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Academic literature on the topic 'Intensive care units - Evaluation'

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Published: 4 June 2021
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Journal articles on the topic "Intensive care units - Evaluation"

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BAYRAKCI, Benan, Selman KESİCİ, Tanıl KENDİRLİ, Gökhan KALKAN, Aydın SARI, Necvan TOKMAK, Gökmen YILMAZ, Orkun BALOĞLU, and İrfan ŞENCAN. "Evaluation report of pediatric intensive care units in Turkey." TURKISH JOURNAL OF MEDICAL SCIENCES 44 (2014): 1073–86. http://dx.doi.org/10.3906/sag-1307-102.

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ÜZEN CURA, Şengül, Aysel ÖZSABAN, and Ela YILMAZ COŞKUN. "EVALUATION OF BEHAVIORAL CARE SCALES USED IN INTENSIVE CARE UNITS: SISTEMATIC REVIEW." INTERNATIONAL REFEREED JOURNAL OF NURSING RESEARCHES, no. 13 (2018): 0. http://dx.doi.org/10.17371/uhd.2018.2.5.

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Premaratne, S., H. Jagoda, M. M. Ikram, and A. Abayadeera. "Acquired-Hypernatraemia in the Intensive Care Units." Open Anesthesiology Journal 10, no. 1 (February 10, 2016): 1–7. http://dx.doi.org/10.2174/1874321801610010001.

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Objectives: Determine the incidence and predisposing factors of acquired-hypernatraemia in the intensive care units (ICU) and its impact on the outcome. Design: Observational cross-sectional study with prospective analysis. Setting: Surgical, medical and trauma intensive care units of National Hospital of Sri Lanka. Study Population: 174 consecutive patients were included in this study. Definition: Hypernatraemia was defined as serum sodium concentration > 145 mmol/l. Results: 74 patients (42.5%) developed hypernatraemia after admission to the intensive care units. Incidence in medical, surgical and trauma ICUs were 47%, 48% and 31% respectively. Significantly lower incidence was reported in patients with trauma compared to the patients from the other two ICUs. High APACHE II (Acute Physiology and Chronic Health Evaluation) score, low GCS (Glasgow Coma Scale), organ dysfunction, transfusion of blood and blood products were associated with an increased incidence of hypernatraemia. Hypernatraemic patients had received significantly greater volume of intravenous fluids exceeding their daily fluid requirement. Compared to normonatraemic patients, hypernatraemic patients demonstrated a longer length of stay (LOS) in the ICU (mean 4.8 days versus 11 days, p< 0.001) and a higher ICU-mortality rate (15% versus 43%, p<0.001). Conclusions: Severity of the illness, inappropriate intravenous fluid therapy and blood transfusions contribute to the incidence of hypernatraemia in intensive care units. It is associated with increased risk of ICU-mortality and longer length of stay in the ICU.
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Tutanc, Murat, Tanju Celik, Fatmagul Basarslan, Ali Gunes, Capan Konca, Servet Yel, and Mehmet Bosnak. "Evaluation of Cases of Diabetic Ketoascidosis in Intensive Care Units." Journal of Dr. Behcet Uz Children's Hospital 1, no. 3 (December 10, 2011): 121–25. http://dx.doi.org/10.5222/buchd.2011.121.

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Thrall, Samuel, Margaret K. Doll, Charles Nhan, Milagros Gonzales, Thérèse Perreault, Philippe Lamer, and Caroline Quach. "Evaluation of pentavalent rotavirus vaccination in neonatal intensive care units." Vaccine 33, no. 39 (September 2015): 5095–102. http://dx.doi.org/10.1016/j.vaccine.2015.08.015.

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Park, Sojin, Yongwon In, Gee young Suh, Kieho Sohn, and Eunyoung Kim. "Evaluation of adverse drug reactions in medical intensive care units." European Journal of Clinical Pharmacology 69, no. 1 (June 7, 2012): 119–31. http://dx.doi.org/10.1007/s00228-012-1318-2.

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Van Berkel, Megan, Marina Rabinovich, and Andrea Newsome. "913: EVALUATION OF CRITICAL CARE PHARMACIST-TO-PATIENT RATIOS IN INTENSIVE CARE UNITS." Critical Care Medicine 46, no. 1 (January 2018): 440. http://dx.doi.org/10.1097/01.ccm.0000528920.59351.25.

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Sari, Sema, Hayriye Cankar Dal, Ibrahim Mungan, Busra Tezcan, Dilek Kazanci, and Sema Turan. "Retrospective Evaluation of Non-neutropenic Candidemia Cases in Intensive Care Units." Turkish Journal of Medical and Surgical Intensive Care 9, no. 3 (December 17, 2018): 74–77. http://dx.doi.org/10.5152/dcbybd.2018.1799.

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Quin, G. "Chest pain evaluation units." Emergency Medicine Journal 17, no. 4 (July 1, 2000): 237–40. http://dx.doi.org/10.1136/emj.17.4.237.

