scholarly journals A systematic scoping review of the cost-impact of ventilator-associated pneumonia (VAP) intervention bundles in intensive care

2020 ◽  
Author(s):  
Elyse Ladbrook ◽  
Damien Khaw ◽  
Stéphane Bouchoucha ◽  
Anastasia Hutchinson
Keyword(s):  
Intensive Care ◽  
Scoping Review ◽  
Ventilator Associated Pneumonia ◽  
Cost Impact ◽  
The Cost

scholarly journals Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study

2017 ◽  
Vol 19 (2) ◽  
pp. 94-100 ◽  
Author(s):  
Heyman Luckraz ◽  
Na’ngono Manga ◽  
Eshan L Senanayake ◽  
Mahmoud Abdelaziz ◽  
Shameer Gopal ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
National Health Service ◽  
Ventilator Associated Pneumonia ◽  
Significant Morbidity ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care ◽  
The Cost ◽  
Post Cardiac Surgery

Background Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Methods Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416). Patients who were diagnosed as developing ventilator-associated pneumonia, as per the surveillance definition for ventilator-associated pneumonia (n = 338), were propensity score matched with those who did not (n = 338). Costs of treating post-op cardiac surgery patients in intensive care and cost difference if ventilator-associated pneumonia occurred based on Healthcare Resource Group categories were assessed. Secondary outcomes included differences in morbidity, mortality and cardiac intensive care unit and in-hospital length of stay. Results There were no significant differences in the pre-operative characteristics or procedures between the groups. Ventilator-associated pneumonia developed in 10% of post-cardiac surgery patients. Post-operatively, the ventilator-associated pneumonia group required longer ventilation (p < 0.01), more respiratory support, longer cardiac intensive care unit (8 vs 3, p < 0.001) and in-hospital stay (16 vs 9) days. The overall cost for post-operative recovery after cardiac surgery for ventilator-associated pneumonia patients was £15,124 compared to £6295 for non-ventilator-associated pneumonia (p < 0.01). The additional cost of treating patients with ventilator-associated pneumonia was £8829. Conclusion Ventilator-associated pneumonia was associated with significant morbidity to the patients, generating significant costs. This cost was nearer to the lower end for the cost for general intensive care unit patients in privately reimbursed systems.

scholarly journals The socioeconomic burden of antibiotic resistance in conflict-affected settings and refugee hosting countries: a systematic scoping review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Elsa Kobeissi ◽  
Marilyne Menassa ◽  
Krystel Moussally ◽  
Ernestina Repetto ◽  
Ismail Soboh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Scoping Review ◽  
Statistical Power ◽  
Data Extraction ◽  
Quality Data ◽  
Sufficient Information ◽  
Socioeconomic Burden ◽  
General Populations ◽  
Global Threat ◽  
The Cost

Abstract Background Antibiotic resistance (ABR) is a major global threat. Armed and protracted conflicts act as multipliers of infection and ABR, thus leading to increased healthcare and societal costs. We aimed to understand and describe the socioeconomic burden of ABR in conflict-affected settings and refugee hosting countries by conducting a systematic scoping review. Methods A systematic search of PubMed, Medline (Ovid), Embase, Web of Science, SCOPUS and Open Grey databases was conducted to identify all relevant human studies published between January 1990 and August 2019. An updated search was also conducted in April 2020 using Medline/Ovid. Independent screenings of titles/abstracts followed by full texts were performed using pre-defined criteria. The Newcastle-Ottawa Scale was used to assess study quality. Data extraction and analysis were based on the PICOS framework and following the PRISMA-ScR guideline. Results The search yielded 8 studies (7 publications), most of which were single-country, mono-center and retrospective studies. The studies were conducted in Lebanon (n = 3), Iraq (n = 2), Jordan (n = 1), Palestine (n = 1) and Yemen (n = 1). Most of the studies did not have a primary aim to assess the socioeconomic impact of ABR and were small studies with limited statistical power that could not demonstrate significant associations. The included studies lacked sufficient information for the accurate evaluation of the cost incurred by antibiotic resistant infections in conflict-affected countries. Conclusion This review highlights the scarcity of research on the socioeconomic burden of ABR on general populations in conflict-affected settings and on refugees and migrants in host countries, and lists recommendations for consideration in future studies. Further studies are needed to understand the cost of ABR in these settings to develop and implement adaptable policies.

scholarly journals Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review

2021 ◽  
Vol 7 ◽  
pp. 237796082110261
Author(s):  
Takeshi Unoki ◽  
Hideaki Sakuramoto ◽  
Ryuhei Sato ◽  
Akira Ouchi ◽  
Tomoki Kuribara ◽  
...  
Keyword(s):  
Intensive Care ◽  
Adverse Effects ◽  
Scoping Review ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
World Health ◽  
Protective Equipment ◽  
Medical Database ◽  
Publication Type ◽  
Skin Injuries

Introduction To avoid exposure to SARS-COV-2, healthcare professionals use personal protective equipment (PPE) while treating COVID-19 patients. Prior studies have revealed the adverse effects (AEs) of PPE on healthcare workers (HCWs); however, no review has focused on the AEs of PPE on HCWs in intensive care units (ICUs). This review aimed to identify the AEs of PPE on HCWs working in ICUs during the COVID-19 pandemic. Methods A scoping review was conducted. MEDLINE, CINAHL, the World Health Organization (WHO) global literature on COVID-19, and Igaku-chuo-zasshi (a Japanese medical database), Google Scholar, medRxiv, and Health Research Board (HRB) open research were searched from January 25–28, 2021. The extracted data included author(s) name, year of publication, country, language, article title, journal name, publication type, study methodology, population, outcome, and key findings. Results The initial search identified 691 articles and abstracts. Twenty-five articles were included in the analysis. The analysis comprised four key topics: studies focusing on PPE-related headache, voice disorders, skin manifestations, and miscellaneous AEs of PPE. The majority of AEs for HCWs in ICUs were induced by prolonged use of masks. Conclusion The AEs of PPE among HCWs in ICUs included heat, headaches, skin injuries, chest discomfort, and dyspnea. Studies with a focus on specific diseases were on skin injuries. Moreover, many AEs were induced by prolonged use of masks.

Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review

2018 ◽  
Vol 24 (6) ◽  
pp. 495-509 ◽  
Author(s):  
Kristy Loewenstein
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Neonatal Intensive Care Unit ◽  
Scoping Review ◽  
Neonatal Intensive Care ◽  
Family Cohesion ◽  
Ecological Model ◽  
Well Being

BACKGROUND: Neonatal intensive care unit (NICU) parents are at risk for psychological distress and impaired mental health, and statistics related to parent psychological distress vary. OBJECTIVE: To determine the scope of literature regarding the mental health and psychosocial well-being of parents in the NICU. DESIGN: A scoping review within the Arksey and O’Malley framework and the SEM was undertaken to answer, “What factors contribute to parent’s mental health in the NICU?” A systematic review of the literature was performed using the PRISMA methodology. RESULTS: Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress. History of mental illness, family cohesion, birth trauma, altered parenting role, gestational age, birth weight, and severity of prematurity/illness emerged as themes. CONCLUSION: Further research is required to provide a standard for the screening and assessment of parents’ mental health and psychosocial well-being during a NICU hospitalization. The experiences of nonbirth parents in the NICU should be explored to examine the effects of the hospitalization on all types of parents.

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