Готові списки джерел за темами / Intensive care nursing

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Добірка наукової літератури з теми "Intensive care nursing"

Автор: Grafiati
Опубліковано: 4 червня 2021
Оновлено: 29 липня 2024

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Статті в журналах з теми "Intensive care nursing"

1

Forshee, Terri, and Barbara J. Daly. "Intensive Care Nursing." American Journal of Nursing 86, no. 6 (June 1986): 770. http://dx.doi.org/10.2307/3425439.

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2

&NA;. "Intensive Care Nursing." AJN, American Journal of Nursing 86, no. 6 (June 1986): 770. http://dx.doi.org/10.1097/00000446-198606000-00034.

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&NA;. "Intensive Care Nursing." AJN, American Journal of Nursing 86, no. 6 (June 1986): 770. http://dx.doi.org/10.1097/00000446-198686060-00034.

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4

Killman, Debbie. "Paediatric Intensive Care NursingPaediatric Intensive Care Nursing." Nursing Children and Young People 25, no. 3 (April 2013): 12. http://dx.doi.org/10.7748/ncyp2013.04.25.3.12.s9.

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5

McGurk, Valerie. "Neonatal Intensive Care Nursing – Second editionNeonatal Intensive Care Nursing – Second edition." Nursing Standard 25, no. 27 (March 9, 2011): 30. http://dx.doi.org/10.7748/ns2011.03.25.27.30.b1177.

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6

HENDRICKS, PETER, and DOROTHY G. LAPPE. "Pediatric intensive care nursing." Critical Care Medicine 21, Supplement (September 1993): S393. http://dx.doi.org/10.1097/00003246-199309001-00061.

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7

Quinn, Tom. "Cardiovascular intensive care nursing." Intensive and Critical Care Nursing 9, no. 3 (September 1993): 211. http://dx.doi.org/10.1016/0964-3397(93)90035-v.

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Pearson, S. "Cardiovascular Intensive Care Nursing." Journal of Advanced Nursing 18, no. 9 (September 1993): 1507. http://dx.doi.org/10.1046/j.1365-2648.1993.180915055.x.

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9

McKinley, Sharon. "Australian intensive care nursing." Intensive and Critical Care Nursing 23, no. 6 (December 2007): 309–12. http://dx.doi.org/10.1016/j.iccn.2007.08.007.

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10

Nunn, Melissa. "Pediatric Intensive Care Nursing." Critical Care Nursing Clinics of North America 35, no. 3 (September 2023): i. http://dx.doi.org/10.1016/s0899-5885(23)00065-5.

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Дисертації з теми "Intensive care nursing"

1

Adomat, Reneé. "Measuring nursing workload in intensive care." Thesis, University of Birmingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397781.

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2

Dunbar, Pervell Velethia. "Nursing Care of Terminal patients in Intensive Care Units." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1379.

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Анотація:
Nursing Care for Terminal Patients in Intensive Care Units by Pervell Dunbar Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2015 Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A literature review revealed a poster previously used by a major health organization as a conversation starter to facilitate decision-making among ICU nurses, EOL patients, and their families related to EOL issues. The purpose of this quality improvement initiative was to introduce and implement an educational EOL tool that would engage patients and family members in meaningful and useful conversations with ICU nurses. Twenty seven ICU nurses were selected by the unit's director to attend a PowerPoint presentation on the use of the EOL educational poster. Four ICU nurses were chosen by the director to be champions for this project. After the presentation, there was a period for questions and answers, and the ICU nurses were requested to give feedback on the presentation. The result from the feedback revealed that EOL care is outside previous practice and may require extra education and support. These comments substantiated similar conclusions from other researchers as described in this paper. With an increase in EOL training for ICU nurses and the implementation of EOL teaching tools like the poster used in this study, ICU nurses may be better able to have conversations with EOL patients and families, thus improving patient care.
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3

Cronqvist, Agneta. "The moral enterprise in intensive care nursing." Doctoral thesis, Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-942-0/.

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4

Moon, Mikyung. "Relationship of nursing diagnoses, nursing outcomes, and nursing interventions for patient care in intensive care units." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/3356.