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Jeong, Yu Jin, and Hyunjung Kim. "Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units." Journal of Korean Biological Nursing Science 20, no. 4 (January 12, 2017): 228–35. http://dx.doi.org/10.7586/jkbns.2018.20.4.228.

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Dissertations / Theses on the topic "Intensive care units - Evaluation"

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Lone, Nazir Iftikhar. "Evaluation of five year survival and major health care resource use following admission to Scottish intensive care units." Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/8826.

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Long-term outcomes for patients admitted to intensive care units (ICUs) are recognised to be of increasing importance. Published studies indicate that ICU survivors have significant physical impairment, impaired quality of life, and excess mortality during the post-ICU period. The period of excess mortality has been variously estimated as lasting from one to 16 years after ICU discharge. Remarkably little information about long-term mortality and healthcare resource use exists for critical care populations, and outcomes relative to a non-ICU control population are unknown. The aims of the studies presented in the thesis were (i) to describe long-term (five year) mortality and identify factors associated with mortality for patients admitted to ICUs in Scotland (ICU admission cohort) and those surviving to be discharged from hospital alive (ICU survivor cohort); (ii) to compare mortality rates with control populations after adjustment for relevant confounders; (iii) to evaluate the extent of, and factors associated with, long-term (five year) major healthcare resource use of survivors of critical illness (ICU survivor cohort); and (iv)to compare major healthcare resource use with a control hospital inpatient population. I undertook a detailed systematic review of the international literature relating to healthcare resource use in ICU survivors to inform the design of the part of the study relating to resource use. This revealed a paucity of high quality studies but led to recommendations for improving the conduct and reporting of future research in this field. Using both retrospective cohort and matched cohort study designs, I analysed data relating to all patients admitted to Scottish ICUs in 2005 from the Scottish Intensive Care Society Audit Group (SICSAG) database. Two cohorts were defined: an ICU admission cohort, representing all ICU admissions, and a subcohort of those who survived to hospital discharge (ICU survivor cohort). Matched control cohorts of non-ICU hospital inpatients were selected from national datasets. The main outcomes were five-year mortality and major healthcare resource use obtained from linkage to national datasets. Major healthcare use was measured by number of hospital readmissions, number of days spent in hospital and hospital costs during the five years after hospital discharge. Five year mortality was 53% in the ICU cohort compared with 27% for the matched control hospital cohort and 16% for an age/sex-standardised general population. Among hospital survivors, ICU patients had higher five year mortality after adjustment for confounders (HR 1.3, 95%CI 1.2 to 1.4, p<0.001). Age, comorbidity, ICU admission diagnosis and deprivation quintile were independently associated with five-year mortality. The ICU diagnosis with greatest five year mortality (relative to self-poisoning) was variceal bleeding (HR 3.9, 95%CI 2.2 to 6.7, p<0.001). The readmission rate for the 5259 ICU patients surviving to hospital discharge declined from 1.7 readmissions per person in the first year to 0.9 in the fifth year of follow-up. Overall, ICU survivors spent a mean of 29 days in hospital over the five year follow up period, at a cost of £14593 per person. Previous number of admissions was the factor most strongly associated with resource use. ICU patients had a significant increased rate of hospital admission compared with the control cohort throughout the five year follow up period (admission rate ratio 1.21 (95%CI 1.14 to 1.29, p<0.001)). In the programme of work presented in this thesis, I have systematically reviewed evidence for resource use following critical illness, and have demonstrated that ICU patients are more likely to die compared with other hospital inpatients over a five-year horizon, even when only hospital survivor cohorts are considered. Furthermore, I have demonstrated that ICU survivors utilise a significant amount of excess acute hospital resource, which is relevant to health service planning and economic evaluations.
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Cretikos, Michelle School of Anaesthetics Intensive Care &amp Emergency Medicine UNSW. "An evaluation of activation and implementation of the medical emergency team system." Awarded by:University of New South Wales. School of Anaesthetics, Intensive Care and Emergency Medicine, 2006. http://handle.unsw.edu.au/1959.4/25720.

