scholarly journals Characteristics of mechanically ventilated patients with COVID-19 and persons under investigation negative for COVID-19 at an academic medical center: A retrospective cross-sectional pilot study

2020 ◽  
Vol 67 ◽  
pp. 110029
Author(s):  
Patrick H. Lam ◽  
Adam J. Milam ◽  
Emiley Tou ◽  
Navpreet K. Dhillon ◽  
Samantha Toscano ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Academic Medical ◽  
Ventilated Patients

Comparison of Ketamine- Versus Nonketamine-Based Sedation on Delirium and Coma in the Intensive Care Unit

2018 ◽  
Vol 35 (6) ◽  
pp. 536-541 ◽  
Author(s):  
Vanessa Shurtleff ◽  
John J. Radosevich ◽  
Asad E. Patanwala
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Adult Patients ◽  
Study Cohort ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Background: At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. Objective: The objective of this study was to evaluate the number of days alive without delirium or coma in mechanically ventilated patients in the intensive care unit receiving analgosedation infusions with ketamine versus without ketamine. Methods: This was a retrospective cohort study conducted at an academic medical center in the United States. Consecutive mechanically ventilated adult patients between November 2015 and April 2017 were evaluated. Patients were divided into 2 groups based on the sedative regimen used: ketamine based or nonketamine based. The primary outcome was the number of days alive without delirium or coma. The secondary outcomes were incidence of delirium, incidence of coma, and ventilator-free days at day 28. Results: The study cohort consisted of 79 patients, of which 39 received ketamine- and 40 received nonketamine-based sedation. The number of days alive without delirium or coma was 6 days (interquartile range [IQR]: 2-9 days) with ketamine and 4 days (IQR: 3-7 days) with nonketamine ( P = .351). Delirium occurred in 29 (74%) of 39 patients with ketamine and 34 (85%) of 40 patients with nonketamine ( P = .274). Coma occurred in 16 (41%) of 39 patients with ketamine and 6 (15%) of 40 patients with nonketamine ( P = .013). The median ventilator-free days were 13 days (IQR: 0-23 days) with ketamine and 21 days (0-25 days) with nonketamine ( P = .229). Conclusions: Sustained ketamine-based sedation in mechanically ventilated patients may be associated with a higher rate of observed coma but similar delirium- and coma-free days compared nonketamine-based regimens.

CUIDADOS BUCAIS EM PACIENTES VENTILADOS MECANICAMENTE: CONHECIMENTO DE ENFERMEIROS DE UM HOSPITAL ESCOLA

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Gérsica Sampaio Silva ◽  
Fernanda Alves Ferreira Gonçalves ◽  
Bárbara Ribeiro Miquelin Bueno ◽  
Georlucya Kátia Da Silva Ferreira ◽  
Ludmila Pinheiro Da Silva ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Oral Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Complicating Factors ◽  
Materials Used ◽  
Ventilated Patients