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Анотація:
The purpose of the study was to identify NANDA - I diagnoses, NOC outcomes, and NIC interventions used in nursing care plans for ICU patient care and determine the factors which influenced the change of the NOC outcome scores. This study was a retrospective and descriptive study using clinical data extracted from the electronic patient records of a large acute care hospital in the Midwest. Frequency analysis, one-way ANOVA analysis, and multinomial logistic regression analysis were used to analyze the data. A total of 578 ICU patient records between March 25, 2010 and May 31, 2010 were used for the analysis. Eighty - one NANDA - I diagnoses, 79 NOC outcomes, and 90 NIC interventions were identified in the nursing care plans. Acute Pain - Pain Level - Pain Management was the most frequently used NNN linkage. The examined differences in each ICU provide knowledge about care plan sets that may be useful. When the NIC interventions and NOC outcomes used in the actual ICU nursing care plans were compared with core interventions and outcomes for critical care nursing suggested by experts, the core lists could be expanded. Several factors contributing to the change in the five common NOC outcome scores were identified: the number of NANDA - I diagnoses, ICU length of stay, gender, and ICU type. The results of this study provided valuable information for the knowledge development in ICU patient care. This study also demonstrated the usefulness of NANDA - I, NOC, and NIC used in nursing care plans of the EHR. The study shows that the use of these three terminologies encourages interoperability, and reuse of the data for quality improvement or effectiveness studies.
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5

郭子琪 and Chi-ki Priscilla Kwok. "Nurse-controlled intensive insulin infusion in adult intensive care unit." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720858.

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Kwok, Chi-ki Priscilla. "Nurse-controlled intensive insulin infusion in adult intensive care unit." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720858.

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Davis, Clare. "Optimising nursing shift handover in Paediatric Intensive Care." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2943.

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Ferreira, Josà Hernevides Pontes. "Team perception of nursing care humanized in intensive care unit neonatal." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16481.

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Анотація:
CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior
Hospitalization of the newborn is necessary when health conditions require immediate assistance for their recovery. Humanized actions in the neonatal unit have been developed in order to make it less painful separation parent-child when it needs technological support and team of trained professionals. It was aimed to analyze the perception and knowledge of the nursing team on the promotion of humanized care for newborn in a Neonatal Intensive Care Unit . It is a qualitative study conducted in a public hospital, large, tertiary level, in Fortaleza, Brazil, in the months October and November 2015, after approval by the Research Ethics Committee, under Protocol N. 1,191,339. The subjects were 14 nurses and 20 nursing technicians working in neonatal care. The data collected through semi-structured interviews consist identification data and five guiding issues that permeate the knowledge of the nursing team about the care and promotion of humanized care in the UTIN. In addition, we used no-participant observation and field diary. For analysis, we sought to Bardin technique that extracted the three categories lines: âTaking care of the human personâ, ânursing contributions to the humane careâ and âFactors that affect the quality of humanized care.â The results showed that the nursing team understands humanization as an indispensable element for the comprehensive care to the baby and family, which was observed from the speeches of welcome, restoring health and disease of the newborn process. The professionals had knowledge of the humanized care, played their actions conscious, oriented and appreciative way about the quality of neonatal care and parents who face the challenges inherent in the admission process. We conclude that the performance of these professionals permeates compliance with the regulations of the National Humanization Policy regarding humanized care to the newborn, family and neonatal ambience. It is believed that such actions minimize the impact caused by the characteristics of the disease treatment as well as stressors.
A hospitalizaÃÃo do recÃm-nascido faz-se necessÃria, quando as condiÃÃes de saÃde requerem assistÃncia imediata para o seu restabelecimento. As aÃÃes humanizadas na unidade neonatal tÃm sido desenvolvidas, a fim de tornar menos dolorosa à separaÃÃo pais-filho, quando este necessita de suporte tecnolÃgico e equipe de profissionais capacitados. Objetivou-se analisar a percepÃÃo e conhecimentos da equipe de enfermagem sobre a promoÃÃo do cuidado humanizado ao recÃm-nascido internado na Unidade de Terapia Intensiva Neonatal (UTIN). Trata-se de estudo qualitativo, realizado em hospital pÃblico, de grande porte, nÃvel terciÃrio, em Fortaleza-CE-Brasil, nos meses outubro e novembro de 2015, apÃs aprovaÃÃo pelo Comità de Ãtica em Pesquisa, sob Protocolo n 1.191.339. Os sujeitos foram 14 enfermeiros e 20 tÃcnicos de enfermagem atuantes na assistÃncia ao neonato. Os dados coletados, por meio de entrevista semiestruturada, consistem dados de identificaÃÃo e cinco questÃes norteadoras, que permeiam o conhecimento da equipe de enfermagem acerca do cuidado e a promoÃÃo da assistÃncia humanizada na UTIN. Ademais, utilizou-se observaÃÃo nÃo participante e diÃrio de campo. Para anÃlise, sÃntese e descriÃÃo, buscou-se a tÃcnica de Bardin, que se extraÃram das falas trÃs categorias: âCuidar do ser humanoâ, âContribuiÃÃes de enfermagem para o cuidado humanizadoâ e âFatores que interferem na qualidade do cuidado humanizadoâ. Os resultados revelaram que a equipe de enfermagem compreende a humanizaÃÃo como elemento indispensÃvel para o cuidado integral ao bebà e famÃlia, o que se observou desde as intervenÃÃes de acolhimento, ao restabelecimento do processo saÃde-doenÃa do neonato. Os profissionais apresentaram conhecimentos acerca do cuidado humanizado, desempenharam suas aÃÃes de forma consciente, orientada e sensibilizada, quanto à qualidade da assistÃncia ao neonato e aos pais que enfrentam os desafios inerentes ao processo de internaÃÃo. Percebe-se, portanto, que a atuaÃÃo desses profissionais permeia o cumprimento aos regulamentos da PolÃtica Nacional de HumanizaÃÃo. Conclui-se que o cuidado humanizado aplicado nessa ambiÃncia à essencial ao recÃm-nascido e famÃlia, uma vez que minimiza o impacto causado pelas caracterÃsticas da doenÃa, tratamento, bem como os fatores estressantes da UTIN.
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9

