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Pellathy, Tiffany Purcell, Michael R. Pinsky, and Marilyn Hravnak. "Intensive Care Unit Scoring Systems." Critical Care Nurse 41, no. 4 (August 1, 2021): 54–64. http://dx.doi.org/10.4037/ccn2021613.
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Background Illness severity scoring systems are commonly used in critical care. When applied to the populations for whom they were developed and validated, these tools can facilitate mortality prediction and risk stratification, optimize resource use, and improve patient outcomes. Objective To describe the characteristics and applications of the scoring systems most frequently applied to critically ill patients. Methods A literature search was performed using MEDLINE to identify original articles on intensive care unit scoring systems published in the English language from 1980 to 2020. Search terms associated with critical care scoring systems were used alone or in combination to find relevant publications. Results Two types of scoring systems are most frequently applied to critically ill patients: those that predict risk of in-hospital mortality at the time of intensive care unit admission (Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score, and Mortality Probability Models) and those that assess and characterize current degree of organ dysfunction (Multiple Organ Dysfunction Score, Sequential Organ Failure Assessment, and Logistic Organ Dysfunction System). This article details these systems’ differing features and timing of use, score calculation, patient populations, and comparative performance data. Conclusion Critical care nurses must be aware of the strengths, limitations, and specific characteristics of severity scoring systems commonly used in intensive care unit patients to effectively employ these tools in clinical practice and critically appraise research findings based on their use.
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Happ, Mary Beth, Brooke M. Baumann, Jennifer Sawicki, Judith A. Tate, Elisabeth L. George, and Amber E. Barnato. "SPEACS-2: Intensive Care Unit “Communication Rounds” with Speech Language Pathology." Geriatric Nursing 31, no. 3 (May 2010): 170–77. http://dx.doi.org/10.1016/j.gerinurse.2010.03.004.
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Edlow, Brian L., and Lionel Naccache. "Unmasking Covert Language Processing in the Intensive Care Unit with Electroencephalography." Annals of Neurology 89, no. 4 (February 16, 2021): 643–45. http://dx.doi.org/10.1002/ana.26030.
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McRae, Jackie, Elizabeth Montgomery, Zoë Garstang, and Eibhlin Cleary. "The role of speech and language therapists in the intensive care unit." Journal of the Intensive Care Society 21, no. 4 (September 30, 2019): 344–48. http://dx.doi.org/10.1177/1751143719875687.
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National guidance recommends the involvement of speech and language therapists in intensive care particularly for those requiring tracheostomy and ventilation. However, the role of speech and language therapists is poorly understood especially in the context of critical care. This article aims to increase awareness of the background training and skills development of speech and language therapists working in this context to demonstrate their range of specialist abilities. Speech and language therapists support and enhance the process of laryngeal weaning alongside the rehabilitation of speech and swallowing as part of the multidisciplinary team. Examples are provided of the types of interventions that are used and technological innovations that may enhance rehabilitation of oropharyngeal impairments.
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Branch-Elliman, Westyn, Judith Strymish, Valmeek Kudesia, Amy K. Rosen, and Kalpana Gupta. "Natural Language Processing for Real-Time Catheter-Associated Urinary Tract Infection Surveillance: Results of a Pilot Implementation Trial." Infection Control & Hospital Epidemiology 36, no. 9 (May 26, 2015): 1004–10. http://dx.doi.org/10.1017/ice.2015.122.
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BACKGROUNDIncidence of catheter-associated urinary tract infection (CAUTI) is a quality benchmark. To streamline conventional detection methods, an electronic surveillance system augmented with natural language processing (NLP), which gathers data recorded in clinical notes without manual review, was implemented for real-time surveillance.OBJECTIVETo assess the utility of this algorithm for identifying indwelling urinary catheter days and CAUTI.SETTINGLarge, urban tertiary care Veterans Affairs hospital.METHODSAll patients admitted to the acute care units and the intensive care unit from March 1, 2013, through November 30, 2013, were included. Standard surveillance, which includes electronic and manual data extraction, was compared with the NLP-augmented algorithm.RESULTSThe NLP-augmented algorithm identified 27% more indwelling urinary catheter days in the acute care units and 28% fewer indwelling urinary catheter days in the intensive care unit. The algorithm flagged 24 CAUTI versus 20 CAUTI by standard surveillance methods; the CAUTI identified were overlapping but not the same. The overall positive predictive value was 54.2%, and overall sensitivity was 65% (90.9% in the acute care units but 33% in the intensive care unit). Dissimilarities in the operating characteristics of the algorithm between types of unit were due to differences in documentation practice. Development and implementation of the algorithm required substantial upfront effort of clinicians and programmers to determine current language patterns.CONCLUSIONSThe NLP algorithm was most useful for identifying simple clinical variables. Algorithm operating characteristics were specific to local documentation practices. The algorithm did not perform as well as standard surveillance methods.Infect. Control Hosp. Epidemiol. 2015;36(9):1004–1010
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Zhang, Wei, Yun Tang, Huan Liu, Li ping Yuan, Chu chu Wang, Shu fan Chen, Jin Huang, and Xin yuan Xiao. "Risk prediction models for intensive care unit-acquired weakness in intensive care unit patients: A systematic review." PLOS ONE 16, no. 9 (September 24, 2021): e0257768. http://dx.doi.org/10.1371/journal.pone.0257768.
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Background and objectives Intensive care unit-acquired weakness (ICU-AW) commonly occurs among intensive care unit (ICU) patients and seriously affects the survival rate and long-term quality of life for patients. In this systematic review, we synthesized the findings of previous studies in order to analyze predictors of ICU-AW and evaluate the discrimination and validity of ICU-AW risk prediction models for ICU patients. Methods We searched seven databases published in English and Chinese language to identify studies regarding ICU-AW risk prediction models. Two reviewers independently screened the literature, evaluated the quality of the included literature, extracted data, and performed a systematic review. Results Ultimately, 11 studies were considered for this review. For the verification of prediction models, internal verification methods had been used in three studies, and a combination of internal and external verification had been used in one study. The value for the area under the ROC curve for eight models was 0.7–0.923. The predictor most commonly included in the models were age and the administration of corticosteroids. All the models have good applicability, but most of the models are biased due to the lack of blindness, lack of reporting, insufficient sample size, missing data, and lack of performance evaluation and calibration of the models. Conclusions The efficacy of most models for the risk prediction of ICU-AW among high-risk groups is good, but there was a certain bias in the development and verification of the models. Thus, ICU medical staff should select existing models based on actual clinical conditions and verify them before applying them in clinical practice. In order to provide a reliable basis for the risk prediction of ICU-AW, it is necessary that large-sample, multi-center studies be conducted in the future, in which ICU-AW risk prediction models are verified.
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Idowu, Peter Adebayo, Franklin Oladiipo Asahiah, Jeremiah Ademola Balogun, and Olayinka Olufunmilayo Olusanya. "An Online Neonatal Intensive-Care Unit Monitoring System for Hospitals in Nigeria." International Journal of Biomedical and Clinical Engineering 6, no. 1 (January 2017): 1–22. http://dx.doi.org/10.4018/ijbce.2017010101.
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This paper presents an online monitoring system for the storage and retrieval of physiological data from neonates admitted into the Neonatal intensive care units (NICU) of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. In order to develop this system, the requirements of the proposed system were identified and analyzed as system and user requirements independently and the requirements were designed using the Unified Modeling Language (UML) tools. The system was implemented using Web 2.0 technologies such as, the hypertext markup language (HTML), the cascading styling sheets (CSS), PHP and MySQL. With the system, storage and retrieval of information by the nurses and any authorized users will be easy.