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Problem investigated: The activation and implementation of the Medical Emergency Team (MET) system. Procedures followed: The ability of the objective activation criteria to accurately identify patients at risk of three serious adverse events (cardiac arrest, unexpected death and unplanned intensive care admission) was assessed using a nested, matched case-control study. Sensitivity, specificity and Receiver Operating Characteristic curve (ROC) analyses were performed. The MET implementation process was studied using two convenience sample surveys of the nursing staff from the general wards of twelve intervention hospitals. These surveys measured the awareness and understanding of the MET system, level of attendance at MET education sessions, knowledge of the activation criteria, level of intention to call the MET and overall attitude to the MET system, and the hospital level of support for change, hospital capability and hospital culture. The association of these measures with the intention to call the MET and the level of MET utilisation was assessed using nonparametric correlation. Results obtained: The respiratory rate was missing in 20% of subjects. Using listwise deletion, the set of objective activation criteria investigated predicted an adverse event within 24 hours with a sensitivity of 55.4% (50.6-60.0%) and specificity of 93.7% (91.2-95.6%). An analysis approach that assumed the missing values would not have resulted in MET activation provided a sensitivity of 50.4% (45.7- 55.2%) and specificity of 93.3% (90.8-95.3%). Alternative models with modified cut-off values provided different results. The MET system was implemented with variable success during the MERIT study. Knowledge and understanding of the system, hospital readiness, and a positive attitude were all significantly positively associated with MET system utilisation, while defensive hospital cultures were negatively associated with the level of MET system utilisation. Major conclusions: The objective activation criteria studied have acceptable accuracy, but modification of the criteria may be considered. A satisfactory trade-off between the identification of patients at risk and workload requirements may be difficult to achieve. Measures of effectiveness of the implementation process may be associated with the level of MET system utilisation. Trials of the MET system should ensure good knowledge and understanding of the system, particularly amongst nursing staff.
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Alamu, Josiah Olusegun Herwaldt Loreen A. "Evaluation of antimicrobial use in a pediatric intensive care unit." Iowa City : University of Iowa, 2009. http://ir.uiowa.edu/etd/277.

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Alamu, Josiah Olusegun. "Evaluation of antimicrobial use in a pediatric intensive care unit." Diss., University of Iowa, 2009. https://ir.uiowa.edu/etd/277.

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A pediatric intensivist in the University of Iowa Hospitals and Clinic's (UIHC) Pediatric Intensive Care Unit (PICU) was concerned about antimicrobial use in the unit. However, no one had quantified antimicrobial use in the UIHC's PICU or described the patterns of antimicrobial use in this unit. To address the intensivist's concern, the principal investigator (PI) conducted a retrospective study to determine the percentage of patients who received antimicrobial treatments, to determine the indications for antimicrobial use, and to identify antimicrobial agents used most frequently in the unit. On basis of our data, we hypothesized that empiric antimicrobial use, particularly the duration of therapy, could be decreased. We implemented a six-month intervention during which we asked the pediatric intensivists to complete an antimicrobial assessment form (AA) to document their rationale for starting antimicrobial treatments. We postulated that this documentation process might remind physicians to review antimicrobial therapies, especially empiric therapies, when the microbiologic data became available. In addition, we utilized the AA form to identify factors pediatric intensivists considered when deciding to prescribe empiric antimicrobial treatments. Data from the AA forms suggested that pediatric intensivists in the UIHC's PICU often considered elevated C-reactive protein, elevated white blood cell counts, and elevated temperatures when deciding to start empiric antimicrobial therapy. Data from the three nested periods showed that the median duration of empiric and targeted treatments decreased during the intervention and remained stable during the post-intervention period. The PI estimated that 193 days of empiric antimicrobial therapy and 59 days of targeted antimicrobial therapy, respectively, may have been saved by the decreased durations of therapy. Time series analysis assessing the trend in use of piperacillin-tazobactam, cefepime, and ceftriaxone (measured in mg/wk) did not reveal a significant change over time. On the basis of our results, an intervention strategy using an AA form alone may not be an effective strategy for antimicrobial stewardship in PICUs. Additional measures such as automatic stop orders and computer decision support may be useful for reducing the duration of empiric therapy in PICUs.
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Tridente, Ascanio. "Evaluating outcome in patients with faecal peritonitis admitted to European Intensive Care Units." Thesis, University of Sheffield, 2017. http://etheses.whiterose.ac.uk/19160/.

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Hanekom, Susan. "The implementation and evaluation of a best practice physiotherapy protocol in a surgical ICU." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5328.

