. "Assessment of Burnout in Critical Care Physicians Across 23 Intensive Care Units in a Large Health System: A Survey Based Study." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4294.

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Checkley, William, Gregory S. Martin, Samuel Brown, Steven Y. Chang, Ousama Dabbagh, Richard Fremont, Timothy D. Girard, et al. "Organizational Structure Of 27 Intensive Care Units In The United States: Critical Illness Outcomes Study (CIOS)." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a1020.

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Ostendorf, Andreas, Markus Grafen, Sven Delbeck, Hendrik Busch, and Herbert M. Heise. "Evaluation and benchmarking of an EC-QCL-based mid-infrared spectrometer for monitoring metabolic blood parameters in critical care units." In Optical Diagnostics and Sensing XVIII: Toward Point-of-Care Diagnostics, edited by Gerard L. Coté. SPIE, 2018. http://dx.doi.org/10.1117/12.2289625.

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Renteria, Martha, Sam Bouchillon, Brian Johnson, Daryl Hoban, and Mike Dowzicky. "Tigecycline In Vitro Activity Against Vancomycin-Resistant Enterococci And Methicillin-Resistant Staphylococcus Aureus In Critical Care Units." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6084.

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Andreev, A., S. Khanuja, M. Gioia, J. K. Magruder, and S. Sahni. "The Middle of the Road - A Safety Net Hospital Pilot Study of Resident Placed Midline Catheters in Critical Care Units." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5298.

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Esteves Brandão, Maria, Joelma Silva, Ricardo Reis, Artur Vale, Bebiana Conde, and Abel Afonso. "Non-invasive ventilation for treatment of acute and chronic exacerbated respiratory failure: What to expect outside the critical care units?" In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa2184.

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Filss, Martin, and Christian Wallner. "Evaluation of the Safety of Mobile Units for the Conditioning of Radioactive Waste." In ASME 2013 15th International Conference on Environmental Remediation and Radioactive Waste Management. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/icem2013-96056.

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In Germany mobile units are used to treat and condition radioactive waste. On behalf of the relevant authorities TUV SUD Industrie Service GmbH evaluates their safety. In this paper we outline the general procedure we apply and point out typical results. Generally, a generic safety case evaluates the effects of incidents and accidents and its consequences for the workers and the public. Special care is necessary to define the radioactive inventory, the nuclide composition and the mobility of the radioactive substances. A systems analysis is carried out. Typical aspects to be considered are the handling procedures, the measurement devices and automatic actions. From the various possible malfunctions the critical ones have to be identified. Generally one or only a few scenarios have to be considered in detail.
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Reports on the topic "Critical care units"

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Driscoll, Dennis M. Burn Dressings: A Critical Indicator for Patient Care Classification in Burn Units. Fort Belvoir, VA: Defense Technical Information Center, January 1991. http://dx.doi.org/10.21236/ada251390.

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Ding, Huaze, Yiling Dong, Kaiyue Zhang, Jiayu Bai, and Chenpan Xu. Comparison of dexmedetomidine versus propofol in mechanically ventilated patients with sepsis: A meta-analysis of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0103.

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Review question / Objective: The aim of the present study was to evaluate the effects of dexmedetomidine compared with propofol in mechanically ventilated patients with sepsis. Condition being studied: Sepsis, which is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, contributes the highest mortality to intensive care units (ICU) worldwide . Because of the high incidence of respiratory failure in sepsis care, mechanical ventilation is always adopted to give life support and minimize lung injury . And sedation is a necessary component of sepsis care who suffers from mechanical ventilation. The Society of Critical Care Medicine suggested using either propofol or dexmedetomidine for sedation in mechanically ventilated adults. However, it remained unknown whether patients with sepsis requiring mechanical ventilation will benefit from sedation with dexmedetomidine.
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Sajjanhar, Anuradha, and Denzil Mohammed. Immigrant Essential Workers During the COVID-19 Pandemic. The Immigrant Learning Center Inc., December 2021. http://dx.doi.org/10.54843/dpe8f2.