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Ciriello, Anne G., Zoelle B. Dizon, and Tessie W. October. "Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians." American Journal of Hospice and Palliative Medicine® 35, no. 3 (March 21, 2017): 384–89. http://dx.doi.org/10.1177/1049909117700101.
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Background: Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present. Aim: To compare language used by PC team and ICU physicians during family conferences. Design: A retrospective cohort review of ICU family conferences with and without the PC team. Setting: Forty-four bed pediatric ICU in a tertiary medical center. Participants: Nine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences. Results: Of the 9 transcripts without the PC team, we identified 526 ICU physician statements, generating 10 thematic categories. The most common themes were giving medical information and discussing medical options. Themes unique to ICU physicians included statements of hopelessness, insensitivity, and “health-care provider challenges.” Among the 9 transcripts with the PC team, there were 280 statements, generating 10 thematic categories. Most commonly, the PC team offered statements of support, giving medical information, and quality of life. Both teams promoted family engagement by soliciting questions; however, the PC team was more likely to use open-ended questions, offer support, and discuss quality of life. Conclusion: Pediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.
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Monson, Brian B., Jenna Rock, Molly Cull, and Vitaliy Soloveychik. "Neonatal intensive care unit incubators reduce language and noise levels more than the womb." Journal of Perinatology 40, no. 4 (February 4, 2020): 600–606. http://dx.doi.org/10.1038/s41372-020-0592-6.
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Palau, Mauricio A., Maxene R. Meier, John T. Brinton, Sunah S. Hwang, Genie E. Roosevelt, and Thomas A. Parker. "The impact of parental primary language on communication in the neonatal intensive care unit." Journal of Perinatology 39, no. 2 (December 10, 2018): 307–13. http://dx.doi.org/10.1038/s41372-018-0295-4.
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Machado Tironi, Rafael. "Reporting on Glucose Control Metrics in the Intensive Care Unit." European Endocrinology 11, no. 2 (2015): 75. http://dx.doi.org/10.17925/ee.2015.11.02.75.
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The ‘diabetes of injury’ typically associated with critical illness has recently been thoroughly revisited and much better characterised following major therapeutic advances. The occurrence of severe hyperglycaemia, moderate hypoglycaemia or high glycaemic variability has been associated with an increased mortality and rate of complications in large independent cohorts of acutely ill patients. Hence, current guidelines advocate the prevention and avoidance of each of these three dysglycaemic domains, and the use of a common metrics for a quantitative description of dysglycaemic events, such as the proportion of time spent in the target glycaemic range as a unifying variable. Using a common language will help to face the future challenges, including the definition of the most appropriate blood glucose (BG) target according to the category of admission, the time interval from the initial injury and the medical history. The clinical testing of technological improvements in the monitoring systems and the therapeutic algorithms should be assessed using the same metrics.
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Durieux-smith, AndrÉE, Terence W. Picton, Christopher G. Edwards, Brock Macmurray, and John T. Goodman. "Brainstem Electric-Response Audiometry in Infants of a Neonatal Intensive Care Unit." International Journal of Audiology 26, no. 5 (January 1987): 284–97. http://dx.doi.org/10.3109/00206098709081556.
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Gruenberg, David A., Wayne Shelton, Susannah L. Rose, Ann E. Rutter, Sophia Socaris, and Glenn McGee. "Factors Influencing Length of Stay in the Intensive Care Unit." American Journal of Critical Care 15, no. 5 (September 1, 2006): 502–9. http://dx.doi.org/10.4037/ajcc2006.15.5.502.
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• Background Long stays in the intensive care unit are associated with high costs and burdens on patients and patients’ families and in turn affect society at large. Although factors that affect length of stay and outcomes of care in the intensive care unit have been studied extensively, the conclusions reached have not been reviewed to determine whether they reveal an organizational pattern that might be of practical use in reducing length of stay in the unit. • Objective To identify and categorize the factors associated with prolonged stays in the intensive care unit and to describe briefly the nonmedical interventions to date designed to reduce length of stay. • Methods Articles published between January 1990 and March 2005 in English-language journals indexed by MEDLINE were searched for studies on outcomes and costs of care in the intensive care unit and on care at the end of life. • Results The emerging consensus is that length of stay in the intensive care unit is exacerbated by several increasingly discernible medical, social, psychological, and institutional factors. At the same time, several nonmedical, experimental interventions have been designed to reduce length of stay. • Conclusions Interventions involving palliative care, ethics consultations, and other methods to increase communication between healthcare personnel, patients, and patients’ families may be helpful in decreasing length of stay in the intensive care unit. Further studies are needed to provide a strategy for targeting specific risk factors indicated by the literature review.
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Nasrulloh, M. alaika, and Ahmad Zulfikri. ""تنفيد تعليم اللغة العربية لبرنامج اللّغة المكثّف للطّلّاب الجديدة." TADRIS AL-ARABIYAT: Jurnal Kajian Ilmu Pendidikan Bahasa Arab 1, no. 01 (January 5, 2021): 108. http://dx.doi.org/10.30739/arabiyat.v1i01.732.
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Language Intensive Program is a form of effort and innovation on the campus of the Darussalam Islamic Institute of Blokagung to equip students' mastery of foreign languages, especially new students. This program is directly handled by the IAIDA campus Language Technical Implementation Unit (UPT-B). This effort is the latest innovation at the tertiary level which may rarely be applied in other campuses. In addition, this program is still relatively young because it has only been running for 3 semesters. As a new program, enabling innovation to occur, this program is still undergoing changes in response to emerging problems. So that in the future it is really able to equip students with quality foreign language competences. In this case, by using a descriptive approach, the writer wants to describe the process as well as the supporting and inhibiting factors for the implementation of Arabic learning which is packaged attractively in the Language Intensive Program in Campus institutions.
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Bidabadi, Farimah Shirani, Ahmadreza Yazdannik, and Ali Zargham-Boroujeni. "Patient’s dignity in intensive care unit: A critical ethnography." Nursing Ethics 26, no. 3 (August 24, 2017): 738–52. http://dx.doi.org/10.1177/0969733017720826.
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Background: Maintaining patient’s dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units. Objectives: The aim of this study was to uncover the cultural factors that impeded maintaining patients’ dignity in the cardiac surgery intensive care unit. Research Design: The study was conducted using a critical ethnographic method proposed by Carspecken. Participants and research context: Participants included all physicians, nurses and staffs working in the study setting (two cardiac surgery intensive care units). Data collection methods included participant observations, formal and informal interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace. Ethical Consideration: Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained. Findings: The findings of the study fell into the following main themes: “Presence: the guarantee for giving enough attention to patients’ self-esteem”, “Instrumental and objectified attitudes”, “Adherence to the human equality principle: value-action gap”, “Paternalistic conduct”, “Improper language”, and “Non-interactive communication”. The final assertion was “Reductionism as a major barrier to the maintaining of patient’s dignity”. Discussion: The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches. Conclusion: Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships.
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Iredell, J., and J. Lipman. "Antibiotic Resistance in the Intensive Care Unit: A Primer in Bacteriology." Anaesthesia and Intensive Care 33, no. 2 (April 2005): 188–95. http://dx.doi.org/10.1177/0310057x0503300206.
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The clinical use of potent, well-tolerated, broad-spectrum antibiotics has been paralleled by the development of resistance in bacteria, and the prevalence of highly resistant bacteria in some intensive care units is despairingly commonplace. The intensive care community faces the realistic prospect of untreatable nosocomial infections and should be searching for new approaches to diagnose and manage resistant bacteria. In this review, we discuss some of the relevant underlying biology, with a particular focus on genetic transfer vehicles and the relationship of selection pressure to their movements. It is an attempt to demystify the relevant language and concepts for the anaesthetist and intensivist, to explain some of the reasons for the emergence of resistance in bacteria, and to provide a contextual basis for discussion of management approaches such as selective decontamination and antibiotic cycling.