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Bibliography
Thesis (PhD ( Interdisciplinary Health))--University of Stellenbosch, 2010.
Bibliography
ENGLISH ABSTRACT: Introduction: It is increasingly being recognized that how intensive care services are delivered may have a greater impact on patient outcome than the individual therapies. Uncertainty regarding the optimal physiotherapy service provision model in a surgical intensive care unit (ICU) exists. Methodology: The aims of this study were to 1) develop an evidence-based physiotherapy protocol; 2) validate the content of the protocol; and 3) conduct an explorative intervention trial to compare usual care to the estimated effects of providing a physiotherapy service guided by an evidence-based physiotherapy protocol by a dedicated physiotherapist. A systematic review process was used to synthesize the evidence in eight subject areas. The GRADE system was used to formulate best practice recommendations and algorithm statements. Forty-two experts from a variety of disciplines were invited to participate in a Delphi process. Finally, the evidence-based physiotherapy protocol was implemented in a surgical ICU over four three-week intervention periods by a group of research therapists. The outcomes measured included ventilator time, ventilation proportions, failed extubation proportions, length of ICU and hospital stay, mortality, functional capacity, functional ability and cost (using nursing workload as proxy). Results: Fifty-three research reports in eight subject areas were identified, 23 draft best-practice recommendations and 198 algorithm statements were formulated. The draft protocol consisted of five clinical management algorithms. Fifteen international research experts and twelve national academics in the field of critical care agreed to participate in the Delphi process. Consensus was reached on the formulation of 87% (20/23) recommendations and the rating of 66% (130/198) statements. The risk of an adverse event during the protocol care intervention period was 6:1000 treatment sessions (p=0.34). Patients admitted to the unit during the protocol care intervention period were less likely to be intubated (RR 0.16 95%CI 0.07 – 0.71; RRR 0.84 NNT 5.02; p=0.005) or fail extubation (RR 0.23 95%CI 0.05 – 0.98; RRR =0.77 NNT 6.95; p=0.04). The mean difference in the daily unit TISS-28 score between the two condition periods was 1.99 95%CI 0.65 – 3.35 (p=0.04). Patients managed by the protocol tended to remain in the hospital for a shorter time after unit discharge (p=0.05). There was no difference in the time spent on the ventilator (p=0.50), mortality (p=0.52) or in the six minute walk distance (p=0.65). In addition there was no difference in the proportion of patients who reached independence in any of the Barthel Index activities measured within 48 hours of discharge from the unit. Conclusions: The use of an evidence-based physiotherapy protocol for the comprehensive physiotherapeutic management of patients in a surgical ICU was feasible and safe. The preliminary results of this study suggest that a physiotherapy service, which is guided by an evidence-based protocol and offered by a dedicated unit therapist, has the potential to lower the cost of ICU care and facilitate the functional recovery of patients after unit discharge. This information can now be considered by administrators to optimize the physiotherapy service provided in ICU.
AFRIKAANSE OPSOMMING: Inleiding: Daar word toenemend erken dat die wyse waarop dienste gelewer word, ‘n groter impak mag hê op die uitkoms van pasiënte as die spesifieke modaliteite in gebruik. Onsekerheid heers tans oor die optimale fisioterapie diens model om te volg in ‘n chirurgiese intensiewe sorg eenheid (ISE). Metodologie: The doel van hierdie projek was om 1) ‘n bewysgesteunde protokol te ontwikkel; 2) die geldigheid van die protokol te bevestig; en 3) om deur middel van ‘n eksploratiewe studie die uitkoms van pasiënte te vergelyk wanneer die fisioterapie diens gelewer word aan die hand van die bewysgesteunde protokol deur ‘n toegewyde fisioterapeut, teenoor wanneer die gewone fisioterapie diens gelewer word. Die empiriese bewyse in agt onderwerp areas is gesintetiseer na afloop van ‘n sistematiese literatuur oorsig proses. Die GRADE sisteem is gebruik om beste praktyk aanbevelings en algoritme stellings te formuleer. Twee en veertig kundige persone van verskeie disiplines is genooi om deel te neem aan die Delphi proses om die geldigheid van die protokol te bevestig. Uiteindelik is die geldige bewysgesteunde protokol oor ‘n tydperk van vier drie weke intervensie periodes deur ‘n groep navorsings terapeute in ‘n chirurgiese ISE geïmplementeer. Die tyd wat pasiënte geventileer is, die proporsie pasiënte wat geïntubeer en geherintubeer is in die tydperk, die lengte van ISE en hospitaal verblyf, mortaliteit, funksionele kapasiteit asook funksionele vaardigheid en koste (deur die verpleeg werkslading te gebruik as ‘n indikasie van koste) is gemeet. Resultate: Drie en vyftig navorsings verslae in agt onderwerp areas is geïdentifiseer, 23 konsep aanbevelings en 198 algoritme stellings is geformuleer. Die konsep protokol het uit vyf algoritmes bestaan. Vyftien internasionale en twaalf nasionale kundiges het die uitnodiging aanvaar om aan die delphi proses deel te neem. Konsensus is bereik vir die formulering van 87% (20/23) van die aanbevelings en die gradering van 66% (130/198) van die algoritme stellings. Die risiko vir ‘n ongunstige episode tydens die protokol intervensie periode was 6:1000 sessies (p=0.34). Pasiënte wat tydens die protokol intervensie periode tot die eenheid toegelaat is was minder geneig om geïntubeer te word (RR 0.16 95%CI 0.07 – 0.71; RRR 0.84 NNT 5.02; p=0.005) of om ‘n ekstubasie te faal (RR 0.23 95%CI 0.05 – 0.98; RRR =0.77 NNT 6.95; p=0.04). Die gemiddelde verskil in die daaglikse eenheid TISS-28 telling tussen die twee intervensie periodes was 1.99 95%CI 0.65 – 3.35 (p=0.04). Patiente wat tydens die protokol intervensie periode behandel is was geneig om vinniger uit die hospitaal ontslaan te word nadat hul uit die eenheid ontslaan is (p=0.05). Daar was geen verskil in die ventilasie tyd, (p=0.50) die mortaliteit (p=0.52) of die afstand wat pasiente in ses minute kon aflê binne 48 uur na ontslag uit die eenheid (p=0.65) nie. Daar was ook geen verskil in die proporsie pasiente wat onafhanklikheid bereik het in enige van die kategorieë van die Barthell Index instrument nie. Gevolgtrekking: Die gebruik van die protokol vir die omvattende hantering van pasiënte in ‘n chirurgiese eenheid is haalbaar en veilig. Die voorlopige resultate van hierdie studie dui daarop dat wanneer ‘n fisioterapie diens in ‘n chirurgiese ISE gelewer word aan die hand van ‘n bewysgesteunde protokol deur ‘n toegewyde fisioterapeut dit die potensiaal het om ISE koste te verminder en die funksionele herstel van pasiente na ontslag uit die eenheid te fasiliteer. Hierdie inligting kan nou deur administrateurs oorweeg word om ‘n optimale fisioterapie diens in ‘n chirurgiese ISE te verseker.
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Bennett-Baird, Penny. "Development and psychometric evaluation of an instrument : neonatal infection control and compliance index to measure infection control compliance in the neonatal intensive care unit environment : a dissertation /." San Antonio : UTHSC, 2006. http://proquest.umi.com/pqdweb?did=1221711861&sid=1&Fmt=2&clientId=70986&RQT=309&VName=PQD.