Wolak, Eric S. "Perceptions of an intensive care unit mentorship program." Greensboro, N.C. : University of North Carolina at Greensboro, 2007. http://libres.uncg.edu/edocs/etd/1492Wolak/umi-uncg-1492.pdf.

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Анотація:
Thesis (M.S.N.)--University of North Carolina at Greensboro, 2007.
Title from PDF t.p. (viewed Mar. 3, 2008). Directed by Susan Letvak; submitted to the School of Nursing. Includes bibliographical references (p. 53-58).
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10

Goldsborough, Jennifer. "Palliative Care Integration in the Intensive Care Unit." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4787.

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Palliative health care is offered to any patient experiencing a life limiting or life changing illness. The palliative approach includes goals of care, expert symptom management, and advance care planning in order to reduce patient suffering. Complex care can be provided by palliative care specialists while primary palliative care can be given by educated staff nurses. However, according to the literature, intensive care unit (ICU) nurses have demonstrated a lack of knowledge in the provision of primary care as well as experiencing moral distress from that lack of knowledge. In this doctor of nursing practice staff education project, the problem of ICU nurses' lack of knowledge was addressed. Framed within Rosswurm and Larrabee's model for evidence-based practice, the purpose of this project was to develop an evidence-based staff education plan. The outcomes included a literature review matrix, an educational curriculum plan, and a pretest and posttest of questions based on the evidence in the curriculum plan. A physician and a master's prepared social worker, both certified in palliative care, and a hospital nurse educator served as content experts. They evaluated the curriculum plan using a dichotomous 6-item format and concluded that the items met the intent of the objectives. They also conducted content validation on each of the pretest/posttest items using a Likert-type scale ranging from 1 (not relevant) to 4 (very relevant). The content validation index was 0.82 indicating that test items were relevant to the educational curriculum objectives. Primary palliative care by educated ICU nurses can result in positive social change by facilitating empowerment of patients and their families in personal goal-directed care and reduction of suffering.
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Книги з теми "Intensive care nursing"

1

Woodrow, Philip. Intensive Care Nursing. Edited by Philip Woodrow. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174.

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2

J, Daly Barbara, ed. Intensive care nursing. 2nd ed. [New Hyde Park, N.Y.]: Medical Examination Pub. Co., 1985.

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3

1957-, Boxwell Glenys, ed. Neonatal intensive care nursing. 2nd ed. Abingdon, Oxon: Routledge, 2010.

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4

Boxwell, Glenys. Neonatal Intensive Care Nursing. London: Taylor & Francis Group Plc, 2004.

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5

M, Ashworth Pat, and Clarke Cilla, eds. Cardiovascular intensive care nursing. Edinburgh: Churchill Livingstone, 1992.

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6

Crawford, Doreen, and Michaela Dixon. Paediatric intensive care nursing. Chichester, West Sussex: Wiley-Blackwell, 2012.

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7

Manley, Kim. Primary nursing in intensive care. London: Scutari, 1989.

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8

Eliezer, Nussbaum, ed. Pediatric intensive care. 2nd ed. Mount Kisco, NY: Futura Pub. Co., 1989.