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The COVID-19 pandemic affected everyone in the United States, and essential workers across industries like health care, agriculture, retail, transportation and food supply were key to our survival. Immigrants, overrepresented in essential industries but largely invisible in the public eye, were critical to our ability to weather the pandemic and recover from it. But who are they? How did they do the riskiest of jobs in the riskiest of times? And how were both U.S.-born and foreign-born residents affected? This report explores the crucial contributions of immigrant essential workers, their impact on the lives of those around them, and how they were affected by the pandemic, public sentiment and policies. It further explores the contradiction of immigrants being essential to all of our well-being yet denied benefits, protections and rights given to most others. The pandemic revealed the significant value of immigrant essential workers to the health of all Americans. This report places renewed emphasis on their importance to national well-being. The report first provides a demographic picture of foreign-born workers in key industries during the pandemic using U.S. Census Bureau American Community Survey (ACS) data. Part I then gives a detailed narrative of immigrants’ experiences and contributions to the country’s perseverance during the pandemic based on interviews with immigrant essential workers in California, Minnesota and Texas, as well as with policy experts and community organizers from across the country. Interviewees include: ■ A food packing worker from Mexico who saw posters thanking doctors and grocery workers but not those like her working in the fields. ■ A retail worker from Argentina who refused the vaccine due to mistrust of the government. ■ A worker in a check cashing store from Eritrea who felt a “responsibility to be able to take care of people” lining up to pay their bills. Part II examines how federal and state policies, as well as increased public recognition of the value of essential workers, failed to address the needs and concerns of immigrants and their families. Both foreign-born and U.S.-born people felt the consequences. Policies kept foreign-trained health care workers out of hospitals when intensive care units were full. They created food and household supply shortages resulting in empty grocery shelves. They denied workplace protections to those doing the riskiest jobs during a crisis. While legislation and programs made some COVID-19 relief money available, much of it failed to reach the immigrant essential workers most in need. Part II also offers several examples of local and state initiatives that stepped in to remedy this. By looking more deeply at the crucial role of immigrant essential workers and the policies that affect them, this report offers insight into how the nation can better respond to the next public health crisis.
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Bullard, Paulina, Emma Gadberry, Siham Sherif, Virginia Strawn, Courtney Travis, and Delaney Weller. Effects of Sensory Intervention on Neurological Development in the Neonatal Intensive Care Unit: A Critically Appraised Topic. University of Tennessee Health Science Center, May 2022. http://dx.doi.org/10.21007/chp.mot2.2022.0018.

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James-Scott, Alisha, Rachel Savoy, Donna Lynch-Smith, and tracy McClinton. Impact of Central Line Bundle Care on Reduction of Central Line Associated-Infections: A Scoping Review. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0014.

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Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use. Methods A literature review was completed of nine critically appraised articles from the years 2010-2021. The association of the use of central line bundles and CLABSI rates was examined. These relationships were investigated to determine if the adherence to a central line bundle directly reduced the number of CLABSI rates in critically ill adult patients. A summary evaluation table was composed to determine the associations related to the implementation or current central line bundle care use. Results Of the study sample (N=9), all but one demonstrated a significant decrease in CLABSI rates when a central line bundle was in place. A trend towards reducing CLABSI was noted in the remaining article, a randomized controlled study, but the results were not significantly different. In all the other studies, a meta-analysis, randomized controlled trial, control trial, cohort or case-control studies, and quality improvement project, there was a significant improvement in CLABSI rates when utilizing a central line bundle. The extensive use of different levels of evidence provided an excellent synopsis that implementing a central line bundle care would directly affect decreasing CLABSI rates. Implications for Nursing Practice Results provided in this scoping review afforded the authors a diverse level of evidence that using a central line bundle has a direct outcome on reducing CLABSI rates. This practice can be implemented within the hospital setting as suggested by the literature review to prevent or reduce CLABSI rates. Implementing a standard central line bundle care hospital-wide helps avoid this hospital-acquired infection.
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Arora, Sanjana, and Olena Koval. Norway Country Report. University of Stavanger, 2022. http://dx.doi.org/10.31265/usps.232.