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Gilson, Sheryl L. "Promoting Early Mobility of Patients in the Intensive Care Unit." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6433.

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Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically ill ICU patients. The theory of knowledge to action was used to guide the development of the educational program. The practice-focused question addressed whether an educational program would improve nurses' perceptions of their knowledge of EM and if they would promote the use of EM among ICU patients. After a literature review to identify evidence-based practices and a protocol on EM, an educational program was developed that included a 25-item Likert-style pretest and posttest to measure percent agreement with perceptions of knowledge gained and likelihood of behavior change related to the practice of EM. Participants included 60 ICU nurses. Results demonstrated improvement in perceptions of knowledge of EM (from 74% before education to 88% after) and in likelihood of behavior change related to EM (from 69% before education to 91% after). Findings may be used to integrate EM into the ICU setting to reduce complications such as neuromuscular weakness, muscle wasting, and pneumonia. Results may also include improved patient outcomes, reduced length of stay, and increased quality of life for patients and their families, and thereby promote positive social change.
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Magalhães, Bárbara Gomes. "Evaluation of a new molecular typing strategy of Pseudomonas aeruginosa." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/13861.

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Mestrado em Microbiologia
Pseudomonas aeruginosa is the third leading cause of hospital acquired infection in intensive care unit (ICU) patients. This microorganism holds responsibility in a high number of nosocomial infections and their severity. Because it is ubiquitous in the environment and also constitutes the endogenous microbiota of hospitalized patients, there is a need to use powerful molecular typing methods to establish clonal relationships between individual isolates. Double Locus Sequence Typing (DLST) has recently been used in the analysis of P. aeruginosa strains relatedness, proving to be efficient, easy, and also reducing the working time and costs of analysis. Another typing technique called Double Digest Sequence Label (DDSL) had also been reported in the molecular study of this microorganism. A higher discriminatory power makes DDSL a putative typing complement to resolve DLST clusters in specific situations. From 2010 to 2012, an increase in P. aeruginosa infections incidence was observed in the ICUs of the Lausanne University Hospital, Switzerland. During this period, 689 isolates were retrieved from 254 patients. All isolates were analyzed with DLST and grouped in 46 DLST clusters, from which 4 clusters were further investigated in this study (cluster 1_18, 1_21, 6_7 and 28_77). These 4 clusters were retrospectively typed with the DDSL method to verify if an improved discrimination of isolates could be achieved. To do so, a first DDSL optimization step was performed, which resulted in good quality fingerprinting profiles. However, a quantitative analysis of the results using BioNumerics software was not possible. Visual comparison of DDSL fingerprinting patterns within each cluster allowed the formation of different DDSL types, but not the determination of bands differences between them. Epidemiological data showed that contamination of humid environments probably played an important role in the dissemination of P. aeruginosa strains in this outbreak. Comparison of epidemiological and molecular information showed that most of undistinguishable DDSL types were epidemiologically linked, leading to the assumption that patient-to-patient transmission should be highly suspected, as seen for cluster 1_18. Nevertheless, strain evolution should be considered when studying a long period outbreak. In conclusion, this new typing strategy of P. aeruginosa allowed the acquisition of a general picture about this outbreak’s epidemiology. Nevertheless, the DDSL is a technically complex, time consuming and subjective technique, not efficient to be use for epidemiological investigation purposes.
Pseudomonas aeruginosa é a terceira causa de infeção adquirida em hospitais, em pacientes hospitalizados em unidades de cuidado intensivo (UCIs). Este microrganismo é responsável por um elevado número de doenças nosocomiais, e pelo sua gravidade. Uma vez que é ubíquo no ambiente e também constitiu a microbita endógena de pacientes hospitalizados, existe a necessidade de utilizar métodos de tipagem molecular eficientes no estabelecimento de relações clonais entre isolados. Double Locus Sequence Typing (DLST) tem sido usado recentemente na análise de relações clonais entre estirpes de P. aeruginosa, provando ser eficaz, fácil, e reduzindo também o tempo de manipulação e custos de análise. Outra técnica de tipagem chamada Double Digest Sequence Label (DDSL) foi também descrita no estudo molecular deste microrganismo. Um elevado poder discriminatório torna DDSL num complemento putativo à tipagem para resolver clusters de DLST em situações específicas. De 2010 a 2012 observou-se um aumento da incidência de infeções por P. aeruginosa nas UCIs do Hospital Universitário de Lausana, na Suíça. Durante este período, 689 isolados foram recolhidos de 254 pacientes. Todos os isolados foram analisados com DLST e agrupados em 46 DLST clusters, dos quais 4 clusters foram posteriormente investigados neste estudo (cluster 1_18, 1_21, 6_7 e 28_77). Estes 4 clusters foram retrospectivamente tipados com o método DDSL para verificar se se poderia alcançar uma melhor discriminação dos isolados. Para isso, um primeiro passo de optimização de DDSL foi realizado, o qual resultou em perfis de fingerprinting de boa qualidade. Contudo, a análise quantitativa dos resultados usando o software BioNumerics não foi possível. A comparação visual dos perfis de fingerprinting de DDSL para cada cluster permitiu a formação de diferentes tipos de DDSL, mas não a determinação de bandas diferentes entre os mesmos. Os dados epidemiológicos mostraram que a contaminação de ambientes húmidos provavelmente desempenhou um papel importante na disseminação de estirpes de P. aeruginosa neste surto. Comparação de informação epidemiológica e molecular mostrou que a maioria dos tipos de DDSL não distinguíveis estavam epidemiologicamente ligados, levando à suposição de que a transmissão paciente-para-paciente deveria ser altamente considerada, como visto para o cluster 1_18. No entanto, a evolução da estirpe deve ser considerada aquando do estudo de um surto de longa duração. Concluindo, esta nova estratégia de tipagem de P. aeruginosa permitiu obter uma imagem geral acerca da epidemiologia deste surto. Todavia, DDSL é um método tecnicamente complexo, demorado e subjectivo, não eficiente para ser usado para fins de investigação epidemiológica.
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Johnson, Randall. "Evaluation of an Education Intervention for the Staff on the Head of the Bed Elevation in the Pediatric Intensive Care Unit." Doctoral diss., University of Central Florida, 2007. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3036.