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9

Sole, Mary Lou. Introduction to critical care nursing. 4th ed. St. Louis, MO: Elsevier Saunders, 2005.

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10

M, Rippe James, ed. Intensive care medicine. Boston: Little, Brown, 1985.

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Частини книг з теми "Intensive care nursing"

1

Woodrow, Philip. "Nursing perspectives." In Intensive Care Nursing, 3–10. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-1.

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Woodrow, Philip. "Psychological care." In Intensive Care Nursing, 18–28. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-3.

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Woodrow, Philip. "Costs of intensive care." In Intensive Care Nursing, 485–91. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-50.

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Woodrow, Philip. "Nutrition and bowel care." In Intensive Care Nursing, 87–96. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-9.

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Woodrow, Philip. "Mouthcare." In Intensive Care Nursing, 97–103. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-10.

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Woodrow, Philip. "Eyecare." In Intensive Care Nursing, 104–9. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-11.

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Woodrow, Philip. "Tissue viability." In Intensive Care Nursing, 110–16. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-12.

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Woodrow, Philip. "Children in adult ICUs." In Intensive Care Nursing, 117–25. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-13.

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Woodrow, Philip. "Older patients in ICU." In Intensive Care Nursing, 126–32. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-14.

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Woodrow, Philip. "Infection prevention and control." In Intensive Care Nursing, 133–42. Fourth edition. | Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2018. http://dx.doi.org/10.4324/9781315231174-15.

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Тези доповідей конференцій з теми "Intensive care nursing"

1

Dian Kurniawati, Ninuk, Suharto Suharto, and Nursalam Nursalam. "Mind-Body-Spiritual Nursing Care in Intensive Care Unit." In 8th International Nursing Conference on Education, Practice and Research Development in Nursing (INC 2017). Paris, France: Atlantis Press, 2017. http://dx.doi.org/10.2991/inc-17.2017.59.

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2

Chon, KyungJa, and NamYoung Yang. "The Type A/B Personality, Attitudes and Behaviors to Oral Care in Intensive Care Unit Nurses." In Healthcare and Nursing 2015. Science & Engineering Research Support soCiety, 2015. http://dx.doi.org/10.14257/astl.2015.116.07.

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3

Jung, Su Kyoung, and Mi-Young Chon. "A study on intensive care unit patients' subjectivity for transfer experience." In Healthcare and Nursing 2014. Science & Engineering Research Support soCiety, 2014. http://dx.doi.org/10.14257/astl.2014.72.01.

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4

Schlotman, K., T. Quinn, S. Basapur, C. Glover, and J. A. Greenberg. "A Nursing Assessment of Intensive Care Unit Rounding Summaries." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1654.

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5

Mustanir. "Knowledge of Disaster Response among Nurses in Emergency Departments and Intensive Care Units: A Comparative Study." In Aceh International Nursing Conference. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0008394200300037.

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6

Espino, Danicsa, Carmen Arbulu, Madeleine Espino, Dávila Valdera Anny Katherine, Luis Dávila, Espino Carrasco Mayury Jackeline, Vasquez Cachay Royer, et al. "Specialized nurse care for the patient with an internal tracheotomy cannula in the intensive care public hospital of Peru." In 14th International Conference on Applied Human Factors and Ergonomics (AHFE 2023). AHFE International, 2023. http://dx.doi.org/10.54941/ahfe1003482.

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Анотація:
In the intensive care unit (ICU), specialized critical care is provided to patients with multi- organ problems resulting from multiple diseases, requiring invasive and intensive care, therapy and monitoring with the support of high-tech equipment (Moreno et al., 2021). The general objective was to collect evidence to generate specialized nursing care guides for patients with internal tracheostomy cannula in intensive care units (ICU) in public hospitals of the Minsa of Peru. A type of secondary research was developed with an Evidence-Based Nursing methodology, formulating the PICOT clinical question: What are the nursing care that must be performed to avoid complications in the intensive care unit patient with internal cannula? For the collection of information, the following techniques and instruments were used, systematic review, for the bibliographic search, Google Scholar, Pubmed search engines were used, as well as databases: Science Direct and SciELO, finding a total of 7 investigations that They were evaluated through the Gálvez Toro validation guide, then the Boverieth Astete checklist, finally the level of evidence is given through the list of the USPreventive Services Task Force (USPSTF) the review had a level of evidence III (Referring to the opinion of experts based on clinical experience) had a grade of recommendation B , based on the GRADE classification system. The results obtained show 12 relevant care such as: Secretion aspiration, stoma cure, tracheal cannula changes, decannulation, expulsion of the mucous plug, hydration of the patient, treatment with mucolytics, humidification of the environment with mucolytics, respiratory physiotherapy, avoiding bleeding, prevent infection of the stoma, cleaning the cannula. It is concluded that the use of electronic equipment allows the nursing professional to provide specialized care to the patient with tracheotomy, evidence that at the same time allows the addition of guidelines in which care is unified in the Intensive Care Unit (ICU).
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khan, ihsan U., saleem Shazad, Viswanath P. Vasudevan, Rana Ali, and Farhand Arjomand. "Clinical Outcome Of Nursing Home And Non-nursing Home Patients Admitted To Medical Intensive Care Unit." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1630.