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Maxim, Tom, Agustin Alvarez, Yvonne Hojberg, Derek Antoku, Chioma Moneme, Andrew Singleton, Caroline Park, and Kazuhide Matsushima. "Family satisfaction in the trauma and surgical intensive care unit: another important quality measure." Trauma Surgery & Acute Care Open 4, no. 1 (August 2019): e000302. http://dx.doi.org/10.1136/tsaco-2019-000302.
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BackgroundA growing body of research has explored patient satisfaction as one of the healthcare quality measures. To date, scarce data are available regarding family experience in the trauma and surgical intensive care unit (TSICU). The purpose of this study was to describe and analyze the results of a family satisfaction survey in the TSICU.MethodsFamily members of patients at a level 1 trauma center were invited to participate in this study after 72 hours of intensive care unit stay. Participants completed a modified version of the Family Satisfaction in the Intensive Care Unit questionnaire, a validated survey measuring family satisfaction with care and decision-making. Data collection spanned from April 2016 to July 2017. Patient characteristics were compiled from the medical record. Quantitative analysis was performed using a 5-point Likert score, converted to a scale of 0 (poor) to 100 (excellent).ResultsThe overall response rate was 78.6%. Of the 103 family members for 88 patients, most were young (median age: 41 years) and female (75%). Language fluency was 44.6% English-only, 31.7% Spanish-only, and 23.8% bilingual. Mean summary family satisfaction scores (±SD) were 80.6±26.4 for satisfaction with care, 79.3±27.1 for satisfaction with decision-making, and 80.1±26.7 for total satisfaction. Respondents were less satisfied with the frequency of communication with physicians (70.7±27.4) and language translation (73.2±31.2).DiscussionOverall family satisfaction with the care provided to patients in the TSICU is high, although opportunities for improvement were noted in the frequency of communication between physicians and family and language translation services. Further quality improvement projects are warranted.Level of evidenceCare management study: level V.
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Madhoun, Lauren L., and Robert Dempster. "The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond." Perspectives of the ASHA Special Interest Groups 4, no. 6 (December 26, 2019): 1507–15. http://dx.doi.org/10.1044/2019_persp-19-00097.
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Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.
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Reed, Michael D., Maria L. Santeiro, Carine Stromquist, and Lynda Coppola. "Guidelines for Continuous Infusion Medications in the Neonatal Intensive Care Unit." Annals of Pharmacotherapy 26, no. 5 (May 1992): 671–74. http://dx.doi.org/10.1177/106002809202600512.
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OBJECTIVE: To present practical guidelines in tabular form for dosage, calculation, preparation, and monitoring of common medications administered by continuous infusion to neonatal intensive care patients. DATA SOURCES: Review articles and clinical trials were identified through a computer literature search with subsequent bibliography scanning. STUDY SELECTION: Articles selected for review were considered important contributions. DATA EXTRACTION: Data from human studies and review articles published in the English language were evaluated. DATA SYNTHESIS: In emergency situations, physicians and other healthcare providers caring for critically ill newborns often perform rapid calculations to determine the dosage and rate of continuous intravenous medication infusions. Because of the crisis situation, there is the potential for calculation errors. We compiled a concise table designed to provide a standardized method for the administration of emergency medications to neonatal intensive care patients. This table must be used in conjunction with clinical judgment and each medication infusion rate must be adjusted to the patient's clinical response and individual parameters. CONCLUSIONS: These guidelines help to minimize the volume of fluid needed for medication administration and facilitate the calculation, preparation, and timely administration of these medications, thus preventing errors that might occur in an emergency situation.
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Rodríguez, Agustín Martín, and Mª Ángeles Pérez San Gregorio. "Psychosocial Adaptation in Relatives of Critically Injured Patients Admitted to an Intensive Care Unit." Spanish Journal of Psychology 8, no. 1 (May 2005): 36–44. http://dx.doi.org/10.1017/s1138741600004947.
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The aim of this study is to analyze how the length of time a patient spends in an Intensive Care Unit (ICU) affects close relatives, with regard to specific clinical variables of personality, family relationships and fear of death. The study group consisted of 57 relatives of seriously ill patients admitted to the ICU of “Virgen del Rocío” Rehabilitation and Trauma Hospital (Seville, Spain). The instruments applied were: a psychosocial questionnaire, clinical analysis questionnaire, family environment scale and fear of death scale. The relatives of patients admitted to ICU obtained higher scores in hypochondria, suicidal depression, agitation, anxious depression, guilt-resentment, paranoia, psychasthenia, psychological maladjustment and self-expression, and less in fear of their own death, as when compared to interviews with the same relatives 4 years later. The length of time a patient spent in the ICU influenced relatives in some clinical variables of personality, family relationships and fear of death.
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Lee, Brittany M., Farr A. Curlin, and Philip J. Choi. "Documenting presence: A descriptive study of chaplain notes in the intensive care unit." Palliative and Supportive Care 15, no. 2 (June 20, 2016): 190–96. http://dx.doi.org/10.1017/s1478951516000407.
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AbstractObjective:To clarify and record their role in the care of patients, hospital chaplains are increasingly called on to document their work in the medical record. Chaplains' documentation, however, varies widely, even within single institutions. Little has been known, however, about the forms that documentation takes in different settings or about how clinicians interpret chaplain documentation. This study aims to examine how chaplains record their encounters in an intensive care unit (ICU).Method:We performed a retrospective chart review of the chaplain notes filed on patients in the adult ICUs at a major academic medical center over a six-month period. We used an iterative process of qualitative textual analysis to code and analyze chaplains' free-text entries for emergent themes.Results:Four primary themes emerged from chaplain documentation. First, chaplains frequently used “code language,” such as “compassionate presence,” to recapitulate interventions already documented elsewhere in a checklist of ministry interventions. Second, chaplains typically described what they observed rather than interpreting its clinical significance. Third, chaplains indicated passive follow-up plans, waiting for patients or family members to request further interaction. Fourth, chaplains sometimes provided insights into particular relationship dynamics.Significance of results:As members of the patient care team, chaplains access the medical record to communicate clinically relevant information. The present study suggests that recent emphasis on evidence-based practice may be leading chaplains, at least in the medical center we studied, to use a reduced, mechanical language insufficient for illuminating patients' individual stories. We hope that our study will promote further consideration of how chaplain documentation can enhance patient care and convey the unique value that chaplains add to the clinical team.
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Tavoosy, Yoones. "Evaluation of the intensive English language teaching programme for the fifth grade according to teachers’ views." International Journal of Learning and Teaching 13, no. 3 (July 26, 2021): 106–24. http://dx.doi.org/10.18844/ijlt.v13i3.5273.
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With the increase in international exchange of information, language policies of countries have focused especially on the teaching and learning of English, the universal language of communication. The aim of the study is to evaluate the intensive English language teaching programme for the fifth grade according to the teachers’ views. The research is conducted in the phenomenological pattern, one of the qualitative research methods. In the 2018–2019 academic year, data were collected by interviewing with 26 volunteer English teachers in 7 different districts of İstanbul. Descriptive and content analysis methods were used for analysing the data. From the results, most of the teachers generally have expressed positive opinions about the intensive English language course for the fifth grade and its curriculum. This paper recommends that the content should be eased by reducing the number of unit numbers and grammar subjects in the curriculum. Keywords: Intensive course, English language, teaching programme, programme evaluation, teachers’ views, the fifth grade.
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Chow, Vivian Y., and Renée A. Shellhaas. "Acoustic environment profile of the neonatal intensive care unit: High ambient noise and limited language exposure." Journal of Neonatal Nursing 22, no. 4 (August 2016): 159–62. http://dx.doi.org/10.1016/j.jnn.2016.03.003.