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This report is part of a larger cross-country comparative project and constitutes an account and analysis of the measures comprising the Norwegian national response to the COVID-19 pandemic during the year of 2020. This time period is interesting in that mitigation efforts were predominantly of a non-medical nature. Mass vaccinations were in Norway conducted in early 2021. With one of the lowest mortality rates in Europe and relatively lower economic repercussions compared to its Nordic neighbours, the Norwegian case stands unique (OECD, 2021: Eurostat 2021; Statista, 2022). This report presents a summary of Norwegian response to the COVID-19 pandemic by taking into account its governance, political administration and societal context. In doing so, it highlights the key features of the Nordic governance model and the mitigation measures that attributed to its success, as well as some facets of Norway’s under-preparedness. Norway’s relative isolation in Northern Europe coupled with low population density gave it a geographical advantage in ensuring a slower spread of the virus. However, the spread of infection was also uneven, which meant that infection rates were concentrated more in some areas than in others. On the fiscal front, the affluence of Norway is linked to its petroleum industry and the related Norwegian Sovereign Wealth Fund. Both were affected by the pandemic, reflected through a reduction in the country’s annual GDP (SSB, 2022). The Nordic model of extensive welfare services, economic measures, a strong healthcare system with goals of equity and a high trust society, indeed ensured a strong shield against the impact of the COVID-19 pandemic. Yet, the consequences of the pandemic were uneven with unemployment especially high among those with low education and/or in low-income professions, as well as among immigrants (NOU, 2022:5). The social and psychological effects were also uneven, with children and elderly being left particularly vulnerable (Christensen, 2021). Further, the pandemic also at times led to unprecedented pressure on some intensive care units (OECD, 2021). Central to handling the COVID-19 pandemic in Norway were the three national executive authorities: the Ministry of Health and Care services, the National directorate of health and the Norwegian Institute of Public Health. With regard to political-administrative functions, the principle of subsidiarity (decentralisation) and responsibility meant that local governments had a high degree of autonomy in implementing infection control measures. Risk communication was thus also relatively decentralised, depending on the local outbreak situations. While decentralisation likely gave flexibility, ability to improvise in a crisis and utilise the municipalities’ knowledge of local contexts, it also brought forward challenges of coordination between the national and municipal level. Lack of training, infection control and protection equipment thereby prevailed in several municipalities. Although in effect for limited periods of time, the Corona Act, which allowed for fairly severe restrictions, received mixed responses in the public sphere. Critical perceptions towards the Corona Act were not seen as a surprise, considering that Norwegian society has traditionally relied on its ‘dugnadskultur’ – a culture of voluntary contributions in the spirit of solidarity. Government representatives at the frontline of communication were also open about the degree of uncertainty coupled with considerable potential for great societal damage. Overall, the mitigation policy in Norway was successful in keeping the overall infection rates and mortality low, albeit with a few societal and political-administrative challenges. The case of Norway is thus indeed exemplary with regard to its effective mitigation measures and strong government support to mitigate the impact of those measures. However, it also goes to show how a country with good crisis preparedness systems, governance and a comprehensive welfare system was also left somewhat underprepared by the devastating consequences of the pandemic.
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Kim, Changmo, Ghazan Khan, Brent Nguyen, and Emily L. Hoang. Development of a Statistical Model to Predict Materials’ Unit Prices for Future Maintenance and Rehabilitation in Highway Life Cycle Cost Analysis. Mineta Transportation Institute, December 2020. http://dx.doi.org/10.31979/mti.2020.1806.

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The main objectives of this study are to investigate the trends in primary pavement materials’ unit price over time and to develop statistical models and guidelines for using predictive unit prices of pavement materials instead of uniform unit prices in life cycle cost analysis (LCCA) for future maintenance and rehabilitation (M&R) projects. Various socio-economic data were collected for the past 20 years (1997–2018) in California, including oil price, population, government expenditure in transportation, vehicle registration, and other key variables, in order to identify factors affecting pavement materials’ unit price. Additionally, the unit price records of the popular pavement materials were categorized by project size (small, medium, large, and extra-large). The critical variables were chosen after identifying their correlations, and the future values of each variable were predicted through time-series analysis. Multiple regression models using selected socio-economic variables were developed to predict the future values of pavement materials’ unit price. A case study was used to compare the results between the uniform unit prices in the current LCCA procedures and the unit prices predicted in this study. In LCCA, long-term prediction involves uncertainties due to unexpected economic trends and industrial demand and supply conditions. Economic recessions and a global pandemic are examples of unexpected events which can have a significant influence on variations in material unit prices and project costs. Nevertheless, the data-driven scientific approach as described in this research reduces risk caused by such uncertainties and enables reasonable predictions for the future. The statistical models developed to predict the future unit prices of the pavement materials through this research can be implemented to enhance the current LCCA procedure and predict more realistic unit prices and project costs for the future M&R activities, thus promoting the most cost-effective alternative in LCCA.
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Berkman, Nancy D., Eva Chang, Julie Seibert, Rania Ali, Deborah Porterfield, Linda Jiang, Roberta Wines, Caroline Rains, and Meera Viswanathan. Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer246.

