Готові списки джерел за темами / Pediatric intensive care Victoria Melbourne

Добірка наукової літератури з теми "Pediatric intensive care Victoria Melbourne"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 29 січня 2023

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Статті в журналах з теми "Pediatric intensive care Victoria Melbourne"

James, Christopher, Carmel Delzoppo, James Tibballs, Siva Namachivayam, and Warwick Butt. "Adverse Events Sustained by Children in The Intensive Care Unit: Guiding local quality improvement." Asia Pacific Journal of Health Management 13, no. 3 (December 16, 2018): i20. http://dx.doi.org/10.24083/apjhm.v13i3.113.

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Objective: To determine the frequency, nature and consequence of adverse events sustained by children admitted to a combined general and cardiac paediatric intensive care unit (PICU). Design: Retrospective analysis of data collected between January 1st 2008 and December 31st 2017 from PICU. Setting: The Royal Children’s Hospital, a paediatric tertiary referral centre in Melbourne, Victoria, Australia. The PICU has thirty beds. Results: During the study period, PICU received 15208 admissions, of which 73% sustained at least one adverse event with a frequency of 67 adverse events per 100 PICU-days and 3 per admission. One adverse event was sustained for every 35 hours of care. The risk of an adverse event was highest in children less than a month of age, or if mechanically ventilated, a high Pediatric Index of Mortality (PIM2) score, longer PICU length of stay, had a pre-existing disability or a high risk adjustment for congenital heart surgery (RACHS) score. Those patients who sustained an adverse event, as compared to those who did not, were mechanically ventilated for longer (80 hrs Vs. 7 hrs, p=<0.001), had a longer PICU length of stay (131 hrs Vs. 35 hrs, p=<0.001), had a longer hospital length of stay (484 hrs Vs. 206 hrs, p=<0.001) and had a higher mortality rate (3% vs. 0.1%, p=<0.001). Conclusion: Whilst admission to PICU is an essential aspect of care for many patients, the risk of adverse events is high and is associated with significant clinical consequences. Monitoring of adverse events as part of quality improvement enables targeted intervention to improve patient safety.

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WAPOLE, BRYAN. "The first national meeting of emergency medicine doctors JULY 1981 MELBOURNE: VICTORIA." Emergency Medicine 3 (August 26, 2009): 188–89. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00730.x.

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Rose, Louise, Sioban Nelson, Linda Johnston, and Jeffrey J. Presneill. "Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit." American Journal of Critical Care 16, no. 5 (September 1, 2007): 434–43. http://dx.doi.org/10.4037/ajcc2007.16.5.434.

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Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

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Frawley, Geoff P., and Andrew Fock. "Pediatric hyperbaric oxygen therapy in Victoria, 1998–2010." Pediatric Critical Care Medicine 13, no. 4 (July 2012): e240-e244. http://dx.doi.org/10.1097/pcc.0b013e318238b3f3.

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Campbell, Lynda. "The Families First Pilot Program in Victoria: Cuckoo or contribution?" Children Australia 19, no. 2 (1994): 4–10. http://dx.doi.org/10.1017/s1035077200003898.

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The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.

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Chia, A. C. L., M. G. Irwin, P. W. H. Lee, T. H. W. Lee, and S. F. Man. "Comparison of Stress in Anaesthetic Trainees between Hong Kong and Victoria, Australia." Anaesthesia and Intensive Care 36, no. 6 (November 2008): 855–62. http://dx.doi.org/10.1177/0310057x0803600617.

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A postal survey was sent to anaesthetic trainees in Hong Kong and Victoria, Australia to compare work-related stress levels. Demographic data were collected. Anaesthetist-specific stressors, Maslach Burnout Inventory and Global Job Satisfaction scores were used for psychological testing. The response rates from Hong Kong and Melbourne were 64 of 133 (48.1%) and 108 of 196 (55.1%), respectively. Victorian respondents were older with greater family commitments, but more advanced in fulfilling training requirements. Hong Kong respondents, being faced with both the challenge of dual College requirements, exhibited consistently higher indices of stress (P <0.001) and less job satisfaction (P <0.001). Common occupational stressors related to dealing with critically ill patients and medicolegal concerns. Higher stress scores observed in Hong Kong trainees related to service provision and a perceived lack of resources. Despite the complex nature of stress, its antecedents and manifestations, an inverse relationship between emotional exhaustion and job satisfaction was evident in correlation analysis (P <0.001). This survey suggests that stress was present in some trainees in both areas. Hong Kong trainees may benefit from local development to address mental wellbeing as being important to fulfil this highly competitive training program.

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Polmear, C. M., H. Nathan, S. Bates, C. French, J. Odisho, E. Skinner, A. Karahalios, and F. McGain. "The Effect of Intensive Care Unit Admission on Smokers’ Attitudes and Their Likelihood of Quitting Smoking." Anaesthesia and Intensive Care 45, no. 6 (November 2017): 720–26. http://dx.doi.org/10.1177/0310057x1704500612.