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Istanboulian, Laura, and Lindsay Siple. "Simple-language tool to guide patients in recovery after prolonged treatment in the intensive care unit." Canadian Medical Association Journal 193, no. 7 (February 15, 2021): E251. http://dx.doi.org/10.1503/cmaj.77844.
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Arroyo-Novoa, Carmen Mabel, Milagros I. Figueroa-Ramos, Kathleen A. Puntillo, and Céline Gélinas. "Translation into Spanish and Cultural Adaptation of the Critical-Care Pain Observation Tool." American Journal of Critical Care 29, no. 3 (May 1, 2020): 226–32. http://dx.doi.org/10.4037/ajcc2020763.
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Background The Critical-Care Pain Observation Tool (CPOT) is recommended for evaluating pain behaviors in patients in the intensive care unit who are unable to report pain. The source of the only published Spanish version of the CPOT does not verify that it underwent a formal translation process. Objective To describe the translation into Spanish and cultural adaptation of the original French version of the CPOT. Methods Key persons in the translation process included one with a master’s degree in translation, a critical care physician, nurse faculty members with vast experience in intensive care units, and the instrument’s developer. This team followed the Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes Measures as a guide to translate and culturally adapt the CPOT. Results The first Spanish-language version was back translated to French and was also compared with the English version. Revisions necessitated a second version, which was submitted to experts in critical care. Their modifications required a third version, which was back translated to French and discussed with the CPOT developer, after which a fourth version was created. Finally, a linguistic expert proofread the tool, and the translation leaders incorporated the recommendations, thereby obtaining a final Spanish version. Conclusion The Spanish version is ready to undergo validation with patients in the intensive care unit, which is the next step toward its use in assessing pain behaviors among patients in intensive care units where Spanish is spoken.
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Amendola, Leopoldo M., Alessandro Galazzi, Irene Zainaghi, Ivan Cortinovis, Anna Zolin, Rik T. Gerritsen, Ileana Adamini, Maura Lusignani, and Dario Laquintana. "Validation and Analysis of the European Quality Questionnaire in Italian Language." International Journal of Environmental Research and Public Health 17, no. 23 (November 28, 2020): 8852. http://dx.doi.org/10.3390/ijerph17238852.
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The European Quality Questionnaire (euroQ2) is the culturally-adapted version to the European context of the Family Satisfaction in Intensive Care Unit (FS-ICU) and Quality of Dying and Death (QODD) tools in a single instrument divided into three parts (the last is optional). These tools were created for an adult setting. The aim of this study was the Italian validation and analysis of the euroQ2 tool. The Italian version of euroQ2 questionnaire was administered to the relatives, over 18 years of age, of adult intensive care unit patients, with the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale—Revised (IES-r). For the re-test phase the questionnaire was administered a second time. One hundred questionnaires were filled in. The agreement between test and retest was between 17–19 out of 20 participants with an upward trend in the re-test phase. A measure of coherence and cohesion between the euroQ2 variables was given by Cronbach’s alpha: in the first part of the questionnaire alpha was 0.82, in the second part it was 0.89. The linear Pearson’s correlation coefficients between all questions showed a weak positive correlation. The results obtained agreed with the original study. This study showed a good stability of the answers, an indication of an unambiguous understanding of the Italian translation.
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Durieux-Smith, Andrée, Terence W. Picton, Philippe Bernard, Brock Macmurray, and John T. Goodman. "Prognostic Validity of Brainstem Electric Response Audiometry in Infants of a Neonatal Intensive Care Unit." International Journal of Audiology 30, no. 5 (January 1991): 249–65. http://dx.doi.org/10.3109/00206099109072889.
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Desai, Jay, Logan Key, Alyson Swindall, Kan Gaston, and Ajay J. Talati. "The danger of diazoxide in the neonatal intensive care unit." Therapeutic Advances in Drug Safety 12 (January 2021): 204209862110113. http://dx.doi.org/10.1177/20420986211011338.
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Background: The most common cause of persistent hypoglycemia in infancy is hyperinsulinemic hypoglycemia. When conservative measures fail, providers often use medications to treat persistent hypoglycemia. Diazoxide is first-line therapy for neonatal hypoglycemia and works by inhibiting insulin secretion. Diazoxide is associated with fluid retention, and less commonly with respiratory decompensation and pulmonary hypertension. Case reports documenting these severe adverse events exist in the literature, although the overall incidence, risk factors, and timing for these effects in a newborn are not clearly defined. Methods: We performed a retrospective chart review of all infants admitted to the neonatal intensive care unit (NICU) at Regional One Health from 1 January 2013 until 15 August 2019, who received diazoxide as a treatment for persistent hypoglycemia secondary to hyperinsulinism. Patients were stratified as either having no adverse event or having an adverse outcome to the medication. A severe adverse outcome was defined as any known major side effect of the medication, which a patient developed within 2 weeks of medication initiation that led to medication discontinuation. Results: From our pharmacy database, we identified a total of 15 babies who received diazoxide for persistent hypoglycemia. Of these patients, eight (53%) were classified as having a complication requiring discontinuation of the medication. Six out of eight patients required intubation with mechanical ventilation and five out of eight patients developed pulmonary hypertension. All patients returned to their baseline respiratory support after drug discontinuation. Conclusions: A total of 53% of our study population had an adverse outcome to diazoxide. Previous studies suggest 5% of patients may have respiratory decompensation and require ventilatory support while on diazoxide; however, 40% of our patients deteriorated and then required mechanical ventilation. Based on our data, respiratory deterioration may be more likely to occur when diazoxide is used in preterm infants, those with lower birth weight and intrauterine growth restriction. Plain language summary The dangers in diazoxide Newborns could experience a transient period of low blood glucose levels soon after birth. However, some may progress to persistent low blood glucose levels that cannot be controlled with adequate glucose infusion and may require other ways of treatment. Diazoxide is the first-line drug approved by the US Food and Drug Administration (FDA) for this condition. However, certain cases have reported the development of respiratory deterioration, including increased blood pressure in lung circulation after its use. This prompted a black box warning in 2015 by the FDA. The incidence of neonatal low blood glucose levels seems to have increased and so has the use of this drug. Our study identifies 15 newborns who received diazoxide at Regional One Health neonatal intensive care unit in the past 6 years and reports a significantly higher rate of adverse events in our population leading to drug discontinuation in almost 53% of our cases.
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Wan Abdul Rahman, Wan Nor Aliza, Abdul Karim Othman, Azizul Fazli Jusoh, Hasnah Zani, Zainudin Awang, and Suriawati Ghazali. "Validation Instrument Measuring FS-ICU on Satisfaction Care Malay Language Version Among Relatives at the Intensive Care Unit in Public Hospitals." Asian Journal of Medicine and Biomedicine 4, no. 2 (October 20, 2020): 22–29. http://dx.doi.org/10.37231/ajmb.2020.4.2.358.
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The aim of this study is to measure the reliability and validity of the Family Satisfaction in the Intensive Care Unit (FS-ICU) Malay language version of family member’s satisfaction with care (19 items) during their stay at the intensive care units. A cross sectional study was conducted among 196 respondents. The self-administered FS-ICU comprises of three domains with a total of 19 items. Descriptive analysis, Cronbach’s alpha and Exploratory Factor Analysis (EFA) were performed on the Malay language version of FS-ICU. The final model EFA on the Malay language version of the FS-ICU indicated Bartlett’s Test of Sphericity was significant (Chi Square= 2321.013, p value <0.000) and the Kaiser-Meyer-Olkin (KMO) was 0.878. The EFA procedure has grouped 19 items into three domains, whereby one of the items from domain 3 was deleted since it failed to achieve the minimum requirement for factor loading of 0.6 and only 18 items were retained. The Cronbach’s alpha analysis of each domain in the FS-ICU exceeded the threshold value of 0.6. The study concluded that the instruments measuring the construct in this study has achieved the internal validity.