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Wang, Janice, Viera Lakticova, and Rubin Cohen. "Time Allocation Of Intensive Care Unit Nursing To Rapid Responses In A Tertiary Care Academic Hospital." 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.a5074.

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Christiane Marocco Duran, Erika, and Raisa Camilo Ferreira. "Content validation of a tool to the Nursing Care Process for Pacients in Intensive Care Unit." In XXIII Congresso de Iniciação Científica da Unicamp. Campinas - SP, Brazil: Galoá, 2015. http://dx.doi.org/10.19146/pibic-2015-37759.

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Bicalho, Tamires, Ana Paula Peçanha Passos, Aline Marques, and Carolina Magalhães dos Santos. "Impact of the COVID-19 pandemic on the life habits of the nursing staff working in intensive care units of hospitals in the city of Campos dos Goytacazes-RJ." In 7th International Congress on Scientific Knowledge. Biológicas & Saúde, 2021. http://dx.doi.org/10.25242/8868113820212387.

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Анотація:
The COVID-19 pandemic remains a major public health challenge. Most patients infected with the SARS-CoV2 virus are critical patients requiring admission to intensive care units (ICU) and qualified nursing care. However, the experiences of nurses from China and Italy showed that one of the biggest obstacles in the care of patients with the disease occurred within the scope of the organization of trained and qualified teams, staff dimensioning, management of supplies and equipment, and attention to the mental health of these professionals. Faced with this pandemic scenario, professional nurses face important challenges concerning care and the quality of nursing services in intensive care. The objective of this research will be to identify the impact caused by the COVID-19 pandemic on the life habits of professionals from the Nursing teams who work in the Intensive Care Units in the municipality of Campos dos Goytacazes-RJ. This is a cross-sectional study to be carried out between October and December 2021. Data collection will be carried out through an online questionnaire (Google Forms®) whose sample will consistof professionals from the Nursing teams (nurses and nursing technicians), working in the Intensive Care Units of Private and Public Hospitals in the city of Campos dos Goytacazes-RJ. Subsequently, the data obtained will be analyzed using descriptive statistics in the SPSS® software. This study aims to contribute to improving the quality of life and health of nursing professionals working in ICUs and, consequently, the quality of care and patient safety. Furthermore, it is expected that the results corroborate the need to implement health protection strategies for these professionals in the context of the pandemic.
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Звіти організацій з теми "Intensive care nursing"

1

Moore, Gabriel, Anton du Toit, Susie Thompson, Jillian Hutchinson, Adira Wiryoatmodjo, Prithivi Prakash Sivaprakash, and Rebecca Gordon. Effectiveness of school located nurse models. The Sax Institute, May 2021. http://dx.doi.org/10.57022/gmwr5438.

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This Rapid Evidence Summary looks at the effectiveness of school-located nurse models on student health, education and wellbeing. The strongest evidence was found for nurse-led models. All the included studies found that having a school nurse and school nursing interventions to be valuable for health promotion, early intervention, and timely care for at-risk students. They also found expanded nursing roles with more intensive care coordination and navigation, and efforts to engage families and social care providers to be of value. The authors note that the literature suggests that where nurses are an integral part of the school team and act as a central point of communication there is greater capacity for understanding students’ needs and mobilising targeted, appropriate and coordinated care.
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Clavet, Nicholas-James, Réjean Hébert, and Pierre-Carl Michaud. The future of long-term care in Quebec: what are the cost savings from a realistic shift towards more home care? CIRANO, April 2022. http://dx.doi.org/10.54932/zrzh8256.

