The critical care environment

2017 ◽  
Author(s):  
Sheila Adam ◽  
Sue Osborne ◽  
John Welch
Keyword(s):  
Critical Care ◽  
Clinical Information ◽  
Electronic Patient Records ◽  
Care Environment ◽  
Team Working ◽  
Use Of Technology ◽  
Design Structure ◽  
Key Factor ◽  
The Impact ◽  
Location Design

This chapter details the optimal location, design, structure, staffing, and equipment required to support high quality critical care. The chapter covers the impact of the critical care environment on patients, family, and staff themselves. The use of technology, including clinical information systems and electronic patient records, is described. Staffing numbers and roles and the importance of team working and collaboration as a key factor in the effectiveness of the critical care environment are also covered. The impact of cleanliness and infection control features as part of the design. The role that the environment has in mitigating the impact on patients in critical care as well as improving outcomes is described as well as other aspects of safety within critical care.

scholarly journals Implementation, Evolution and Impact of ICU Telepharmacy Services Across a Health care System

2019 ◽  
Vol 54 (4) ◽  
pp. 232-240 ◽  
Author(s):  
Desiree E. Kosmisky ◽  
Sonia S. Everhart ◽  
Carrie L. Griffiths
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Healthcare System ◽  
Improve Patient Care ◽  
The United States ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Use Of Technology ◽  
American Society ◽  
The Impact

Purpose: A review of the implementation and development of telepharmacy services that ensure access to a critical care-trained pharmacist across a healthcare system. Summary: Teleintensive care unit (tele-ICU) services use audio, video, and electronic databases to assist bedside caregivers. Telepharmacy, as defined by the American Society of Health-System Pharmacists, is a method in which a pharmacist uses telecommunication technology to oversee aspects of pharmacy operations or provide patient care services. Telepharmacists can ensure accurate and timely order verification, recommend interventions to improve patient care, provide drug information to clinicians, assist in standardization of care, and promote medication safety. This tele-ICU pharmacy team is one of the only entirely clinical-based tele-ICU pharmacy models among the tele-ICU programs across the United States. The use of technology for customized alert generation and intervention proposal with medication orders and chart notation are unique. In a 34-month period from September 2015 to July 2018, more than 110 000 alerts were generated and 13 000 interventions were performed by telepharmacists. Conclusions: Tele-ICU pharmacists employ limited resources to provide critical care pharmacy expertise to multiple sites within a healthcare system during nontraditional hours with documented clinical and financial benefits. Further study is needed to determine the impact of tele-ICU pharmacists on ICU and hospital length of stay, morbidity, and mortality.

Normal physiology of the renal system

2016 ◽  
Author(s):  
Bruce Andrew Cooper
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Renal Dysfunction ◽  
Critical Role ◽  
Renal Physiology ◽  
Electrolyte Balance ◽  
Care Environment ◽  
System P ◽  
Urine Production ◽  
The Impact

Patients with critical illness often have renal dysfunction, either primary or secondary, that can both complicate and prolong their medical management. Therefore, an understanding of normal renal physiology can help recognize the process or processes that caused the renal dysfunction, and determine the most appropriate corrective and supportive care. The kidney has many important roles other than just urine production. The impact of kidney disease is often predictable. The kidney plays a critical role in fluid and electrolyte balance via many specialized transmembrane pathways. The kidney is also involved in the production and modification of two key hormones and one enzyme. Understanding normal renal physiology can help determine clinical management.This chapter summarizes the important aspects of renal physiology relevant to those who work in a critical care environment.

Telemedicine in critical care

2016 ◽  
Author(s):  
Bela Patel ◽  
Eric J. Thomas
Keyword(s):  
Critical Care ◽  
Best Practices ◽  
Bloodstream Infections ◽  
Ventilator Associated Pneumonia ◽  
Care Model ◽  
Stress Ulcers ◽  
Care Environment ◽  
The Past ◽  
The Usa ◽  
The Impact