Keywords: validity, reliability, exploratory factor analysis, FS-ICU-M, satisfaction, family members
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Nurizzati, Yeti. "Persepsi Mahasiswa Tentang Penyelenggaraan Program Intensif Bahasa pada Pusat Pengembangan Bahasa." At-Tarbawi: Jurnal Kajian Kependidikan Islam 2, no. 2 (December 14, 2017): 141. http://dx.doi.org/10.22515/attarbawi.v2i2.830.
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Abstract: Language Development Center (PPB) IAIN Syekh Nurjati Cirebon is one of the Technical Implementation Unit of higher education related to intensive English and Arabic development program. All students from semester one to four must follow and graduate on this program. Assessment of the implementation of this program based on student perceptions of 100 samples is an evaluative study conducted by researchers. Using a questionnaire as a research instrument, it contains input, process, output, lecturers and staff indicators in the learning process. From the research results obtained conclusion that the assessment of the implementation of language intensive program on PPB IAIN Syekh Nurjati Cirebon based on students' perceptions goes pretty well. Most of the students considered that the lecturers of PPB had prepared the teaching well, mastered the taught material, and the exam questions were in accordance with the taught material. Some things that need to be improved are intensive course lectures held on Saturday Sunday, late module distribution, team teaching implementation that has not been optimal, and poor lecturer behavior. Keywords: Language intensive program, Perception
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Whitmore, Kirsty A., Shane C. Townsend, and Kevin B. Laupland. "Management of tracheostomies in the intensive care unit: a scoping review." BMJ Open Respiratory Research 7, no. 1 (July 2020): e000651. http://dx.doi.org/10.1136/bmjresp-2020-000651.
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ObjectivesWhile there is an extensive body of literature surrounding the decision to insert, and methods for inserting, a tracheostomy, the optimal management of tracheostomies within the intensive care unit (ICU) from after insertion until ICU discharge is not well understood. The objective was to identify and map the key concepts relating to, and identify research priorities for, postinsertion management of adult patients with tracheostomies in the ICU.DesignScoping review of the literature.Data sourcesPubMed, Embase and Cumulative Index to Nursing and Allied Health Literature were searched from inception to 3 October 2019. Additional sources were searched for published and unpublished literature.Eligibility criteriaWe included studies of any methodology that addressed the a priori key questions relating to tracheostomy management in the ICU. No restrictions were placed on language or year of publication.Data extraction and synthesisTitles and abstracts were screened by two reviewers. Studies that met inclusion criteria were reviewed in full by two reviewers, with discrepancies resolved by a third. Data were extracted for included studies, and results mapped along the prespecified research questions.Results6132 articles were screened, and 102 articles were included for detailed analysis. Protocolised weaning was found to be successful in liberating patients from the ventilator in several cohort studies. Observational studies showed that strategies that use T-pieces and high-flow oxygen delivery improve weaning success. Several lines of evidence, including one clinical trial, support early cuff deflation as a safe and effective strategy as it results in a reduced time to wean, shorter ICU stays and fewer complications. Early tracheostomy downsizing and/or switching to cuffless tubes was found to be of benefit in one study. A substantial body of evidence supports the use of speaking valves to facilitate communication. While this does not influence time to wean or incidence of complications, it is associated with a major benefit in patient satisfaction and experience. Use of care bundles and multidisciplinary team approaches have been associated with reduced complications and improved outcomes in several observational studies.ConclusionsThe limited body of evidence supports use of weaning protocols, early cuff deflation, use of speaking valves and multidisciplinary approaches. Clinical trials examining post-tracheostomy management strategies in ICUs are a priority.
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Hsieh, Hui-Chen. "High School Students’ Topic Preferences and Oral Development in an English-only Short-term Intensive Language Program." English Language Teaching 9, no. 9 (August 4, 2016): 116. http://dx.doi.org/10.5539/elt.v9n9p116.
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<p>Developing the ability to speak English is a daunting task that has long been omitted in a test-driven pedagogy context (Chang, 2011; Li, 2012a, 2012b; Chen & Tsai, 2012; Katchen, 1989, 1995). Since speaking is not tested for school admissions, most students are not motivated to learn it (Chang, 2011; Chen & Tsai, 2012). Now, globalization makes English Lingua Franca; speaking English is definitely bound to be one key capability to connect oneself with the world (Graddol, 2007). Thus, teachers strive to help learenrs learn English by selecting appropriate and interesting topics to motivate them to learn more effectively (Dörnyei & Csizér, 1998; Spratt, Pulverness & Williams, 2011), especially in speaking. However, with only one internationally published research on Taiwanese college students’ topics preference (Chen, 2012) and none on high school students, selecting appropriate topics seems challenging. Consequently, this study intended to investigate the potential topics that motivated learners to practice speaking and their oral performance. The results show that learners preferred topics related to their daily life and their speaking improved in terms of speech unit, clause unit, and words uttered.</p>
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Beckstrand, Renea L., Nicole L. Rawle, Lynn Callister, and Barbara L. Mandleco. "Pediatric Nurses’ Perceptions of Obstacles and Supportive Behaviors in End-of-Life Care." American Journal of Critical Care 19, no. 6 (November 1, 2010): 543–52. http://dx.doi.org/10.4037/ajcc2009497.
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BackgroundEach year 55 000 children die in the United States, and most of these deaths occur in hospitals. The barriers and supportive behaviors in providing end-of-life care to children should be determined.ObjectiveTo determine pediatric intensive care unit nurses’ perceptions of sizes, frequencies, and magnitudes of selected obstacles and helpful behaviors in providing end-of-life care to children.MethodA national sample of 1047 pediatric intensive care unit nurses who were members of the American Association of Critical-Care Nurses were surveyed. A 76-item questionnaire adapted from 3 similar surveys with critical care, emergency, and oncology nurses was mailed to possible participants. Nurses who did not respond to the first mailing were sent a second mailing. Nurses were asked to rate the size and frequency of listed obstacles and supportive behaviors in caring for children at the end of life.ResultsA total of 474 usable questionnaires were received from 985 eligible respondents (return rate, 48%). The 2 items with the highest perceived obstacle magnitude scores for size and frequency means were language barriers and parental discomfort in withholding and/or withdrawing mechanical ventilation. The highest supportive behavior item was allowing time alone with the child when he or she has died.ConclusionsPediatric intensive care unit nurses play a vital role in caring for dying children and the children’s families. Overcoming language and communication barriers with children’s families and between interdisciplinary team members could greatly improve the end-of-life experience for dying children.
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Parreco, Joshua, Antonio Hidalgo, Robert Kozol, Nicholas Namias, and Rishi Rattan. "Predicting Mortality in the Surgical Intensive Care Unit Using Artificial Intelligence and Natural Language Processing of Physician Documentation." American Surgeon 84, no. 7 (July 2018): 1190–94. http://dx.doi.org/10.1177/000313481808400736.
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The purpose of this study was to use natural language processing of physician documentation to predict mortality in patients admitted to the surgical intensive care unit (SICU). The Multiparameter Intelligent Monitoring in Intensive Care III database was used to obtain SICU stays with six different severity of illness scores. Natural language processing was performed on the physician notes. Classifiers for predicting mortality were created. One classifier used only the physician notes, one used only the severity of illness scores, and one used the physician notes with severity of injury scores. There were 3838 SICU stays identified during the study period and 5.4 per cent ended with mortality. The classifier trained with physician notes with severity of injury scores performed with the highest area under the curve (0.88 ± 0.05) and accuracy (94.6 ± 1.1%). The most important variable was the Oxford Acute Severity of Illness Score (16.0%). The most important terms were “dilated” (4.3%) and “hemorrhage” (3.7%). This study demonstrates the novel use of artificial intelligence to process physician documentation to predict mortality in the SICU. The classifiers were able to detect the subtle nuances in physician vernacular that predict mortality. These nuances provided improved performance in predicting mortality over physiologic parameters alone.
