Statistics, Ethics, and Management

2019 ◽  
pp. 115-123
Author(s):  
George W. Williams
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical Literature ◽  
Role Of Government ◽  
Hospital Administrators ◽  
General Overview ◽  
Multidisciplinary Model ◽  
Regulatory Management

While regulatory, management, and statistics concepts are commonly considered pertinent primarily for examinations, the mastery of this skillset allows for effective leadership in an intensive care unit. In the modern multidisciplinary model of critical care, an intensivist needs to be comfortable interpreting quality metrics as well as medical literature. Additionally, an understanding of the regulatory role of government and how such policies affect the care of patients is directly pertinent to interactions with hospital administrators and peers of other specialties. This chapter provides a general overview of these concepts for the examination, but the reader is encouraged to read more into the background of these topics in order to gain a practical mastery of these concepts for practice.

Organization and Structure of the Cardiothoracic Intensive Care Unit

2015 ◽  
pp. 86-104
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

Oncology ◽  
2017 ◽  
pp. 709-727
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

scholarly journals The role of speech and language therapists in the intensive care unit

2019 ◽  
Vol 21 (4) ◽  
pp. 344-348 ◽  
Author(s):  
Jackie McRae ◽  
Elizabeth Montgomery ◽  
Zoë Garstang ◽  
Eibhlin Cleary
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Multidisciplinary Team ◽  
Skills Development ◽  
Technological Innovations ◽  
Speech And Language ◽  
National Guidance

National guidance recommends the involvement of speech and language therapists in intensive care particularly for those requiring tracheostomy and ventilation. However, the role of speech and language therapists is poorly understood especially in the context of critical care. This article aims to increase awareness of the background training and skills development of speech and language therapists working in this context to demonstrate their range of specialist abilities. Speech and language therapists support and enhance the process of laryngeal weaning alongside the rehabilitation of speech and swallowing as part of the multidisciplinary team. Examples are provided of the types of interventions that are used and technological innovations that may enhance rehabilitation of oropharyngeal impairments.

Animal-Assisted Interventions in Intensive Care Delirium: A Literature Review

2021 ◽  
Vol 32 (4) ◽  
pp. 391-397
Author(s):  
Jahanzeb Malik
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Cognitive Function ◽  
Critical Illness ◽  
The Body ◽  
High Incidence ◽  
The Mind ◽  
Animal Assisted Intervention

Critical illness has lasting consequences on the mind and the body. Acute sequelae include a decline in cognitive function known as delirium. Increased interest in improving outcomes for intensive care unit survivors without a high incidence of delirium has initiated a focus on an array of nonpharmacologic interventions in many countries. One such intervention is animalassisted intervention. As the role of animals in human healing is being recognized by clinicians, need is increasing for formal and professionally directed therapies. This review ascertains the effect of interaction with animals on critically ill patients. Emerging evidence indicates that animal-assisted intervention improves the efficacy of critical care regarding primary symptoms and secondary factors of delirium.

scholarly journals Words Faithful to the Phenomenon

2018 ◽  
Vol 17 (1) ◽  
pp. 160940691879779
Author(s):  
Luigina Mortari ◽  
Roberta Silva
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Critical Care ◽  
Intensive Care ◽  
Phenomenological Approach ◽  
Discursive Practice ◽  
Team Members ◽  
The Creation ◽  
Do So

The article presents the developing of a tool aimed to analyze the decision-making (DM) processes in critical care contexts. It was developed in a study conducted through a phenomenological approach. By analyzing the discursive practice through which physicians in an intensive care unit (ICU) arrive at decisions, we construct a discursive profile of each ICU involved, to improve the ICU team members’ knowledge of the complexity of their DM processes. To do so, we develop a system of analysis capable of capturing discursive actions faithfully. Our method facilitates a system of analysis that highlights the role of the various discursive acts in conversational flow, starting from the needs in an ICU setting, which are spontaneously recognized from the data, to the almost simultaneous processes of description and understanding. This has led to the creation of a tool follows the phenomenological-grounded route.

scholarly journals Prevention of Nosocomial Infection & role of Hand Hygiene Compliance in a Private Hospital of Bangladesh

2017 ◽  
Vol 5 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Afsana Begum ◽  
Md Shafiqul Bari ◽  
Md Abul Kalam Azad ◽  
Md Iqbal Hossain ◽  
Pradip Ranjan Saha
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Hand Hygiene Compliance ◽  
High Dependency Unit ◽  
High Dependency ◽  
Hygiene Compliance

Background: Nosocomial infection (NI) is a major cause of morbidity and mortality of patients attending the healthcare facilities all over the world. Only a few studies regarding this issue have been conducted in Bangladesh.Objective: To describe the load of NI and to assess role of hand hygiene compliance of doctors and nurses regarding its prevention.Method: In this cross-sectional study, medical records of all patients admitted from January 2014 to June 2014 were reviewed and data were collected from patients who had diagnosis of NI. Collected data includes month wise number of NI patients, types of NI, organism responsible for NI and hand hygiene compliance of doctors and nurses. Regarding hand hygiene compliance only critical care areas were considered.Results: During the study period, a total of 8769 patients were admitted in all inpatient departments and critical care areas (cardiac intensive care unit, neonatal intensive care unit, general intensive care unit, coronary care unit, general high dependency unit and cardiac high dependency unit) of the hospital and number of NI was 201 (2.29%). The highest NI was respiratory tract infection (63%) and the lowest was skin & soft tissue infection (2%). Predominant organisms responsible were E. coli (16%), acinetobacter species (15%), Pseudomonas species (14%), Klebsiella species (13%), Serratia species (13%) and Candida species (13%). The highest average hand hygiene compliance (67.67%) and lowest NI (1.14%) was observed in June 2014.Conclusion: In this study, NI rate was the lowest when the hand hygiene compliance was the highest. So, it is obvious that implementation of hand hygiene may be one of the important measures to prevent NI. So, hospitals should have strict guidelines and review measures to prevent this man made phenomenon. All these efforts will not only reduce patient morbidity, but will also reduce the use of antibiotics and healthcare costs of the country.Bangladesh Crit Care J September 2017; 5(2): 83-87

scholarly journals The Role of Dexmedetomidine for the Prevention of Acute Kidney Injury in Critical Care

2021 ◽  
pp. 97-106
Author(s):  
Gion Ruegg ◽  
Nora Luethi ◽  
Luca Cioccari
Keyword(s):  
Experimental Data ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Clinical Trials ◽  
Renal Function ◽  
Critical Care ◽  
Intensive Care ◽  
Kidney Injury ◽  
Ischaemia Reperfusion

Acute kidney injury (AKI) occurs in up to 50% of patients admitted to the intensive care unit and is associated with increased mortality. Currently, there is no effective pharmacotherapy for prevention or treatment of AKI. In animal models of sepsis and ischaemia-reperfusion, α2-agonists like dexmedetomidine (DEX) exhibit anti-inflammatory properties and experimental data indicate a potential protective effect of DEX on renal function. However, clinical trials have yielded inconsistent results in critically ill patients. This review discusses the pathophysiological mechanisms involved in AKI, the renal effects of DEX in various intensive care unit-related conditions, and summarises the available literature addressing the use of DEX for the prevention of AKI.

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