Objetivo: Avaliar o conhecimento acerca dos cuidados bucais realizados por enfermeiros a pacientes ventilados mecanicamente. Método: Estudo transversal, realizado em um hospital escola de Goiânia/Goiás. A coleta de dados deu-se por meio de questionário estruturado. Resultados: Os enfermeiros conhecem as medidas recomendadas sobre higiene bucal. Os fatores dificultadores encontrados foram a falta de pessoal (21,7%), falta de tempo (16,7%) e trabalhos burocráticos (15%). Contudo ainda existem lacunas no que se refere a produtos e materiais utilizados na higiene bucal. Conclusão: As Lacunas e os fatores dificultadores sinalizados nesse estudo merecem reflexão, como forma de avaliar a qualidade do cuidado oferecido.Descritores: Biofilme; Higiene Bucal; Cuidados de enfermagem.ORAL CARE IN MECHANICALLY VENTILATED PATIENTS: KNOWLEDGE OF NURSES FROM A SCHOOL HOSPITALObjective: To evaluate the knowledge about oral care performed by nurses in mechanically ventilated patients. Methods: a cross-sectional study, conducted in a teaching hospital of Goiania/Goias. The data collection was performed by means of a structured questionnaire. Results: The nurses know the measures recommended on oral hygiene. The complicating factors found were the lack of personnel (21.7%), lack of time (16.7%) and work on tape (15%). However there are still gaps in relation to products and materials used in oral hygiene. Conclusion: The gaps and the factors complicating factors indicated in this study deserve consideration, as a means of evaluating the quality of care offered.Keywords: Biofilm; Oral hygiene; Nursing care.CUIDADO ORAL EN PACIENTES CON VENTILACIÓN MECÁNICA: EL CONOCIMIENTO DE LAS ENFERMERAS DEL HOSPITAL ESCUELAObjetivo: Evaluar el conocimiento sobre el cuidado bucal realizadas por enfermeras en pacientes ventilados mecánicamente. Métodos: Estudio transversal, realizado en un hospital de Goiania y Goias. La recolección de datos se realizó por medio de un cuestionario estructurado. Resultados: Las enfermeras saben las medidas recomendadas en la higiene bucal. Los factores encontrados fueron la falta de personal (21,7%), la falta de tiempo (16,7%) y trabajar en la cinta (15%). Sin embargo todavía hay lagunas en relación con los productos y los materiales utilizados en la higiene bucal. Conclusión: Las brechas y los factores factores indicados en este estudio merecen consideración, como medio de evaluar la calidad de la atención ofrecida.Palabras clave: Biofilme; Higiene Bucal; Atención de Enfermería.

scholarly journals A Study on Knowledge Towards Brain Death among Residents in Indonesia

2020 ◽  
Vol 56 (2) ◽  
pp. 140
Author(s):  
Asra Al Fauzi ◽  
Christrijogo Sumartono Waloejo ◽  
Abdulloh Machin ◽  
Muhammad Ja'far Shodiq
Keyword(s):  
Brain Death ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cross Sectional Study ◽  
Research Subjects ◽  
Cross Sectional ◽  
Academic Medical ◽  
Center Hospital ◽  
Level 3 ◽  
Level 2

This research was conducted to evaluate the knowledge and diagnosis of brain death among resident in Indonesia. This study used an observational analytic study with a cross-sectional study design using a questionnaire. The research subjects consisted of 132 level 2 (after 2 years of residency) and level 3 (after 4 years of residency) residents, the total sampling for which was taken from the departments of Neurosurgery, Anesthesiology, and Neurology at Dr. Soetomo Academic Medical Center Hospital, Surabaya, Indonesia. Data were taken from November 2018 to January 2019. A total of 132 residents of Neurosurgery, Neurology, and Anesthesiology participated in this study. From the series of studies, residents’ knowledge of the concept of brain death was in the sufficient category (41.7%), residents’ knowledge of the technical diagnosis of brain death was in the good category (40.2%), residents’ knowledge of brain death examination was in the less category (43.2%), and finally, it was found that the resident's knowledge of brain death was in a good category (35.6%). There were also significant differences in knowledge of brain death between Neurosurgery, Neurology, and Anesthesiologist Resident (P <0.001) and knowledge of brain death between level 2 and level 3 residents (P=0.032). In general, the Indonesian resident doctors’ knowledge of brain death is adequate, but knowledge of the clinical examination of brain death is still lacking. Further research must be carried out to promote knowledge of brain death in residents as well as professional doctors/specialists, so that the number of organ transplants, especially in Indonesia, will increase.

Millennials Seeking Healthcare: Examining the Degree to Which Patients Utilize Online Resources (Preprint)

2021 ◽  
Author(s):  
Landon Arensberg ◽  
Jessica Kalender-Rich ◽  
Jaehoon Lee ◽  
Cheryl Gibson
Keyword(s):  
Medical Care ◽  
Baby Boomers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Age Groups ◽  
Online Reviews ◽  
Online Resources ◽  
Cross Sectional ◽  
Academic Medical ◽  
Us Census