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Han, Yan-Qiu, Lei Zhang, Zhi-De Hu, Giuseppe Lippi, Peng Li, Pei-Heng Ouyang, and Li Yan. "Performance of D-dimer for predicting sepsis mortality in the intensive care unit." Biochemia medica 31, no. 2 (June 15, 2021): 309–17. http://dx.doi.org/10.11613/bm.2021.020709.
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The prognostic value of D-dimer (DD) in sepsis remains controversial. This study aimed to investigate the performance of DD for predicting sepsis mortality in the hospital and for identifying its potential correlates. The clinical and laboratory data of adult sepsis patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC III, v1.4) database using the structured query language (SQL). The database contains critical illness admitted to the intensive care unit at Beth Israel Deaconess Medical Center between June 2001 and October 2012. The association between DD and mortality was investigated with receiver operating characteristic (ROC) curve, restricted cubic spline and logistic regression analysis. Subgroup analysis was also used for identifying DD correlates. The study population consisted of 358 sepsis patients. Those who died during hospital stay (N = 160) had significantly higher DD values than those who survived (N = 198). The area under the ROC curve (AUC) of DD was 0.59 (P < 0.010). In subgroup analysis, white blood cell (WBC) count > 18 x109/L and vasopressor therapy significantly decreased DD diagnostic performance. Categorical DD value was independently associated with hospital mortality after sequential organ failure score (SOFA) and blood lactate adjustment. Restricted cubic spline analysis revealed a U-shape relationship between DD and in-hospital mortality. We conclude that the accuracy of DD for predicting in-hospital sepsis mortality depends on WBC count and vasopressor therapy. Both low and extremely elevated DD values are associated with higher risk of death.
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Sun, Lin, Meera Joshi, Sadia N. Khan, Hutan Ashrafian, and Ara Darzi. "Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis." Journal of the Royal Society of Medicine 113, no. 6 (June 2020): 217–24. http://dx.doi.org/10.1177/0141076820925436.
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Objective Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients. Design Systematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction. Setting The search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored. Participants All primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit. Main outcome measures Clinical impact of multi-parameter CoNiM. Results This systematic review identified 14 relevant studies from 3846 search results. Five studies were classified as Group A – associations found between measured vital signs and clinical parameters. Nine studies were classified as Group B – comparison between clinical outcomes of patients with and without multi-parameter CoNiM. Vital signs data from CoNiM were found to associate with type of presenting complaint, level of renal function and incidence of major clinical events. CoNiM also assisted in diagnosis by differentiating between patients with acute heart failure, stroke and sepsis (with sub-clustering of septic patients). In the meta-analysis, patients on multi-parameter CoNiM had a 39% decrease in risk of mortality (risk ratio [RR] 0.61; 95% confidence interval [95% CI] 0.39, 0.95) when compared to patients with regular intermittent monitoring. There was a trend of reduced intensive care unit transfer (RR 0.86; 95% CI 0.67, 1.11) and reduced rapid response team activation (RR 0.61; 95% CI 0.26–1.43). A trend towards reduced hospital length of stay was also found using weighted mean difference (WMD –3.32 days; 95% CI -8.82–2.19 days). Conclusion There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.
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Safitri, Dwi, Anna Kurnia, and Much Al Jihad. "Family Experience during Patient Assistance Process in General Intensive Care Unit: A Phenomenology Study." Open Access Macedonian Journal of Medical Sciences 9, T4 (August 8, 2021): 309–14. http://dx.doi.org/10.3889/oamjms.2021.5804.
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BACKGROUND: Intensive care unit (ICU) treatment can lead to fear, anxiety, depression, panic, and tension in the family. Place of the family as active presence, guardian, facilitator, historian, and coaching of the family cannot be separated from the recovery process. During the assistance of ICU patients, the family is faced with a strange environment, strict rules, emotional stress, and everyday life changes that have caused them to encounter psychological and physiological concerns. AIM: This study aims to describe and interpret of the family’s experience during assistance patient in the ICU. METHODS: A phenomenological methodology is used to explore experience of family. In-depth interviews were conducted on nine participants who were selected using purposive sampling. Data were analyzed by Colaizzi techniques, began with read transcripts, look for phenomenon, formulated data, organized, and verified to the participants. RESULTS: The result is presented in three themes; physically and psychologically tired; good language is a medicine, strengthens each other’s companion. CONCLUSION: The support of the patient in the ICU helps the family face a number of stressful circumstances. Adaptive coping and psychosocial help from health care workers and friends build a supportive family to cope with the difficulties when supporting patients in the ICU.
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Raz, Sarah, Angela K. DeBastos, Julie Bapp Newman, Brittany N. Peters, Andrew M. Heitzer, Jamie C. Piercy, and Daniel G. Batton. "Physical Growth in the Neonatal Intensive-Care Unit and Neuropsychological Performance at Preschool Age in very Preterm-Born Singletons." Journal of the International Neuropsychological Society 21, no. 2 (February 2015): 126–36. http://dx.doi.org/10.1017/s1355617715000077.
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AbstractWe studied the associations between early postnatal growth gains and neuropsychological outcome in very preterm-born children. Specifically, we wished to establish whether relationships exist between gains in head circumference (relative to gains in body-weight or length), from birth to hospital discharge, and intellectual, language, or motor, performance at preschool age. We used data from 127 preschoolers, born <33 weeks, all graduates of the William Beaumont Hospital Neonatal Intensive-Care Unit (NICU) in Royal Oak, MI. Cognitive, motor, and language outcomes were evaluated using the Wechsler Preschool and Primary Scales of Intelligence-Revised, Peabody Developmental Scales – 2nd Edition, and the Preschool Language Scale – 3rd Edition, respectively. Differences between Z-scores at birth and hospital discharge, calculated for three anthropometric measures (head circumference, weight, length), were variables of interest in separate simultaneous multiple regression procedures. We statistically adjusted for sex, socioeconomic status, birth weight, length of hospitalization, perinatal complications, and intrauterine growth. Examination of the relationships between anthropometric indices and outcome measures revealed a significant association between NICU head growth and global intelligence, with the Z-difference score for head circumference accounting for a unique portion of the variance in global intelligence (ηp2 =.04). Early postnatal head growth is significantly associated with neuropsychological outcome in very preterm-born preschoolers. To conclude, despite its relative brevity, NICU stay, often overlapping with the end of 2nd and with the 3rd trimester of pregnancy, appears to be a sensitive developmental period for brain substrates underlying neuropsychological functions. (JINS, 2015, 21, 126–136)
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Kaufman, D., S. Bakken, L. M. Currie, and B. Sheehan. "Cognitive Analysis of Decision Support for Antibiotic Ordering in a Neonatal Intensive Care Unit." Applied Clinical Informatics 03, no. 01 (2012): 105–23. http://dx.doi.org/10.4338/aci-2011-10-ra-0060.
