The role and accountability of senior health care support workers in intensive care units

2004 ◽  
Vol 20 (3) ◽  
pp. 123-132 ◽  
Author(s):  
M JOHNSON
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Senior Health Care ◽  
Care Support ◽  
Senior Health

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units

2018 ◽  
Vol 35 (10) ◽  
pp. 1067-1073
Author(s):  
Vincent Issac Lau ◽  
Fran Priestap ◽  
Joyce N. H. Lam ◽  
John Basmaji ◽  
Ian M. Ball
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Care Facility ◽  
Health Care Facility ◽  
Surgical Trauma ◽  
Home Discharge ◽  
Return Visits

Purpose: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). Methods: Prospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Univariable and multivariable logistic regression analyses were performed to identify factors associated with adverse events or unplanned return visits to a health-care facility following DDH from ICU. Results: A total of 129 DDH patients were enrolled and completed the 8-week follow-up. We identified 39 unplanned return visits (URVs). There was 0% mortality at 8 weeks postdischarge. Eight potential predictors of hospital URVs ( P < .2) were identified in the univariable analysis: prior substance abuse (odds ratio [OR] of URV of 2.50 [95% confidence interval: 1.08-5.80], hepatitis (OR: 6.92 [1.68-28.48]), sepsis (OR: 11.03 [1.19-102.29]), admission nine equivalents of nursing manpower score (NEMS) <24 (OR: 2.28 [1.03-5.04], no fixed address (OR: 22.9 [1.2-437.3]), ICU length of stay (LOS) <2 days (OR: 2.95 [1.28-6.78]), home discharge within London, Ontario (OR: 2.44 [1.00-5.92]), and left against medical advice (AMA; OR: 6.06 [2.04-17.98]). Conclusions: Our study identified 8 covariates that were potential predictors of URV: prior substance abuse, hepatitis, sepsis, admission NEMS <24, no fixed address, ICU LOS <2 days, home discharge within London, Ontario, and left AMA. The practice of direct discharges home from the ICU would benefit from adequately powered multicenter study in order to construct a clinical prediction model (that would require further testing and validation).

scholarly journals Are mobile phones of health care workers portals of pathogenic organisms causing hospital acquired infections in intensive care units? A mini systematic review

2020 ◽  
Vol 47 (3) ◽  
pp. 207-214
Author(s):  
M. Mukhtar-Yola ◽  
B. Andrew
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Mobile Phones ◽  
Health Care Workers ◽  
Pathogenic Bacteria ◽  
Cross Sectional ◽  
Hospital Acquired Infections ◽  
Care Workers ◽  
Hospital Acquired

Background: Health care workers at the bedside of critically ill babies freely carry their mobile phones in between procedures and handling  patients. Concerns are rising as this may contribute to nosocomial infections with pathogenic bacteria. Aim: To determine if mobile phones of health care workers in Intensive care units carry potentially pathogenic bacteria leading to hospital acquired infections. Design: Systematic review.Data sources: Electronic databases (Medline via ovid, CINAHL, Web of science) and hand Searching of references and citations were done to identify studies. Screening and inclusion criteria were used to identify studies with a cross-sectional or cohort design. The search was limited to journal articles published between 2008-2015 and to English language. Quality assessment was done using the National Institute of Health tool for observational studies. Data was extracted on to excel sheets and analysed using SPSS version 22.Results: Six studies with a cohort (1) or cross-sectional design (5) involving 1, 131 health care workers were reviewed. The overall quality of the studies was fair, and a narrative synthesis was done. The colonization rate of the mobile phones ranged between 46.3 % and a 100% with 13-50% carrying potentially pathogenic multidrug resistant microorganisms. Methicillin resistant staphylococcus aureus, Vancomycine resistant enterococci, acinobacter and coagulase negative staphylococci were reported across all studies and were recognized as leading causes of morbidity and mortalityin the ICU. Conclusion: Mobile phones Of HCW are portals of potentially pathogenic microorganisms, which could result in morbidity and mortality.Although no causal relationship could be established, strong associations have been reported. Guidelines by hospital infection control committees are needed on restriction, care and routine cleaning of mobile phones as well as further research. Key words: Health care worker, Intensive care unit, Hospital Acquired Infections, mobile phones

scholarly journals A Bayesian joint model for zero‐inflated integers and left‐truncated event times with a time‐varying association: Applications to senior health care

2020 ◽  
Vol 40 (1) ◽  
pp. 147-166
Author(s):  
Xavier Piulachs ◽  
Eleni‐Rosalina Andrinopoulou ◽  
Montserrat Guillén ◽  
Dimitris Rizopoulos
Keyword(s):  
Health Care ◽  
Joint Model ◽  
Time Varying ◽  
Event Times ◽  
Bayesian Joint Model ◽  
Senior Health Care ◽  
Senior Health