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Elevating the head of bed (HOB) reduces risks for aspiration and ventilator associated pneumonia (VAP) in the adult population. Educational interventions have resulted in improvements in achieving a target HOB elevation of 30[degrees] in adults. Limited research has addressed this intervention in the pediatric intensive care unit (PICU). The aim of this study was to determine if an educational intervention for the PICU staff would result in improvement in the HOB elevation in the PICU. Four research questions were studied: 1) What is the common practice related to the elevation of the HOB in the PICU? 2) Is there a difference in the mean HOB elevation before and after an education intervention? 3) Is there a difference in the percent of time the HOB is at or above 30[degrees] after the intervention? and 4) What factors influence HOB elevation in the PICU? A quasi-experimental, pre, and post measurement, with nonequivalent comparison group design was used. The angle of the HOB elevation was measured with the "Pitch and Angle Locator" (PAL) (Johnson, Mequon, WI). Baseline measurements (n = 99) were obtained for patients admitted to a PICU at various days and times over a 2-week period. An educational intervention was done for the staff members in the PICU, with a focus on the importance of keeping the HOB up and strategies for measuring the HOB elevation. Posters to reinforce the information were placed on the unit. Post-intervention, measurements (n = 98) were obtained for another 2-week period. At the time of data collection, staff members caring for the PICU patients were asked to provide responses for what influenced them to place the patient at the documented HOB elevation. Children were older in the post-intervention group than in the pre-intervention (8.8 yrs, vs. 3.7, yrs, respectively, t = -6.67, df = 195, p= .000). The children also weighed more in the post-intervention group than in the pre-intervention (32.0 kg vs. 19.7 kg, respectively, t = -4.19, df= 195, p = .000). The mean HOB elevation was 23.5[degrees] before the intervention. After the intervention, the mean HOB increased to 26.5[degrees] (t = -1.19, df 195, p = .033). For ventilated patients, the mean HOB elevation went from 23.6[degrees] to 29.1[degrees] (t = -3.25, df 95, p= .001), and for patients mechanically ventilated and in an adult bed, the mean increased from 26[degrees] [plus or minus] 7.89[degrees], pre- intervention to 30[degrees] [plus or minus] 8.59[degrees] post-intervention (t = -1.80, df 63, p = .038). The percent of the time the measures were greater than 30[degrees] increased from 26% to 44% pre- and post-intervention respectively (X2 6.71, df 1, p= .005). Responses (n = 230) related to the factors that influenced positioning were categorized as follows: physician order (3%), safety (7%), found this way (11%), therapeutic intervention (16%), comfort (24%), and patient condition (39%). An educational intervention can impact the practice of elevation of the HOB in a PICU, thus decreasing the risks of developing aspiration and VAP. Although the mean HOB increased statistically, the HOB was less than 30[degrees] in more than half of the post intervention measurements, indicating the need for ongoing reinforcement of the education. The PAL device was a new, reliable method for recording HOB elevation in both adult beds and cribs. Follow-up research is needed to determine if these gains in HOB elevation have been sustained over time and their impact on VAP.
Ph.D.
School of Nursing
Health and Public Affairs
Nursing PhD
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Books on the topic "Intensive care units - Evaluation"