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SummaryBackground: Clinical decision support systems (CDSS) are a method used to support prescribing accuracy when deployed within a computerized provider order entry system (CPOE). Divergence from using CDSS is exemplified by high alert override rates. Excessive cognitive load imposed by the CDSS may help to explain such high rates. Objectives: The aim of this study was to describe the cognitive impact of a CPOE-integrated CDSS by categorizing system use problems according to the type of mental processing required to resolve them.Methods: A qualitative, descriptive design was used employing two methods; a cognitive walk-through and a think-aloud protocol. Data analysis was guided by Norman’s Theory of Action and a theory of cognitive distances which is an extension to Norman’s theory.Results: The most frequently occurring source of excess cognitive effort was poor information timing. Information presented by the CDSS was often presented after clinicians required the information for decision making. Additional sources of effort included use of language that was not clear to the user, vague icons, and lack of cues to guide users through tasks.Conclusions: Lack of coordination between clinician’s task-related thought processes and those presented by a CDSS results in excessive cognitive work required to use the system. This can lead to alert overrides and user errors. Close attention to user’s cognitive processes as they carry out clinical tasks prior to CDSS development may provide key information for system design that supports clinical tasks and reduces cognitive effort.
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Fernandes, Marta, Rúben Mendes, Susana M. Vieira, Francisca Leite, Carlos Palos, Alistair Johnson, Stan Finkelstein, Steven Horng, and Leo Anthony Celi. "Predicting Intensive Care Unit admission among patients presenting to the emergency department using machine learning and natural language processing." PLOS ONE 15, no. 3 (March 3, 2020): e0229331. http://dx.doi.org/10.1371/journal.pone.0229331.
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Lehmann, Christoph, Daniel Fabbri, and Michael Temple. "Natural Language Processing for Cohort Discovery in a Discharge Prediction Model for the Neonatal ICU." Applied Clinical Informatics 07, no. 01 (January 2016): 101–15. http://dx.doi.org/10.4338/aci-2015-09-ra-0114.
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SummaryDischarging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children’s services. We previously created a model to identify patients that will be medically ready for discharge in the subsequent 2–10 days. In this study we use Natural Language Processing to improve upon that model and discern why the model performed poorly on certain patients.We retrospectively examined the text of the Assessment and Plan section from daily progress notes of 4,693 patients (103,206 patient-days) from the NICU of a large, academic children’s hospital. A matrix was constructed using words from NICU notes (single words and bigrams) to train a supervised machine learning algorithm to determine the most important words differentiating poorly performing patients compared to well performing patients in our original discharge prediction model.NLP using a bag of words (BOW) analysis revealed several cohorts that performed poorly in our original model. These included patients with surgical diagnoses, pulmonary hypertension, retinopathy of prematurity, and psychosocial issues.The BOW approach aided in cohort discovery and will allow further refinement of our original discharge model prediction. Adequately identifying patients discharged home on g-tube feeds alone could improve the AUC of our original model by 0.02. Additionally, this approach identified social issues as a major cause for delayed discharge.A BOW analysis provides a method to improve and refine our NICU discharge prediction model and could potentially avoid over 900 (0.9%) hospital days.AUC – Area under the Curve, CART -- Classification And Regression Trees, DTD – Days to Dis- charge, GI – Gastrointestinal, LOS – Length of Stay, NICU – Neonatal Intensive Care Unit, NS – Neurosurgery, RF – Random Forest.
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Viana, Renata Andrea Pietro Pereira, Mara Ambrosina de Oliveira Vargas, Maria Isabel Sampaio Carmagnani, Luiza Hiromi Tanaka, Kely Regina da Luz, and Pablo Henrique Schmitt. "Profile of an intensive care nurse in different regions of Brazil." Texto & Contexto - Enfermagem 23, no. 1 (March 2014): 151–59. http://dx.doi.org/10.1590/s0104-07072014000100018.
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The aim of this quantitative study was to identify the socio-demographic and academic profile of intensive care registered nurses and participants of the events organized by the Department of Nursing of the Brazilian Association of Intensive Care Medicine. Data were collected by means of 400 questionnaires applied between January and July of 2010, however only 324 questionnaires were returned and 295 questionnaires were considered for the analysis. Data were analyzed with descriptive statistics resources with absolute relative frequency and simple mean, presented in tables. Results show the predominance of women, with specific graduate degrees. The skills and values highlighted include technical and scientific knowledge, and leadership. These professionals seek work in intensive care because of the high technological complexity. The study emphasized the existence of the professional profile required to work in the intensive care unit. The qualification of these professionals must prioritize the mastering of the technological language and the comprehensive and safe care.
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Silver, Michael A., and Karen McKinnon. "Finding alternatives to the streets for the homeless mentally Ill: Efficacy at a state hospital intensive placement unit." Journal of Psycholinguistic Research 23, no. 1 (January 1994): 67–73. http://dx.doi.org/10.1007/bf02143176.
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Gregorio, María Ángeles Pérez San, Agustín Martín Rodríguez, and José Pérez Bernal. "Psychological Differences of Patients and Relatives according to Post-Transplantation Anxiety." Spanish Journal of Psychology 11, no. 1 (May 2008): 250–58. http://dx.doi.org/10.1017/s1138741600004285.
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The aim of this investigation is to analyze the psychological differences of patients and their relatives according to the formers' post-transplantation anxiety. We used two groups of participants: transplant patients (n = 166) and close relatives (n = 166). Four questionnaires were applied: a Psychological Survey (to both groups), the Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire (to the transplant patients), and the Leeds Scales for the Self-Assessment of Anxiety and Depression (to the relatives). Participants were assessed twice: post-Intensive Care Unit (ICU; when patients were moved from the ICU to the Transplantation Unit) and post-hospital (one year after transplant). Results showed that high anxiety in patients just after organ transplant was related to an increase of anxiety and depression symptoms both in patients and relatives one year after transplant; it was also related to a decrease in the quality of life of these patients.
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Martins, Belmira D. C. P. C. C., Reinaldo A. Oliveira, and Antonio J. M. Cataneo. "Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis." Palliative and Supportive Care 15, no. 3 (July 27, 2016): 376–83. http://dx.doi.org/10.1017/s1478951516000584.
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AbstractObjective:The purpose of our systematic review was to determine whether the introduction of palliative care (PC) teams reduces length of stay and/or mortality for terminally ill patients (TIPs) in an intensive care unit (ICU).Method:We hoped to examine studies that compared TIPs in an ICU who received end-of-life care following implementation of a PC team (intervention group) to those who received care where PC teams had not yet been introduced (control group). We searched MEDLINE via PubMed, LILACS, Scopus, Embase, and Cochrane CENTRAL (search conducted in December of 2015) without language restrictions. Our outcome measures were length of stay in an ICU, presented as an average difference with a corresponding 95% confidence interval (CI95%), and mortality in the ICU, presented as a risk ratio with a corresponding CI95%. Two of our authors independently extracted all of the data.Results:Of the 399 publications identified, 27 were selected for full-text analysis and 19 were excluded, leaving 8 articles for inclusion, which involved a total of 7,846 patients. A metaanalysis of mortality in the ICU was conducted with four studies. Lower mortality was found in the intervention group: risk ratio = 0.78 (CI95% = 0.70–0.87), p < 0.00001, I2 = 18%. Length of stay in the ICU was presented as a mean and standard deviation in four studies, and the result was a reduction of ~2.5 days in the length of stay with application of the intervention: mean = –2.44 days (CI95% = –4.41 to –0.48), p = 0.01, I2 = 86%.Significance of results:Introduction of palliative care teams can reduce mortality rates in the ICU, and perhaps shorten length of stay in the ICU for terminally ill patients.
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Villioti, Anastasia, Antonia Kalogianni, Dimitrios Papageorgiou, and Edison Jahaj. "Nursing pain assessment in non verbal intensive care patient." Health & Research Journal 4, no. 4 (December 7, 2018): 186. http://dx.doi.org/10.12681/healthresj.19295.