The majority of critically-ill patients are admitted to hospitals that do not have physician intensivist coverage, despite strong evidence that clinical outcomes are improved with intensivist staffing. Telemedicine can leverage clinical resources by providing critical care expertise to patients in intensive care units (ICUs) by off-site clinicians using video, audio, and electronic links. In the past 10 years, telemedicine in critical care has seen tremendous growth in the number of ICU patients being supported by this care model across the USA. The impact of ICU telemedicine coverage has been studied rigorously only in a few studies and the outcomes have been mixed and inconsistent. Telemedicine has been shown in some studies to improve adherence to ICU best practices for the prevention of deep venous thrombosis, stress ulcers, ventilator-associated pneumonia, and catheter-related bloodstream infections. Further research in ICU telemedicine is required to understand the variability of outcomes among the telemedicine programmes studied and to effectively implement the technology to consistently improve outcomes and reduce costs in the critical care environment.

The Impact of the Technological Care Environment on the Nursing Role

1996 ◽  
Vol 12 (2) ◽  
pp. 358-366 ◽  
Author(s):  
Dianne Pelletier ◽  
Christine Duffield ◽  
Anne Adams ◽  
Jackie Crisp ◽  
Sue Nagy ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Care Environment ◽  
Nursing Role ◽  
Australian Health ◽  
Acute Health Care ◽  
Use Of Technology ◽  
Care Technology ◽  
Impact Of Technology ◽  
The Impact

AbstractProliferation of acute health care technology creates problems and benefits for nurses and patients. In this paper the impact of technology on the nursing work role is reviewed through the international literature. The thrust of the nursing literature has, not surprisingly, matured over time as the use of technology has become well established in the acute care environment, and three themes can be identified. The implications for acute care nurse specialists, including their educational needs, are set in context of the Australian health care system, with particular reference to the cardiac care environments.

Telenursing in the Intensive Care Unit: Transforming Nursing Practice

2012 ◽  
Vol 32 (6) ◽  
pp. 62-69 ◽  
Author(s):  
Lisa-Mae Williams ◽  
Kenneth E. Hubbard ◽  
Olive Daye ◽  
Connie Barden
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Nursing Practice ◽  
Care Patient ◽  
Critical Care Nursing ◽  
Telecommunication Technology ◽  
Use Of Technology ◽  
The Impact ◽  
Care Nursing

In tele–intensive care units, informatics, telecommunication technology, telenursing, and telemedicine are merged to provide expert, evidence-based, and cutting-edge services to critically ill patients. Telenursing is an emerging subspecialty in critical care that is neither well documented in the extant literature nor well understood within the profession. Documentation and quantification of telenursing interventions help to clarify the impact of the telenurse’s role on nursing practice, enhancement of patient care, patient safety, and outcomes. Tele–intensive care unit nursing will continue to transform how critical care nursing is practiced by enhancing/leveraging available resources through the use of technology.

Critical Care Nursing

2017 ◽  
Keyword(s):  
Critical Care ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Major Incident ◽  
Organ Support ◽  
Evidence Based ◽  
Care Environment ◽  
Organ Systems ◽  
General Aspects ◽  
The Impact

This textbook encompasses the knowledge, skills, and expertise needed to deliver excellent nursing care to critically ill patients. Emphasis is placed on a holistic and compassionate approach towards humanizing the impact of the environment, organ support, and monitoring, as well as critical illness itself. Chapters cover the general aspects of critical care such as the critical care environment or critical care continuum and specific organ systems and diseases. The structure of the systems chapters reminds the reader of the underlying anatomy and physiology as well as highlighting areas of particular relevance to critical care. The focus on priorities for management builds on the ABCDE assessment and offers insight into key interventions in urgent situations as well as outlining evidence-based practice. The book is ideal for those new to the critical care environment, but will also act as a reminder for more experienced nurses when faced with a new situation or when teaching/mentoring students. The patient and their family remain the centre of all This new edition brings the definitions, pathophysiology, and management of fast-changing and challenging areas such as ARDS, sepsis and multiple organ dysfunction, resuscitation, and acute kidney injury up to date as well as including any evidence-based changes associated with nursing practice in critical care. A new chapter covers major incident planning and management and the role of critical care in pandemic situations.