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We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post–ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients’ attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post–ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post–ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post–ICU discharge (odds ratio 2.98; 95% confidence intervals 1.07, 8.26; P=0.036). Six months post–ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.

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Pilcher, David V., Graeme Duke, Melissa Rosenow, Nicholas Coatsworth, Genevieve O’Neill, Tracey A. Tobias, Steven McGloughlin, et al. "Assessment of a novel marker of ICU strain, the ICU Activity Index, during the COVID-19 pandemic in Victoria, Australia." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 300–307. http://dx.doi.org/10.51893/2021.3.oa7.

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OBJECTIVES: To validate a real-time Intensive Care Unit (ICU) Activity Index as a marker of ICU strain from daily data available from the Critical Health Resource Information System (CHRIS), and to investigate the association between this Index and the need to transfer critically ill patients during the coronavirus disease 2019 (COVID-19) pandemic in Victoria, Australia. DESIGN: Retrospective observational cohort study. SETTING: All 45 hospitals with an ICU in Victoria, Australia. PARTICIPANTS: Patients in all Victorian ICUs and all critically ill patients transferred between Victorian hospitals from 27 June to 6 September 2020. MAIN OUTCOME MEASURE: Acute interhospital transfer of one or more critically ill patients per day from one site to an ICU in another hospital. RESULTS: 150 patients were transported over 61 days from 29 hospitals (64%). ICU Activity Index scores were higher on days when critical care transfers occurred (median, 1.0 [IQR, 0.4–1.7] v 0.6 [IQR, 0.3–1.2]; P < 0.001). Transfers were more common on days of higher ICU occupancy, higher numbers of ventilated or COVID-19 patients, and when more critical care staff were unavailable. The highest ICU Activity Index scores were observed at hospitals in north-western Melbourne, where the COVID-19 disease burden was greatest. After adjusting for confounding factors, including occupancy and lack of available ICU staff, a rising ICU Activity Index score was associated with an increased risk of a critical care transfer (odds ratio, 4.10; 95% CI, 2.34–7.18; P < 0.001). CONCLUSIONS: The ICU Activity Index appeared to be a valid marker of ICU strain during the COVID-19 pandemic. It may be useful as a real-time clinical indicator of ICU activity and predict the need for redistribution of critical ill patients.

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Mcbride, L. J. "Spinal Anaesthesia—Early Australian Experience." Anaesthesia and Intensive Care 33, no. 1_suppl (June 2005): 39–44. http://dx.doi.org/10.1177/0310057x0503301s06.

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Australia in 1902 was a fledgling colony in its second year of Federation with a population of around 3.7 million. European settlement had been largely confined to the coastal margins of this enormous land mass, although some bold adventurers in search of gold and farmland had struggled their way into the interior. Horsham, situated 300 km northwest of Melbourne in the state of Victoria, was founded in June 1849. By 1902 the town, with a population of around 2500, had grown to boast a hospital, two doctors, a pharmacist and a dentist. It was at the Horsham Hospital on January 7, 1902 that Dr Robert Ritchie performed Australia's first recorded spinal anaesthetic. Ritchie performed a lumbar puncture at the L3–4 level, injected 2 ml of 2% cocaine solution and waited for a total of 20 minutes before realising that the sensation the patient was feeling when he pinched him was pressure, not pain. The 78-year-old man with a gangrenous right leg, prostatic obstruction and congestive cardiac failure was laid supine, and had his right leg amputated through the thigh while being administered brandy and water. Strychnine injections were administered four hourly postoperatively. The adoption of the technique of spinal anaesthesia spread quickly in Australia despite communication difficulties at that time.

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Abdulrahiem, Juhaina, Asia Sultan, Faisl Alaklobi, Hala Amer, and Hind Alzoman. "A COMPREHENSIVE UPDATE ON INCIDENCE, PREVALENCE AND COMPLEX ETIOLOGY OF CENTRAL LINE–ASSOCIATED BLOODSTREAM INFECTION IN PEDIATRIC INTENSIVE CARE UNITS IN KING SAUD MEDICAL CITY." International Journal of Research -GRANTHAALAYAH 9, no. 5 (May 31, 2021): 56–63. http://dx.doi.org/10.29121/granthaalayah.v9.i5.2021.3907.

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Central Line Associated Bloodstream Infection (CLABSI) is a type of bloodstream infection that is caused by microorganisms after the insertion of central lines. Paediatric Intensive Care Units have been studied to conduct this research on CLABSI in children from 2 to 15 years old. Children have been divided in two age groups that are 2-5 and 5-15 years. The Royal Children’s Hospital, Melbourne has been chosen as a sample of this besides other five hospitals of Australia. A total of 350 patients are studied in the course of this research and 216 among them were inserted with central lines. Bloodstream infection has been identified in 49 patients from these 216 patients and CLABSI occurred in 75.51% of them that is 37 patients. Associated microorganisms and other underlying diseases are listed in this study to develop an idea about factors responsible for CLABSI.

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