scholarly journals Clinical Trials of Antifungal Prophylaxis among Patients in Surgical Intensive Care Units: Concepts and Considerations

2004 ◽  
Vol 39 (Supplement_4) ◽  
pp. S193-S199 ◽  
Author(s):  
Pamela A. Lipsett
Keyword(s):  
Clinical Trials ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Antifungal Prophylaxis ◽  
Surgical Intensive Care

Volatile Agents in Medical and Surgical Intensive Care Units: A Meta-Analysis of Randomized Clinical Trials

2016 ◽  
Vol 30 (4) ◽  
pp. 1005-1014 ◽  
Author(s):  
Giovanni Landoni ◽  
Laura Pasin ◽  
Luca Cabrini ◽  
Anna Mara Scandroglio ◽  
Martina Baiardo Redaelli ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Surgical Intensive Care ◽  
Volatile Agents

PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

2019 ◽  
Author(s):  
Rabia Arshad
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Carbapenem Resistance ◽  
Chronic Obstructive ◽  
Surgical Intensive Care ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

scholarly journals Hand hygiene and the sequence of patient care

2021 ◽  
pp. 1-6
Author(s):  
Nai-Chung Chang ◽  
Michael Jones ◽  
Heather Schacht Reisinger ◽  
Marin L. Schweizer ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Patient Care ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Resistant Bacteria ◽  
Surgical Intensive Care ◽  
Hygiene Compliance ◽  
Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

Acute kidney injury in the elderly patients of Thai-surgical intensive care units (Thai-SICU) study

2017 ◽  
Vol 30 (2) ◽  
pp. 131
Author(s):  
Konlawij Trongtrakul ◽  
Sujaree Poopipatpab ◽  
Ploynapas Limphunudom ◽  
Chawika Pisitsak ◽  
Kaweesak chittawatanarat ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Elderly Patients ◽  
Intensive Care Units ◽  
Kidney Injury ◽  
The Elderly ◽  
Surgical Intensive Care

Reply about letter regarding “Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units”

2017 ◽  
Vol 40 ◽  
pp. 287-288
Author(s):  
Jonathan K. Aboagye ◽  
Deborah B. Hobson ◽  
Brandyn D. Lau ◽  
Dauryne L. Shaffer ◽  
Peggy S. Kraus ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Compression Stocking ◽  
Surgical Intensive Care

scholarly journals Development of an Algorithm for Surveillance of Ventilator-Associated Pneumonia With Electronic Data and Comparison of Algorithm Results With Clinician Diagnoses

2008 ◽  
Vol 29 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Michael Klompas ◽  
Ken Kleinman ◽  
Richard Platt
Keyword(s):  
Intensive Care ◽  
Positive Predictive Value ◽  
Intensive Care Units ◽  
Predictive Value ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Electronic Data ◽  
Prospective Comparison ◽  
Control And Prevention ◽  
High Positive Predictive Value

Objective.Surveillance for ventilator-associated pneumonia (VAP) using standard Centers for Disease Control and Prevention (CDC) criteria is labor intensive and involves many subjective assessments. We sought to improve the efficiency and objectivity of VAP surveillance by adapting the CDC criteria to make them amenable to evaluation with electronic data.Design.Prospective comparison of the accuracy of VAP surveillance by use of an algorithm with responses to prospective queries made to intensive care physicians. CDC criteria for VAP were used as a reference standard to evaluate the algorithm and clinicians' reports.Setting.Three surgical intensive care units and 2 medical intensive care units at an academic hospital.Methods.A total of 459 consecutive patients who received mechanical ventilation for a total of 2,540 days underwent surveillance by both methods during consecutive 3-month periods. Electronic surveillance criteria were chosen to mirror the CDC definition. Quantitative thresholds were substituted for qualitative criteria. Purely subjective criteria were eliminated. Increases in ventilator-control settings were taken to indicate worsening oxygenation. Semiquantitative Gram stain of pulmonary secretion samples was used to assess whether there was sputum purulence.Results.The algorithm applied to electronic data detected 20 patients with possible VAP. All cases of VAP were confirmed in accordance with standard CDC criteria (100% positive predictive value). Prospective survey of clinicians detected 33 patients with possible VAP. Seventeen of the 33 possible cases were confirmed (52% positive predictive value). Overall, 21 cases of confirmed VAP were identified by either method. The algorithm identified 20 (95%) of 21 known cases, whereas the survey of clinicians identified 17 (81%) of 21 cases.Conclusions.Surveillance for VAP using electronic data is feasible and has high positive predictive value for cases that meet CDC criteria. Further validation of this method is warranted.

scholarly journals Barriers and facilitators to adopting high value practices and de-adopting low value practices in Canadian intensive care units: a multimethod study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024159 ◽  
Author(s):  
Khara Sauro ◽  
Sean M Bagshaw ◽  
Daniel Niven ◽  
Andrea Soo ◽  
Rebecca Brundin-Mather ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Fluid Resuscitation ◽  
Healthcare Providers ◽  
Population Based ◽  
Barriers And Facilitators ◽  
Cross Sectional Survey ◽  
Surgical Intensive Care ◽  
Cross Sectional ◽  
Vte Prophylaxis

ObjectiveTo compare and contrast illustrative examples of the adoption of high value practices and the de-adoption of low value practices.Design(1) Retrospective, population-based audit of low molecular weight heparin (LMWH) for venous thromboembolism (VTE) prophylaxis (high value practice) and albumin for fluid resuscitation (low value practice) and (2) cross-sectional survey of healthcare providers.SettingData were collected from nine adult medical-surgical intensive care units (ICUs) in two large Canadian cities. Patients are managed in these ICUs by a group of multiprofessional and multidisciplinary healthcare providers.ParticipantsParticipants included 6946 ICU admissions and 309 healthcare providers from the same ICUs.Main outcome measures(1) The use of LMWH for VTE prophylaxis (per cent ICU days) and albumin for fluid resuscitation (per cent of patients); and (2) provider knowledge of evidence underpinning these practices, and barriers and facilitators to adopt and de-adopt these practices.ResultsLMWH was administered on 38.7% of ICU days, and 20.0% of patients received albumin.Most participants had knowledge of evidence underpinning VTE prophylaxis and fluid resuscitation (59.1% and 84.2%, respectively). Providers perceived these practices to be followed. The most commonly reported barrier to adoption was insufficient knowledge/understanding (32.8%), and to de-adoption was clinical leader preferences (33.2%). On-site education was the most commonly identified facilitator for adoption and de-adoption (67.8% and 68.6%, respectively).ConclusionsDespite knowledge of and self-reported adherence to best practices, the audit demonstrated opportunity to improve. Provider-reported barriers and facilitators to adoption and de-adoption are broadly similar.

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