BACKGROUND According to the 2020 US Census, a Silver Tsunami is looming with more than 75.4 million persons aged 57-75 (known as “Baby Boomers”) expected to need more costly medical care. Future estimates, however, indicate a much larger wave of individuals is imminent, given the 83.1 million Millennials approaching adulthood who will be seeking medical care. Because Millennials differ from Baby Boomers in several ways, it is important to understand how this population finds their physician to gain insight into what might influence this decision. OBJECTIVE To determine the extent and influence online resources and reviews have on the younger generation as compared to elder generations. METHODS Between the months of May and July 2020 a cross-sectional paper-based survey was conducted at primary care and geriatric clinics located within a large urban academic medical center in the Midwest. RESULTS A sample of 284 patients completed the survey (44.35 ± 17.54 yrs old [range=18-90], 60.6% female, 57.4% white). Of Millennials (respondents aged 22-38 yrs), 67.2% read online reviews before choosing a physician. Millennials were significantly more likely to read online reviews before choosing a physician (P=0.004) and utilize online resources to search for a new physician (P<.001) than older patients. The majority of millennials were likely to be influenced by both negative reviews (59%) and positive reviews (71.3%). Female patients were more likely to read online reviews and use online resources compared to men, but the differences were not significant. CONCLUSIONS Overall, Millennials are much more likely to research online reviews before choosing a physician. Other generations also use online resources to an extent but tend to use personal referrals. Across all age groups, negative online reviews were less influential in decision-making compared to positive ones. Therefore, a presence on review websites and search engines seems to only benefit one’s medical practice to capture the new wave of patients.

scholarly journals IMPACT OF VENTILATOR MODEL ON MORTALITY: A RETROSPECTIVE CROSS-SECTIONAL STUDY IN 147 MECHANICALLY VENTILATED PATIENTS WITH COVID-19 ARDS

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A617
Author(s):  
Christian Castaneda ◽  
Christina Jee Ah Rhee ◽  
Albert Magh ◽  
Christine Eng ◽  
Jack Mann ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Opioid use in the acute setting: A survey of providers at an academic medical center

2018 ◽  
Vol 14 (3) ◽  
pp. 203-210 ◽  
Author(s):  
Douglas R. Oyler, PharmD ◽  
Kristy S. Deep, MD ◽  
Phillip K. Chang, MD
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Providers ◽  
High Risk Patient ◽  
Opioid Analgesics ◽  
Opioid Use ◽  
Cross Sectional ◽  
Academic Medical ◽  
Clinical Scenarios ◽  
Nonopioid Analgesics

Objective: To examine attitudes, beliefs, and influencing factors of inpatient healthcare providers regarding prescription of opioid analgesics.Design: Electronic cross-sectional survey.Setting: Academic medical center.Participants: Physicians, advanced practice providers, and pharmacists from a single academic medical center in the southeast United States.Main Outcome Measures: Respondents completed survey items addressing: (1) their practice demographics, (2) their opinions regarding overall use, safety, and efficacy of opioids compared to other analgesics, (3) specific clinical scenarios, (4) main pressures to prescribe opioids, and (5) confidence/comfort prescribing opioids or nonopioids in select situations.Results: The majority of the sample (n = 363) were physicians (60.4 percent), with 69.4 percent of physicians being attendings. Most respondents believed that opioids were overused at our institution (61.7 percent); nearly half thought opioids had similar efficacy to other analgesics (44.1 percent), and almost all believed opioids were more dangerous than other analgesics (88.1 percent). Many respondents indicated that they would modify a chronic regimen for a high-risk patient, and use of nonopioids in specific scenarios was high. However, this use was often in combination with opioids. Respondents identified patients (64 percent) and staff (43.1 percent) as the most significant sources of pressure to prescribe opioids during an admission; the most common sources of pressure to prescribe opioidson discharge were to facilitate discharge (44.8 percent) and to reduce follow-up requests, calls, or visits (36.3 percent). Resident physicians appear to experience more pressure to prescribe opioids than other providers. Managing pain in patients with substance use disorders and effectively using nonopioid analgesics were the most common educational needs identified by respondents.Conclusion: Most individuals believe opioid analgesics are overused in our specific setting, commonly to satisfy patient requests. In general, providers feel uncomfortable prescribing nonopioid analgesics to patients.

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