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Introduction: It has been found out that pain is one of the most important issues that patients have to deal with while they are hospitalized in an intensive care unit (ICU), especially when they are non-communicative. Nurses play the most important role in the pain assessment through the everyday contact with patients and with the use of a variety of pain assessment tools as well.Aim: The purpose was to determine nurses’ level of knowledge about the use of pain assessment tools (especially pain scales) in the unconscious intensive care patients – To investigate the level of pain assessment tools application in the daily nursing routine by the ICU nurses.Material and Method: A systematic review in the followed database was applied: Pubmed-Medline-Embase. The entry criteria in the review were: a) Publication date: 1990-2017 b) Greek or English language c) the sample of research must necessarily include experienced nurses who work exclusively in an intensive care unit. d) the use of pain assessment tools for non verbal patients should be included in the nursing interventions e) nurses should be responsible for the daily care of non verbal patients f) the results must be concern exclusively non communicative patients.Results: From the research four studies have emerged which met the standards of the review. The common findings among these researches result in the fact that although nurses believe that an effective pain assessment is important to a great extent, very few of them use pain assessment tools according to protocols especially in the unconscious patients.Conclusions: Nursing pain assessment concerning non verbal patients still remain inadequate and doesn’t seem to be a priority during the daily nursing routine. The promotion of education of nurses concerning pain assessment is required and the use of protocols as well in order to ease the process of a reliable and valid pain assessment.
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Journault, Marina, Simone Stenekes, Robin McClure, and Chelsea Ruth. "108 Palliative care for neonates: Retrospective mixed methods review of infant death in the Neonatal Intensive Care Unit." Paediatrics & Child Health 25, Supplement_2 (August 2020): e45-e45. http://dx.doi.org/10.1093/pch/pxaa068.107.
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Abstract Background Neonatal palliative care is an under researched yet growing field in the provision of intensive care to neonates. There are currently no studies which explore infant death in the Neonatal Intensive Care Unit (NICU) itself where a shift from intensive to palliative care may occur. Objectives The purpose of this study was to explore the circumstances of infant death in the NICU and understand current utilization of specialist palliative care in this area. It aimed to characterize the infants’ clinical course and add unique understanding by analyzing documentation related to end of life care. Design/Methods A retrospective chart review of infants who died in a single centre NICU between January 2017 and March 2018 was undertaken. Infants of any gestational and post-natal age were included, excluding infants who died prior to arrival to the NICU or were discharged or transferred prior to death. Chart notes relating to prognosis, advanced care planning, and palliative interventions were sampled, coded, and collated for thematic analysis. Results Twenty-five infants met study criteria. Of these, 92% were preterm with more than half below 28 weeks gestation. Median age at death was 5.2 days (IQR 1, 26.2). All infants required ventilator support with planned withdrawal occurring in 60%. Specialist palliative care was involved in 28%; these infants tended to be older (mean age at death = 78 days). Most infants were labelled as “critical” 2-5 days prior to death. Seventy-six percent of infants were held on their last day of life with 72% of families having memory making documented as part of their care. Qualitative excerpts revealed themes of hope and acceptance, parental presence, and framed discussion. Within these emerged concepts of “parental agreement” and “palliative language/approach”. Conclusion There is a growing need for both primary and specialist palliative care in the NICU. This study highlights an under researched area and generates many more important questions. By exploring documented language, we aim to understand and improve the ability to frame the discussion while ensuring quality end of life care for dying infants and their families in the NICU.
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Abraham, Joanna, Alicia Meng, Sanjna Tripathy, Michael S. Avidan, and Thomas Kannampallil. "Systematic review and meta-analysis of interventions for operating room to intensive care unit handoffs." BMJ Quality & Safety 30, no. 6 (February 9, 2021): 513–24. http://dx.doi.org/10.1136/bmjqs-2020-012474.
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ObjectiveTo conduct a systematic review and meta-analysis to ascertain the impact of operating room (OR) to intensive care unit (ICU) handoff interventions on process-based and clinical outcomes.MethodWe included all English language, prospective evaluation studies of OR to ICU handoff interventions published as original research articles in peer-reviewed journals. The search was conducted on 11 November 2019 on MEDLINE, CINAHL, EMBASE, Scopus and the Cochrane Central Register of Controlled Trials databases, with no prespecified criteria for the type of comparison or outcome. A meta-analysis of similar outcomes was conducted using a random effects model. Quality was assessed using a modified Downs and Black (D&B) checklist.Results32 studies were included for review. 31 studies were conducted at a single site and 28 studies used an observational study design with a control. Most studies (n=28) evaluated bundled interventions which comprised information transfer/communication checklists and protocols. Meta-analysis showed that the handoff intervention group had statistically significant improvements in time to analgesia dosing (mean difference (MD)=−42.51 min, 95% CI −60.39 to −24.64), fewer information omissions (MD=−2.22, 95% CI −3.68 to –0.77), fewer technical errors (MD=−2.38, 95% CI −4.10 to –0.66) and greater information sharing scores (MD=30.03%, 95% CI 19.67% to 40.40%). Only 15 of the 32 studies scored above 9 points on the modified D&B checklist, indicating a lack of high-quality studies.DiscussionBundled interventions were commonly used to support OR to ICU handoff standardisation. Although the meta-analysis showed significant improvements for a number of clinical and process outcomes, the statistical and clinical heterogeneity must be accounted for when interpreting these findings. Implications for OR to ICU handoff practice and future research are discussed.
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Karpilovska, Ievgeniia. "The approaches to the description of innovations in the modern Ukrainian neography." Juznoslovenski filolog 76, no. 2 (2020): 105–25. http://dx.doi.org/10.2298/jfi2002105k.
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The intensive development of the Ukrainian language at the turn of the 21st century due to its new status as the official language of independent Ukraine, the essential changes in Ukrainian society and Ukraine?s openness to globalisation have led to the forming of new disciplines in Ukrainian linguistics - neology and neography. They present two interconnected approaches to the analysis and lexicographic description of new language units (innovations) - the differential and the integral approach. The first approach involves the study of innovations in comparison with the existing units of the language, the search of criteria for determining their types by the features of their novelty in the language system and in text. The second approach focuses on the degree of stability of innovations in modern Ukrainian, i.e. the importance of concepts they verbalise in the conceptual and the linguistic worldview of the modern Ukrainians. The functional potential of a certain innovation in the linguistic activity of a society is an indicator of the degree of its stability in the language. It is a set of units consisting of innovation by paradigmatic, syntagmatic and epidigmatic (derivational) relations. The analysis of the word as the basic unit of Ukrainian nomination, prediction and evaluation enable the identification of other types of language innovations. The modern Ukrainian lexicon presents the following types of neologisms: new derivatives, new borrowings, neosemanticisms, neographisms, actualised and returned words. The application of the differential approach is advisable when gathering new language material, whereas the integrated approach is necessary when identifying the stabilised linguistic innovations, as it can be a resource for replenishing the general lexicon of a language. The results of the analysis of this new lexicon are presented in the differential and integral neological dictionaries.
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Standley, Jayne M. "Pre and Perinatal Growth and Development: Implications of Music Benefits for Premature Infants." International Journal of Music Education os-31, no. 1 (May 1998): 1–13. http://dx.doi.org/10.1177/025576149803100101.
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This article summarizes the current scientific knowledge on foetal and newborn neurological development and related research on beneficial uses of music with the premature infant. As technology and science advance, the survival rate of earlier and earlier premature birth increases with long-term implications for these children having impaired neurological development, delayed growth, and need for special education. Research in the neonatal intensive care unit has focused on uses of music to reduce stress, to promote homeostasis and weight gain, to reinforce non-nutritive sucking, to enhance developmental maturation, and to shorten length of hospitalization. Further, it is theorized that music benefits documented for full term newborns may also apply to the premature infant, i.e., lullabies promote language development; familiar music is recognized, reinforcing, and comforting; and infants orient to and avidly attend to music more so than other auditory stimuli. This burgeoning area of research provides exciting possibilities for the practice of music therapy in the neonatal intensive care unit and for music education in early childhood.