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Stapleton, David C., and Sally J. Kaplan. Ventilator dependent unit demonstration: Outcome evaluation and assessment of post acute care. [Fairfax, Va.?]: Lewin-VHI, 1996.

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Intensive psychiatric care units. Edinburgh: NHS Quality Improvement Scotland, 2010.

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Andrew, Bodenham, and Bellamy Mark C, eds. Intensive care. 3rd ed. Edinburgh: Churchill Livingstone, 2010.

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Andrew, Bodenham, and Bellamy Mark C, eds. Intensive care. 2nd ed. Edinburgh: Churchill Livingstone, 2004.

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J, Pierson David, and Tyler Martha L, eds. Intensive respiratory care. 2nd ed. Philadelphia: W.B. Saunders, 1993.

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Daniel, Teres, ed. Gatekeeping in the intensive care unit. Chicago, Ill: Health Administration Press, 1997.

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Irwin and Rippe's intensive care medicine. 7th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health, 2011.

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ABC of intensive care. 2nd ed. Chichester, West Sussex, UK: Blackwell Pub., 2011.

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E, Oh T., ed. Oh's intensive care manual. 6th ed. Oxford: Butterworth-Heinemann, 2009.

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Intensive care units: Stress, procedures and mortality rates. Hauppauge, N.Y: Nova Science Publisher's, 2011.

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Book chapters on the topic "Intensive care units - Evaluation"

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Giraud, T., J. F. Dhainaut, and J. J. Lanore. "Evaluation of Iatrogenic Complications in Intensive Care Units." In Update in Intensive Care and Emergency Medicine, 567–73. Berlin, Heidelberg: Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-642-84423-2_62.

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Ferreira, Ana, João Paulo Figueiredo, Mariana Girão, and Ana Lança. "Evaluation and Control of Professional Risks in Intensive Care Units." In Occupational and Environmental Safety and Health II, 21–29. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41486-3_3.

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Kato, Akikazu, Shiho Mori, and Masayuki Kato. "Emerging Trends in Performance Evaluation of Pediatric Intensive Care Units in Japanese Children’s Hospitals." In Building Performance Evaluation, 285–94. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-56862-1_22.

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Philippart, François, Alexis Tabah, and Jean Carlet. "Evaluation of the Febrile Patient in the Intensive Care Unit." In Surgical Intensive Care Medicine, 437–47. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-19668-8_32.

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Quintana, Raymundo A., Nicolas Palaskas, and Jose Banchs. "Hemodynamic Evaluation and Echocardiography in the Oncologic Intensive Care Unit." In Oncologic Critical Care, 1–21. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_64-1.

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Quintana, Raymundo A., Nicolas Palaskas, and Jose Banchs. "Hemodynamic Evaluation and Echocardiography in the Oncologic Intensive Care Unit." In Oncologic Critical Care, 753–73. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_64.

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Corl, Keith, Sameer Shah, and Eric Gartman. "Ultrasound Evaluation of Shock and Volume Status in the Intensive Care Unit." In Ultrasound in the Intensive Care Unit, 65–76. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-1723-5_4.

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Graham, Thomas P. "Evaluation of Cardiac Function in the Intensive Care Unit." In Pediatric Cardiology, 687–89. New York, NY: Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8598-1_188.

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Muchada, R., P. Tortoli, and F. Gudi. "Echo Doppler Monitoring for the Evaluation of Cardiovascular Performances in Anaesthesia and in the Intensive Care Units." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 479–85. Milano: Springer Milan, 1999. http://dx.doi.org/10.1007/978-88-470-2145-7_46.

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Alpert, J. S., and L. A. Pape. "The Utility of Non-Invasive Cardiovascular Evaluation in the Intensive Care Unit." In Update in Intensive Care and Emergency Medicine, 327–35. Berlin, Heidelberg: Springer Berlin Heidelberg, 1987. http://dx.doi.org/10.1007/978-3-642-83042-6_41.

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Conference papers on the topic "Intensive care units - Evaluation"

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Savasci, Duygu, and Murat Ceylan. "Thermal image analysis for neonatal intensive care units (First evaluation results)." In 2018 26th Signal Processing and Communications Applications Conference (SIU). IEEE, 2018. http://dx.doi.org/10.1109/siu.2018.8404831.

