Critical care and biological disasters: lessons learned from SARS and pandemic influenza planning

2009 ◽  
pp. 159-178
Author(s):  
Michael D. Christian ◽  
Thomas E. Stewart ◽  
Stephen E. Lapinsky
Keyword(s):  
Critical Care ◽  
Pandemic Influenza ◽  
Lessons Learned

scholarly journals The Beacon Collaborative: A Journey to Excellence

2021 ◽  
Vol 41 (5) ◽  
pp. e17-e25
Author(s):  
Deborah Hurley ◽  
Sarah M. Gantz ◽  
E. Kate Valcin ◽  
Tara L. Sacco
Keyword(s):  
Critical Care ◽  
Care Delivery ◽  
Care Service ◽  
Stakeholder Involvement ◽  
Service Level ◽  
Lessons Learned ◽  
Organizational Level ◽  
Unit Level ◽  
Individual Unit ◽  
The Individual

Topic The development of the Critical Care Beacon Collaborative to achieve meaningful recognition. Clinical Relevance Recognizing nurses for contributions to their work environment and care delivery is important for their professional and personal fulfillment, job satisfaction, and retention; such recognition can occur at the individual, unit, or organizational level. The American Nurses Credentialing Center’s Magnet Recognition Program acknowledges nursing excellence at the organizational level. It would, however, be difficult for an organization to achieve Magnet designation without nursing excellence at the unit level. To recognize excellence at the unit level, the American Association of Critical-Care Nurses developed the Beacon Award in 2003. Objective To describe one academic medical center’s journey toward winning Beacon Awards across 8 units within the adult critical care service. Content Covered The Critical Care Beacon Collaborative resulted in a Beacon Award for each unit and important staff outcomes. This article describes the organization, the process before the Critical Care Beacon Collaborative convened and the desired state, and the methods used to achieve our goal. It also discusses unit- and service-level stakeholder involvement. The successes, lessons learned, sustainability, and growth of the Critical Care Beacon Collaborative are shared to assist readers who aspire to pursue a Beacon Award.

Four Flu Pandemics: Lesson that Cannot be Learned

2021 ◽  
pp. 0169796X2110472
Author(s):  
Ronn Pineo
Keyword(s):  
Pandemic Influenza ◽  
Lessons Learned ◽  
Major Outbreak ◽  
History Of ◽  
Core Questions

This article explores the history of influenza, focusing on the four major flu pandemics in the last century and a half, outbreaks starting in 1889, 1918, 1957, and 1968. The article looks closely at flu etiology and the historical puzzles over which flu subtype was responsible for each major outbreak. Some mysteries regarding pandemic influenza remain, with core questions stubbornly refusing to yield answers. This article seeks to explore the history of flu in the hope that we can take away some lessons learned as we try to get ready for potential future flu pandemics.

Celebrating the 100th Birthday of the Electrocardiogram: Lessons Learned From Research in Cardiac Monitoring

2002 ◽  
Vol 11 (4) ◽  
pp. 378-386 ◽  
Author(s):  
Barbara J. Drew
Keyword(s):  
Critical Care ◽  
Myocardial Ischemia ◽  
Current Trend ◽  
Torsade De Pointes ◽  
Acute Myocardial Ischemia ◽  
Lessons Learned ◽  
Cardiac Monitoring ◽  
Acute Ischemia ◽  
Antiarrhythmic Agents ◽  
St Segment

The electrocardiogram continues to be the gold standard for the diagnosis of cardiac arrhythmias and acute myocardial ischemia. The treatment of arrhythmias in critical care units has become less aggressive during the past decade because research indicates that antiarrhythmic agents can be proarrhythmic, causing malignant ventricular arrhythmias such as torsade de pointes. However, during the same period, the treatment of acute myocardial ischemia has become more aggressive, with the goal of preventing or interrupting myocardial infarction by using new antithrombotic and antiplatelet agents and percutaneous coronary interventions. For this reason, critical care nurses should learn how to use ST-segment monitoring to detect acute ischemia, which is often asymptomatic, in patients with acute coronary syndromes. Because the electrocardiographic lead must be facing the localized ischemic zone of the heart to depict the telltale signs of ST-segment deviation, the challenge is to find ways to monitor patients continuously for ischemia without using an excessive number of electrodes and lead wires. The current trend is to use reduced lead set configurations in which 5 or 6 electrodes, placed at convenient places on the chest, are used to construct a full 12-lead electrocardiogram. Nurse scientists at the University of California, San Francisco, School of Nursing are at the forefront in developing and assessing the diagnostic accuracy of these reduced lead set electrocardiograms.