How I Learned My ABCs: Action, Back to Basics, Collaboration, Discovery

2010 ◽  
Vol 19 (4) ◽  
pp. 326-334 ◽  
Author(s):  
Mary Lou Sole
Keyword(s):  
Critical Care ◽  
Airway Management ◽  
Clinical Studies ◽  
Scientific Evidence ◽  
Ventilator Associated Pneumonia ◽  
Critical Care Nursing ◽  
Care Environment ◽  
New Findings ◽  
Key Factor ◽  
Self Discovery

Background Research is essential to generate the scientific evidence for critical care nursing practice, but it is challenging to conduct research in the busy critical care environment. The challenges are even greater in a setting with limited resources for research and where nurses have not typically conducted independent clinical studies. Objectives To detail a successful research trajectory for studying the ABCs of patient care in the critically ill: airway, breathing, and circulation. Methods After initial studies on circulation were conducted, the research was narrowed to focus on airway management. Airway management may be a key factor in preventing ventilator-associated pneumonia because aspiration of colonized oral, gastric, and tracheal secretions is the primary cause of ventilator-associated pneumonia. Multiple descriptive, pilot, and interventional studies have been conducted; findings from each have contributed to future studies. Results Other ABCs were critical to this research success: action, back to basics, collaboration, and discovery. It is important for researchers to be self-motivated and to take initiative to develop skills and resources for conducting clinical studies. Several guiding principles help to promote success in research: (1) generate research ideas grounded in observation and clinical practice, (2) collaborate with others, and (3) establish affiliations and partnerships. Discovery occurs in many ways: new findings to guide practice and research, resources to conduct the study, and self-discovery. Conclusions Nursing research is not easy. However, determination and resources help nursing researchers achieve success.

Competition Policy under Economic Crisis

2009 ◽  
pp. 54-69 ◽  
Author(s):  
A. Shastitko ◽  
S. Avdasheva ◽  
S. Golovanova
Keyword(s):  
Division Of Labor ◽  
Economic Crisis ◽  
Industrial Policy ◽  
Competition Policy ◽  
Transition Economy ◽  
Economic Recession ◽  
Price Rigidity ◽  
Key Factor ◽  
Policy Measures ◽  
The Impact

The analysis of competition policy under economic crisis is motivated by the fact that competition is a key factor for the level of productivity. The latter, in its turn, influences the scope and length of economic recession. In many Russian markets buyers' gains decline because of the weakness of competition, since suppliers are reluctant to cut prices in spite of the decreasing demand. Data on prices in Russia and abroad in the second half of 2008 show asymmetric price rigidity. At least two questions are important under economic crisis: the 'division of labor' between pro-active and protective tools of competition policy and the impact of anti-crisis policy on competition. Protective competition policy is insufficient in transition economy, especially in the days of crisis it should be supplemented with the well-designed industrial policy measures which do not contradict the goals of competition. The preferable tools of anti-crisis policy are also those that do not restrain competition.

Designing a CRM Framework for online & offline sports footwear retailers

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Rodrigo Cueva ◽  
Guillem Rufian ◽  
Maria Gabriela Valdes
Keyword(s):  
Environmental Changes ◽  
Customer Relationship ◽  
Business Strategies ◽  
Economic Sectors ◽  
Running Shoes ◽  
Brick And Mortar ◽  
Key Factor ◽  
On Line ◽  
The Impact

The use of Customer Relationship Managers to foster customers loyalty has become one of the most common business strategies in the past years.  However, CRM solutions do not fill the abundance of happily ever-after relationships that business needs, and each client’s perception is different in the buying process.  Therefore, the experience must be precise, in order to extend the loyalty period of a customer as much as possible. One of the economic sectors in which CRM’s have improved this experience is retailing, where the personalized attention to the customer is a key factor.  However, brick and mortar experiences are not enough to be aware in how environmental changes could affect the industry trends in the long term.  A base unified theoretical framework must be taken into consideration, in order to develop an adaptable model for constructing or implementing CRMs into companies. Thanks to this approximation, the information is complemented, and the outcome will increment the quality in any Marketing/Sales initiative. The goal of this article is to explore the different factors grouped by three main domains within the impact of service quality, from a consumer’s perspective, in both on-line and off-line retailing sector.  Secondly, we plan to go a step further and extract base guidelines about previous analysis for designing CRM’s solutions focused on the loyalty of the customers for a specific retailing sector and its product: Sports Running Shoes.

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