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Zhengbo Zhang, Joan Lee, D. J. Scott, L. Lehman, and R. G. Mark. "A research infrastructure for real-time evaluation of predictive algorithms for intensive care units." In 2013 ICME International Conference on Complex Medical Engineering (CME 2013). IEEE, 2013. http://dx.doi.org/10.1109/iccme.2013.6548221.

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Willoughby, J., P. Duncan, and A. Trivedi. "Evaluation of a Formal Medical Intensive Care Unit Curriculum for Housestaff." 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.a4788.

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Ernesto, Delgado-Cidranes, Tirado-Conde Gema, Fernandez-Vaquero Miguel Angel, and Estrada-Blanco Zuramis. "Pleural elastography. Evaluation of pulmonary lesions in the intensive care unit." In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.oa497.

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Christmas, Alex, Elizabeth Henderson, and Edgar Brincat. "294 Evaluation of rasburicase use within the paediatric intensive care unit." In RCPCH Conference Singapore. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/bmjpo-2021-rcpch.163.

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Lombard, A., J. Vigneron, E. D’huart, and B. Demore. "3PC-070 Evaluation of compatibility of acetylsalicylic acid and atenolol with medications commonly used in intensive care units." In 25th Anniversary EAHP Congress, Hospital Pharmacy 5.0 – the future of patient care, 23–28 March 2021. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/ejhpharm-2021-eahpconf.45.

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Bhatraju, Pavan, Yingdi Chen, Laura Evans, and Amit Uppal. "Prospective Evaluation Of A Novel Handoff Process In The Intensive Care Unit." 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.a6576.

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Morgado-Gamero, Wendy, Martha Mendoza Hernandez, Dayana Agudelo-Castaneda, Margarita Castillo Ramirez, Alexander Parody, and Leidi Posso Mendoza. "Evaluation of the presence of bioaerosols in a neonatal intensive care unit." In 2019 Congreso Colombiano y Conferencia Internacional de Calidad de Aire y Salud Pública (CASP). IEEE, 2019. http://dx.doi.org/10.1109/casap48673.2019.9364039.

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Mourao, Maria Filipa, and Ana Cristina Braga. "Evaluation of the CRIB as an Indicator of the Performance of Neonatal Intensive Care Units Using the Software ROCNPA." In 2012 12th International Conference on Computational Science and Its Applications (ICCSA). IEEE, 2012. http://dx.doi.org/10.1109/iccsa.2012.37.

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Sarwono, Joko, Ezra Tandian, Andika Rizki, Sentagi Utami, and Ressy Yanti. "Characterizing the hearing comfort in intensive care unit using objective and subjective evaluation." In 2015 4th International Conference on Instrumentation, Communications, Information Technology and Biomedical Engineering (ICICI-BME). IEEE, 2015. http://dx.doi.org/10.1109/icici-bme.2015.7401387.

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Reports on the topic "Intensive care units - Evaluation"

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Chauvin, Juan Pablo, Annabelle Fowler, and Nicolás Herrera L. The Younger Age Profile of COVID-19 Deaths in Developing Countries. Inter-American Development Bank, November 2020. http://dx.doi.org/10.18235/0002879.

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This paper examines why a larger share of COVID-19 deaths occurs among young and middle-aged adults in developing countries than in high-income countries. Using novel data at the country, city, and patient levels, we investigate the drivers of this gap in terms of the key components of the standard Susceptible-Infected-Recovered framework. We obtain three main results. First, we show that the COVID-19 mortality age gap is not explained by younger susceptible populations in developing countries. Second, we provide indirect evidence that higher infection rates play a role, showing that variables linked to faster COVID-19 spread such as residential crowding and labor informality are correlated with younger mortality age profiles across cities. Third, we show that lower recovery rates in developing countries account for nearly all of the higher death shares among young adults, and for almost half of the higher death shares among middle-aged adults. Our evidence suggests that lower recovery rates in developing countries are driven by a higher prevalence of preexisting conditions that have been linked to more severe COVID-19 complications, and by more limited access to hospitals and intensive care units in some countries.
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Design Guidance for Psychiatric Intensive Care Units. NAPICU International Press, 2017. http://dx.doi.org/10.20299/napicu.2017.002.

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Guidance for Commissioners of Psychiatric Intensive Care Units (PICU). NAPICU International Press, April 2016. http://dx.doi.org/10.20299/napicu.2016.001.

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National Minimum Standards for Psychiatric Intensive Care Units for Young People. NAPICU, September 2015. http://dx.doi.org/10.20299/napicu.2015.001.

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A newer sedative agent may shorten length of stay in intensive care units. National Institute for Health Research, June 2016. http://dx.doi.org/10.3310/signal-000259.

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National infection control campaigns led to a rapid decline in superbug infections in UK intensive care units. National Institute for Health Research, November 2020. http://dx.doi.org/10.3310/alert_42408.

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