Medicine and Aviation: A Review of the Comparison

2003 ◽  
Vol 42 (04) ◽  
pp. 433-436 ◽  
Author(s):  
R. Randell
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Comparative Study ◽  
Intensive Care Units ◽  
Medical Error ◽  
Medical Technology ◽  
Research Literature ◽  
Ethnographic Study ◽  
The Subject

Summary Objective: This paper aims to understand the nature of medical error in highly technological environments and argues that a comparison with aviation can blur its real understanding. Methods: This study is a comparative study between the notion of error in health care and aviation based on the author’s own ethnographic study in intensive care units and findings from the research literature on errors in aviation. Results and Conclusions: Failures in the use of medical technology are common. In attempts to understand the area of medical error, much attention has focused on how we can learn from aviation. This paper argues that such a comparison is not always useful, on the basis that (i) the type of work and technology is very different in the two domains; (ii) different issues are involved in training and procurement; and (iii) attitudes to error vary between the domains. Therefore, it is necessary to look closely at the subject of medical error and resolve those questions left unanswered by the lessons of aviation.

scholarly journals Emerging Chryseobacterium indologenes Infection in Indian Neonatal Intensive Care Units: A Case Report

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 109 ◽  
Author(s):  
Rishika Mehta ◽  
Ashish Pathak
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Neonatal Intensive Care Units ◽  
Indwelling Catheters ◽  
Chryseobacterium Indologenes ◽  
Life Threatening ◽  
Health Care Associated Infections

Antibiotic-resistant pathogens and nosocomial infections constitute common and serious problems for neonates admitted to neonatal intensive care units worldwide. Chryseobacterium indologenes is a non-lactose-fermenting, gram-negative, health care-associated pathogen (HCAP). It is ubiquitous and intrinsically resistant to several antibiotics. Despite its low virulence, C. indologenes has been widely reported to cause life-threatening infections. Patients on chronic immunosuppressant drugs, harboring invasive devices and indwelling catheters become the nidus for C. indologenes. Typically, C. indologenes causes major health care-associated infections such as pneumonia, empyema, pyelonephritis, cystitis, peritonitis, meningitis, and bacteremia in patients harboring central venous catheters. Management of C. indologenes infection in neonates is not adequately documented owing to underreporting, particularly in India. Because of its multidrug resistance and the scant availability of data from the literature, the effective empirical treatment of C. indologenes is challenging. We present an uncommon case of bacteremia caused by C. indologenes in a preterm newborn baby with moderate respiratory distress syndrome who was successfully treated. We also provide a review of infections in the neonatal age group. Henceforth, in neonates receiving treatments involving invasive equipment use and long-term antibiotic therapy, multidrug resistant C. indologenes should be considered an HCAP.

scholarly journals PREVALENCE AND DRUG RESISTANCE IN ACINETOBACTER SP. ISOLATED FROM INTENSIVE CARE UNITS PATIENTS IN PUNJAB, INDIA

2018 ◽  
Vol 11 (14) ◽  
pp. 88
Author(s):  
Tanvir Kaur ◽  
Chayanika Putatunda ◽  
Aroma Oberoi ◽  
Ashish Vyas ◽  
Gaurav Kumar
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Sensitivity Pattern ◽  
Acinetobacter Sp

Objective: This study was designed to study the prevalence and antibiotic susceptibility patterns of Acinetobacter sp. as isolated from patients lodged in intensive care units (ICUs) of a tertiary care hospital, Ludhiana, Punjab, India.Methods: The clinical samples were simultaneously streaked on Blood agar and MacConkey agar. The identification of the bacterial isolates was carried out with the aid of Gram stain, motility test and along with a combination of other commonly employed biochemical tests. The antimicrobial susceptibility testing (AST) of all the bacterial isolates was carried out on Muller-Hinton agar through Kirby-Bauer disc diffusion method.Results: Acinetobacter sp. formed a fair allowance contributing at 42% among all ICU culture positive samples. The respiratory tract samples had a major share at 63.15% for all samples attributed to be positive for Acinetobacter sp. nosocomial etiology. The antibiotic sensitivity pattern portrayed that more than 95% of Acinetobacter sp. isolates were multiple drug resistant (MDR) whereas >50% Acinetobacter sp. showed extensive drug resistant (XDR). The last resort for such Acinetobacter sp. nosocomial infections is left to colistin and polymyxin B.Conclusion: Acinetobacter sp. is a highly prevalent microorganism among ICU patients of Ludhiana, Punjab, India, while its potential to acquire resistance toward commonly used antibiotics represents it as a grave threat to the health-care industry, therefore signifying the need for its regular monitoring in the health-care setups.

Sign in / Sign up

Export Citation Format

Share Document