Reorganizing the respiratory high dependency unit for pandemics

2021 ◽  
Author(s):  
Juan Fernando Masa ◽  
Maxime Patout ◽  
Raffaele Scala ◽  
Joao Carlos Winck
Keyword(s):  
High Dependency Unit ◽  
High Dependency

Outcomes of elderly patients with acute kidney injury on a renal high dependency unit

2015 ◽  
Vol 69 (10) ◽  
pp. 1209-1210 ◽  
Author(s):  
J.-H. Wang ◽  
J. Joslin ◽  
R. Jenkins ◽  
C. C. Sharpe ◽  
S. Jayawardene ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Kidney Injury ◽  
High Dependency Unit ◽  
High Dependency

Primary Casualty Reception Ship: the hospital within—Operation Granby

1992 ◽  
Vol 78 (2) ◽  
pp. 55-64
Author(s):  
E. P. Dewa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Support Services ◽  
Persian Gulf ◽  
Medical Team ◽  
High Dependency Unit ◽  
Full Support ◽  
Hospital Facility ◽  
High Dependency

SummaryAs the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RF A Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO).In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed.Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services.The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA.One hundred and five patients were treated of which 78 were returned to duty. Argus as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US.

scholarly journals Application of Lean Methodologies in a Neurosurgery High Dependency Unit

10.5772/64715 ◽  
2016 ◽  
Author(s):  
Ricardo Balau Esteves ◽  
Susana Garrido Azevedo ◽  
Francisco Proença Brójo
Keyword(s):  
High Dependency Unit ◽  
High Dependency

scholarly journals Outcomes following a Shortage of High Dependency Unit Beds for Surgical Patients

2006 ◽  
Vol 34 (4) ◽  
pp. 457-463 ◽  
Author(s):  
D. R. Mcilroy ◽  
B. D. Coleman ◽  
P. S. Myles
Keyword(s):  
Surgical Patients ◽  
High Dependency Unit ◽  
High Dependency

High dependency unit admissions during the first year of a national obstetric early warning system

2015 ◽  
Vol 133 (1) ◽  
pp. 121-122 ◽  
Author(s):  
Patrick J. Maguire ◽  
Karen A. Power ◽  
Niamh Daly ◽  
Maria Farren ◽  
Aoife McKeating ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
First Year ◽  
High Dependency Unit ◽  
High Dependency

scholarly journals Improving the use of the ‘COUGH’ bundle in Surgical High Dependency Unit, Ninewells Hospital, Dundee

2020 ◽  
Vol 9 (2) ◽  
pp. e000851
Author(s):  
Victoria Livie ◽  
Jennifer Livie ◽  
Sharon Hilton-Christie
Keyword(s):  
Oral Care ◽  
Care Patient ◽  
Deep Breathing ◽  
High Dependency Unit ◽  
Respiratory Complications ◽  
Bed Elevation ◽  
High Dependency ◽  
Postoperative Respiratory Complications ◽  
Head Of Bed Elevation ◽  
Incentive Spirometry

Developing respiratory complications postoperatively is one of the major determinants of longer hospital stay, morbidity, mortality and increased healthcare costs. The incidence of postoperative respiratory complications varies from 1% to 23%. Given that postoperative respiratory complications are relatively common and costly, there have been various studies which look at ways to reduce the risk of these occurring. One such protocol is the ICOUGH bundle which stands for Incentive spirometry, Coughing and deep breathing, Oral care, patient Understanding, Getting out of bed and Head of bed elevation. This has been adapted locally to the Coughing and deep breathing, Oral care, patient Understanding, Getting out of bed and Head of bed elevation (COUGH) bundle which consists of these components excluding incentive spirometry. Within our surgical high dependency unit (HDU), the COUGH bundle should be implemented in patients who have a moderate or high risk of developing postoperative respiratory complications with an Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score of 26 or above. Studies have shown that the ICOUGH bundle has reduced rates of pneumonia and unplanned intubation in general surgical and vascular patients. Baseline data taken from surgical HDU showed that the COUGH bundle was not well implemented. One out of eight patients who had an ARISCAT score greater than 26 had the COUGH bundle implemented on admission to the unit. Three out of eight patients had the ARISCAT score documented in their admission medical review. One patient who should have received the bundle, but did not, developed a hospital acquired pneumonia postoperatively. To address this issue, we aimed to increase awareness surrounding the COUGH bundle and to increase the number of patients who had the COUGH bundle started on admission. This quality improvement project had four cycles (plan, do, study, act) and after these, 100% of patients who had an ARISCAT score of 26 or more had the COUGH bundle implemented.

scholarly journals Establishment of a high-dependency unit in Malawi

2020 ◽  
Vol 5 (11) ◽  
pp. e004041
Author(s):  
Ben Morton ◽  
Ndaziona Peter Banda ◽  
Edna Nsomba ◽  
Clara Ngoliwa ◽  
Sandra Antoine ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Delivery ◽  
Physical Space ◽  
Treatment Modalities ◽  
Organ Support ◽  
High Dependency Unit ◽  
Tertiary Referral Centre ◽  
Healthcare Needs ◽  
High Dependency ◽  
Sub Saharan

Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring and facilitates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country’s Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand.

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