scholarly journals Health services restructuring in Alberta and the 2009 pandemic influenza—An untimely concurrence

2020 ◽  
Vol 33 (4) ◽  
pp. 170-173
Author(s):  
Richard Musto ◽  
Judy MacDonald ◽  
Anne Ulrich ◽  
Kevin Fonseca
Keyword(s):  
Health Services ◽  
Pandemic Influenza ◽  
Communicable Disease ◽  
Lessons Learned ◽  
Effective Response ◽  
Services Delivery ◽  
Laboratory Services ◽  
Challenges And Opportunities ◽  
Management Communications ◽  
Significant Health

In the last 12 years, every Canadian province and territory has undertaken significant health services restructuring, with the pace of change accelerating recently. When the H1N1 Pandemic Influenza (PI) hit Alberta in the spring of 2009, the province had just begun a restructuring of health services of a scale unprecedented in Canada. The new province-wide entity, Alberta Health Services (AHS), was faced with mounting an effective response to a global communicable disease outbreak during a time of great organizational flux. In this retrospective, the authors reflect on challenges and opportunities presented during the AHS PI response related to the coordination of public health, laboratory services, emergency and disaster management, communications, and health services delivery. Lessons learned are shared that may be helpful to other provinces and territories as they continue to evolve their systems, so that they may be better prepared to respond to an untimely event such as a pandemic.

scholarly journals An Interprofessional Approach in Caring for a Patient on Maintenance Hemodialysis with COVID-19 in Toronto, Canada: An Educational Case Report

2020 ◽  
Vol 7 ◽  
pp. 205435812095747
Author(s):  
Elizabeth M. Hendren ◽  
Nicola Matthews ◽  
Mathew Oliver ◽  
Julie Rice ◽  
Sheldon W. Tobe ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Hemodialysis Patient ◽  
Clinical Signs ◽  
Significant Risk ◽  
Lessons Learned ◽  
Maintenance Hemodialysis ◽  
Hemodynamic Compromise ◽  
Hemodialysis Unit ◽  
History Of

Rationale: Hemodialysis patients are at significant risk from COVID-19 due to their frequent interaction with the health care system and medical comorbidities. We followed up the trajectory of the first COVID-19–positive maintenance hemodialysis patient at Sunnybrook Health Sciences Centre in Toronto. We present the lessons learned and changes in practices that occurred to prevent an outbreak in our center. Presenting concerns of the patient: The patient, a 66-year-old woman on in-center hemodialysis, initially presented with a 2-day history of a productive cough. She subsequently developed a fever, was placed on contact and droplet isolation, and admitted to hospital. Diagnoses: On March 13, 2020, the patient tested positive for COVID-19. Within the next 48 hours, she developed hypoxia and acute respiratory distress syndrome as a complication of her illness requiring an extended critical care stay. This extended critical care stay resulted in critical illness–associated secondary sclerosing cholangitis. Interventions: An interprofessional team was established, performing rapid Plan-Do-Study-Act quality improvement cycles to improve screening practices and promote the safety of patients and staff in the hemodialysis unit. Outcomes: We present here the lessons learned, the changes to our screening protocols, and the clinical course of our first in-center hemodialysis patient with SARS-CoV-2. Teaching points: Regular review of the infection screening processes is paramount in preventing outbreaks of COVID-19, particularly in hemodialysis units. Hospital admission should be arranged if a patient exhibits any clinical signs of hemodynamic compromise or hypoxia. Early education for health care practitioners caring for patients with COVID-19 and refresher information regarding personal protective equipment helped promote the safety of staff and prevent health care–associated outbreaks.

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