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This paper aims to estimate the future long-term care needs and expenditures in Quebec while proposing and evaluating a reform package that could deliver increased coverage as well as be more financially sustainable than current policy. This reform package consists of a shift towards more intensive use of home care while increasing public coverage of care needs. A key feature of the proposed reform is to improve the ability of users to choose their provider with the creation of a senior’s care account, an account that grants individuals in need to purchase services from several providers, including both home and institutional care. To improve the neutrality of public support across care arrangements, we also propose to increase residents’ contribution in nursing homes while favoring the continued use of existing tax credits to help seniors with lower needs in terms of care. Using detailed dynamic modelling of care needs, living arrangements, and expenditures, we estimate that long-term care needs will grow rapidly in the next two decades and the costs will quickly become prohibitive under current policy. We show that substantial cost savings may exist.
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Clavet, Nicholas-James, Réjean Hébert, and Pierre-Carl Michaud. The future of long-term care in Quebec: what are the cost savings from a realistic shift towards more home care? CIRANO, April 2022. http://dx.doi.org/10.54932/zrzh8256.

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This paper aims to estimate the future long-term care needs and expenditures in Quebec while proposing and evaluating a reform package that could deliver increased coverage as well as be more financially sustainable than current policy. This reform package consists of a shift towards more intensive use of home care while increasing public coverage of care needs. A key feature of the proposed reform is to improve the ability of users to choose their provider with the creation of a senior’s care account, an account that grants individuals in need to purchase services from several providers, including both home and institutional care. To improve the neutrality of public support across care arrangements, we also propose to increase residents’ contribution in nursing homes while favoring the continued use of existing tax credits to help seniors with lower needs in terms of care. Using detailed dynamic modelling of care needs, living arrangements, and expenditures, we estimate that long-term care needs will grow rapidly in the next two decades and the costs will quickly become prohibitive under current policy. We show that substantial cost savings may exist.
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4

McCarthy, Sean T., Aneesa Motala, Emily Lawson, and Paul G. Shekelle. Prevention in Adults of Transmission of Infection With Multidrug-Resistant Organisms. Rapid Review. Agency for Healthcare Research and Quality (AHRQ), April 2024. http://dx.doi.org/10.23970/ahrqepc_mhs4mdro.

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Objectives. This rapid review summarizes literature for patient safety practices intended to prevent and control the transmission of multidrug-resistant organisms (MDROs). Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed to identify eligible systematic reviews from 2011 to May 2023 and primary studies published from 2011 to May 2023, supplemented by targeted gray literature searches. We included literature that addressed patient safety practices intending to prevent or control transmission of MDROs which were implemented in hospitals and nursing homes and that included clinical outcomes of infection or colonization with MDROs as well as unintended consequences such as mental health effects and noninfectious adverse healthcare-associated outcomes. The protocol for the review has been registered in PROSPERO (CRD42023444973). Findings. Our search retrieved 714 citations, of which 42 articles were eligible for review. Systematic reviews, which were primarily of observational studies, included a wide variety of infection prevention and control (IPC) practices, including universal gloving, contact isolation precautions, adverse effects of patient isolation, patient and/or staff cohorting, room decontamination, patient decolonization, IPC practices specifically in nursing homes, features of organizational culture to facilitate implementation of IPC practices and the role of dedicated IPC staff. While systematic reviews were of good or fair quality, strength of evidence for the conclusions was always low or very low, due to reliance on observational studies. Decolonization strategies showed some benefit in certain populations, such as nursing home patients and patients discharging from acute care hospitalization. Universal gloving showed a small benefit in the intensive care unit. Contact isolation targeting patients colonized or infected with MDROs showed mixed effects in the literature and may be associated with mental health and noninfectious (e.g., falls and pressure ulcers) adverse effects when compared with standard precautions, though based on before/after studies in which such precautions were ceased. There was no significant evidence of benefit for patient cohorting (except possibly in outbreak settings), automated room decontamination or cleaning feedback protocols, and IPC practices in long-term settings. Infection rates may be improved when IPC practices are implemented in the context of certain logistical and staffing characteristics including a supportive organizational culture, though again strength of evidence was low. Dedicated infection prevention staff likely improve compliance with other patient safety practices, though there is little evidence of their downstream impact on rates of infection. Conclusions. Selected infection prevention and control interventions had mixed evidence for reducing healthcare-associated infection and colonization by multidrug resistant organisms. Where these practices did show benefit, they often had evidence that applied only to certain subpopulations (such as intensive care unit patients), though overall strength of evidence was low.
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James-Scott, Alisha, Rachel Savoy, Donna Lynch-Smith, and tracy McClinton. Impact of Central Line Bundle Care on Reduction of Central Line Associated-Infections: A Scoping Review. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0014.

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