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Background. In the United States, patients referred to as high-need, high-cost (HNHC) constitute a very small percentage of the patient population but account for a disproportionally high level of healthcare use and cost. Payers, health systems, and providers would like to improve the quality of care and health outcomes for HNHC patients and reduce their costly use of potentially preventable or modifiable healthcare services, including emergency department (ED) and hospital visits. Methods. We assessed evidence of criteria that identify HNHC patients (best fit framework synthesis); developed program theories on the relationship among contexts, mechanisms, and outcomes of interventions intended to change HNHC patient behaviors (realist review); and assessed the effectiveness of interventions (systematic review). We searched databases, gray literature, and other sources for evidence available from January 1, 2000, to March 4, 2021. We included quantitative and qualitative studies of HNHC patients (high healthcare use or cost) age 18 and over who received intervention services in a variety of settings. Results. We included 110 studies (117 articles). Consistent with our best fit framework, characteristics associated with HNHC include patient chronic clinical conditions, behavioral health factors including depression and substance use disorder, and social risk factors including homelessness and poverty. We also identified prior healthcare use and race as important predictors. We found limited evidence of approaches for distinguishing potentially preventable or modifiable high use from all high use. To understand how and why interventions work, we developed three program theories in our realist review that explain (1) targeting HNHC patients, (2) engaging HNHC patients, and (3) engaging care providers in these interventions. Theories identify the need for individualizing and tailoring services for HNHC patients and the importance of building trusting relationships. For our systematic review, we categorized evidence based on primary setting. We found that ED-, primary care–, and home-based care models result in reduced use of healthcare services (moderate to low strength of evidence [SOE]); ED, ambulatory intensive caring unit, and primary care-based models result in reduced costs (low SOE); and system-level transformation and telephonic/mail models do not result in changes in use or costs (low SOE). Conclusions. Patient characteristics can be used to identify patients who are potentially HNHC. Evidence focusing specifically on potentially preventable or modifiable high use was limited. Based on our program theories, we conclude that individualized and tailored patient engagement and resources to support care providers are critical to the success of interventions. Although we found evidence of intervention effectiveness in relation to cost and use, the studies identified in this review reported little information for determining why individual programs work, for whom, and when.
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Wandeler, Christian, and Steve Hart. The Central Valley Transportation Challenge. Mineta Transportation Institute, December 2022. http://dx.doi.org/10.31979/mti.2022.2029.

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The Central Valley Transportation Challenge provides underserved minority students, who are primarily from rural areas, with high quality transportation-related educational experiences so that they learn about transportation-related topics and opportunities in transportation careers. The CVTC is a project-based learning program that brings university faculty and students to K–12 classrooms in rural areas. The project operated with three main objectives: (1) support K–12 teachers’ understanding and implementation of the CVTC programs; (2) connect K–12 students with university faculty and students, and transportation professionals through the CVTC program; and (3) develop an online hub with transportation-related lesson plans and sequences. The results of this study are reported as five case studies and a description of the online hub. The case studies illustrate how different pedagogical approaches and uses of technology were implemented and how the project connections between the schools, community members and professionals from transportation-related fields were developed. In addition, to support the sustainability of transportation-related learning across subsequent years, the research team created an online transportation resource repository. This hub was populated with lessons and units developed by pedagogical and content experts. The lessons cover the grades K–12 and range from brief lessons to very engaging and holistic two-week-long lesson sequences. The CVTC has proven to be a highly flexible and adaptive model due to the use of technology and the teachers’ experience and pedagogical expertise. The timing of the program during the COVID-19 pandemic also provided the students that were learning from home with an engaging learning experience and some relief for teachers who were already dealing with a lot of adjustments. In that sense, the program reached traditionally underserved students, but did so in a critical time where these students faced even more obstacles.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.

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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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