scholarly journals Hospital‐acquired complications in intensive care unit patients with diabetes: A before‐and‐after study of a conventional versus liberal glucose control protocol

2019 ◽  
Vol 63 (6) ◽  
pp. 761-768 ◽  
Author(s):  
Nora Luethi ◽  
Luca Cioccari ◽  
Glenn Eastwood ◽  
Peter Biesenbach ◽  
Rhys Morgan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glucose Control ◽  
Control Protocol ◽  
Before And After ◽  
Patients With Diabetes ◽  
Hospital Acquired ◽  
Before And After Study

An In-Service Educational Package Improves Alarm Management in the Neonatal Intensive Care Unit (NICU): Before and After Study

2021 ◽  
pp. 097321792110512
Author(s):  
Suryaprakash Hedda ◽  
Shashidhar A. ◽  
Saudamini Nesargi ◽  
Kalyan Chakravarthy Balla ◽  
Prashantha Y. N. ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Response Time ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Alarm Management ◽  
Educational Package ◽  
Before And After ◽  
Before And After Study

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs

Performance of Stochastic Targeted Blood Glucose Control Protocol by virtual trials in the Malaysian intensive care unit

2018 ◽  
Vol 162 ◽  
pp. 149-155 ◽  
Author(s):  
Ummu K. Jamaludin ◽  
Fatanah M. Suhaimi ◽  
Normy Norfiza Abdul Razak ◽  
Azrina Md Ralib ◽  
Mohd Basri Mat Nor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Glucose Control ◽  
Blood Glucose Control ◽  
Control Protocol

scholarly journals Implementation of Nurse-Led, Goal-Directed Lung Physiotherapy for Older Patients With Sepsis and Pneumonia in the ICU

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianhua Sun ◽  
Na Cui ◽  
Wen Han ◽  
Qi Li ◽  
Hao Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Treatment Group ◽  
Older Patients ◽  
Control Group ◽  
Icu Mortality ◽  
Two Phase ◽  
Before And After ◽  
Before And After Study

Objectives: This study aimed to investigate the effect of nurse-led, goal-directed lung physiotherapy (GDLPT) on the prognosis of older patients with sepsis caused by pneumonia in the intensive care unit.Methods: We conducted a prospective, two-phase (before-and-after) study over 3 years called the GDLPT study. All patients received standard lung therapy for sepsis caused by pneumonia and patients in phase 2 also received GDLPT. In this study, 253 older patients (age ≥ 65 years) with sepsis and pneumonia were retrospectively analyzed. The main outcome was 28 day mortality.Results: Among 742 patients with sepsis, 253 older patients with pneumonia were divided into the control group and the treatment group. Patients in the treatment group had a significantly shorter duration of mechanical ventilation [5 (4, 6) vs. 5 (4, 8) days; P = 0.045], and a lower risk of intensive care unit (ICU) mortality [14.5% (24/166) vs. 28.7% (25/87); P = 0.008] and 28 day mortality [15.1% (25/166) vs. 31% (27/87); P = 0.005] compared with those in the control group. GDLPT was an independent risk factor for 28 day mortality [odds ratio (OR), 0.379; 95% confidence interval (CI), 0.187–0.766; P = 0.007].Conclusions: Nurse-led GDLPT shortens the duration of mechanical ventilation, decreases ICU and 28-day mortality, and improves the prognosis of older patients with sepsis and pneumonia in the ICU.

How the high acuity unit changes mortality in the intensive care unit: a retrospective before-and-after study

2020 ◽  
Vol 67 (11) ◽  
pp. 1507-1514
Author(s):  
Anish R. Mitra ◽  
Donald E. G. Griesdale ◽  
Gregory Haljan ◽  
Ashley O’Donoghue ◽  
Jennifer P. Stevens
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Before And After ◽  
High Acuity ◽  
Before And After Study

Management of hyperglycemia in the pediatric intensive care unit; implementation of a glucose control protocol

2009 ◽  
Vol 10 (6) ◽  
pp. 648-652 ◽  
Author(s):  
Jennifer J. Verhoeven ◽  
Jeannette B. Brand ◽  
Mirjam M. van de Polder ◽  
Koen F. M. Joosten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Glucose Control ◽  
Pediatric Intensive Care ◽  
Control Protocol

Improvement of Glucose Control in the Intensive Care Unit: An Interdisciplinary Collaboration Study

2008 ◽  
Vol 17 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Ulrike Holzinger ◽  
Monika Feldbacher ◽  
Adelbert Bachlechner ◽  
Reinhard Kitzberger ◽  
Valentin Fuhrmann ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Glucose Control ◽  
Care Staff ◽  
Diabetic Patients ◽  
Control Protocol ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Insulin Use

Background Strict glycemic control in critically ill patients is challenging for both physicians and nurses. Objectives To determine the effect of focused education of intensive care staff followed by implementation of a glucose control protocol. Methods A prospective observational study in a medical intensive care unit in a university hospital. After intensive education of nurses and physicians, a glucose control protocol with a nurse-managed insulin therapy algorithm was developed and implemented. Every measured blood glucose value and insulin dose per hour and per day were documented in 36 patients before and 44 patients after implementation of the protocol. Results Median blood glucose levels decreased after implementation of the protocol (133 vs 110 mg/dL; P &lt; .001). The amounts of time when patients’ blood glucose levels were less than 110 mg/dL and less than 150 mg/dL increased after implementation of the protocol (8% vs 44%; 75% vs 96%; P&lt;.001). The median use of insulin increased after implementation of the protocol (28 vs 35 IU/day; P=.002). Diabetic patients had higher median blood glucose levels than did nondiabetic patients both before (138 vs 131 mg/dL) and after (115 vs 108 mg/dL; P&lt;.001) implementation, although median insulin use also increased (before implementation, 33 vs 26 IU/day; P=.04; after implementation, 46 vs 30 IU/day; P &lt; .001). Conclusions Use of a collaboratively developed glucose control protocol led to decreased median blood glucose levels and to longer periods of normoglycemia. Despite increased insulin use, glucose control was worse in diabetic patients.

Impact of a Clinical Therapeutic Intervention on Pain Assessment, Management, and Nursing Practices in an Intensive Care Unit: A before-and-after Study

2018 ◽  
Vol 19 (3) ◽  
pp. 256-266 ◽  
Author(s):  
Vincenzo Damico ◽  
Flavio Cazzaniga ◽  
Liana Murano ◽  
Rita Ciceri ◽  
Giuseppe Nattino ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Assessment ◽  
Therapeutic Intervention ◽  
Before And After ◽  
Before And After Study
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