scholarly journals Survey on the actual number of nurses required for critical patients with COVID ‐19 in Japanese intensive care units: Preliminary report

2021 ◽  
Author(s):  
Miya Hamamoto ◽  
Takeshi Unoki ◽  
Mitsuhiro Tamoto ◽  
Hideaki Sakuramoto ◽  
Yusuke Kawai ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Preliminary Report ◽  
Actual Number ◽  
Critical Patients

scholarly journals Managing admission and discharge processes in intensive care units

2021 ◽  
Author(s):  
Jie Bai ◽  
Andreas Fügener ◽  
Jochen Gönsch ◽  
Jens O. Brunner ◽  
Manfred Blobner
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Numerical Study ◽  
Early Discharge ◽  
Fixed Costs ◽  
Real World Data ◽  
Trade Off ◽  
Markov Decision ◽  
Critical Patients ◽  
Expected Mortality

AbstractThe intensive care unit (ICU) is one of the most crucial and expensive resources in a health care system. While high fixed costs usually lead to tight capacities, shortages have severe consequences. Thus, various challenging issues exist: When should an ICU admit or reject arriving patients in general? Should ICUs always be able to admit critical patients or rather focus on high utilization? On an operational level, both admission control of arriving patients and demand-driven early discharge of currently residing patients are decision variables and should be considered simultaneously. This paper discusses the trade-off between medical and monetary goals when managing intensive care units by modeling the problem as a Markov decision process. Intuitive, myopic rule mimicking decision-making in practice is applied as a benchmark. In a numerical study based on real-world data, we demonstrate that the medical results deteriorate dramatically when focusing on monetary goals only, and vice versa. Using our model, we illustrate the trade-off along an efficiency frontier that accounts for all combinations of medical and monetary goals. Coming from a solution that optimizes monetary costs, a significant reduction of expected mortality can be achieved at little additional monetary cost.

scholarly journals CONOCIMIENTOS, PERCEPCIONES Y PRÁCTICAS EN PROFESIONALES DE LA SALUD SOBRE MOVILIZACION TEMPRANA EN LOS PACIENTES DE LAS UNIDADES DE CUIDADOS INTENSIVOS

2021 ◽  
Vol 6 (2) ◽  
pp. 5
Author(s):  
Ángela Yaleska Arévalo Tabares ◽  
Freiser Eceomo Cruz Mosquera ◽  
Yuly Viviana Valencia Salazar ◽  
Diego Alonzo Peláez Domínguez ◽  
Juan David Rosero Portocarrero
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Professionals ◽  
Early Mobilization ◽  
Post Discharge ◽  
Cross Sectional ◽  
Usual Practice ◽  
Calidad De Vida ◽  
Critical Patients

Introducción: Los pacientes críticos son sometidos a intervenciones que traen consigo complicaciones que pueden aparecer incluso de manera precoz, entre ellas se encuentra la debilidad muscular adquirida en unidad de cuidados intensivos, en este contexto tiene una importancia fundamental la movilización temprana del paciente crítico, que facilita el destete de la ventilación mecánica e influye en la calidad de vida posterior al alta. Objetivo: determinar los conocimientos, percepciones y prácticas en profesionales de la salud sobre movilizacion temprana en los pacientes de las unidades de cuidados intensivos de dos centros de salud de Cali.  Método: estudio observacional descriptivo de corte transversal en el que se incluyeron 24 profesionales de la salud que laboran en unidades de cuidados intensivos de dos Clínicas de la Ciudad de Cali, a los cuales se les aplicó un cuestionario autoadministrado sobre movilización temprana. El análisis de los datos se realizó en el programa SPSS versión 24. Resultados: La mayoría de los profesionales de la salud encuestados eran de sexo femenino, con una edad promedio de 31±5; se encontró que el 67% tenía un conocimiento medio, el 25% bajo y el 8% conocimiento alto. Por otro lado, el 88% manifestó ejecutar esta estrategia en su práctica habitual, y reportaron como barreras percibidas ausencia de protocolos y personal insuficiente. Conclusiones: gran parte de los profesionales de salud encuestados mostraron un conocimiento medio sobre movilización temprana y una alta incorporación de esta estrategia a la práctica clínica habitual. Palabras claves: movilización precoz de paciente crítico, cuidados intensivos, paciente crítico, ventilación mecánica. ABSTRACT Introduction: Critical patients are subjected to interventions that bring complications that can appear even early, among them is muscle weakness acquired in the intensive care unit, in this context, early mobilization of the critical patient is of fundamental importance, which facilitates weaning from mechanical ventilation and influences post-discharge quality of life. Objective: to determine the knowledge, perceptions and practices in health professionals about early mobilization in patients in the intensive care units of two health centers in Cali. Method: a descriptive, cross-sectional observational study that included 24 health professionals working in intensive care units of two Clinics in the City of Cali, to which a self-administered questionnaire on early mobilization was applied. Data analysis was performed using SPSS version 24. Results: Most of the health professionals surveyed were female, with a mean age of 31 ± 5; It was found that 67% had medium knowledge, 25% low and 8% high knowledge. On the other hand, 88% stated that they executed this strategy in their usual practice, and reported the absence of protocols and insufficient personnel as perceived barriers. Conclusions: a large part of the health professionals surveyed showed a medium knowledge about early mobilization and a high incorporation of this strategy into routine clinical practice. Keywords: early mobilization of critical patients, intensive care, critical patients, mechanical ventilation

scholarly journals Initiation of an early mobilisation programme in intensive care units—A preliminary report

2013 ◽  
Vol 31 (2) ◽  
pp. 105-106
Author(s):  
W.S. Kwan ◽  
C.N. Auw Yang ◽  
Y.H. Poon ◽  
H.W. Lau
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Preliminary Report ◽  
Early Mobilisation

scholarly journals Rapid response air medical evacuation by civilian HEMS crew of critical patients during COVID-19 outbreak – First Fixed Points

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Mauro Del Romano ◽  
Lorenzo Ciapessoni ◽  
Francesca Di Mola ◽  
Gabriele Romanò ◽  
Massimo Gavezzotti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Fixed Points ◽  
Intensive Care Units ◽  
Patient Management ◽  
Communicable Diseases ◽  
Rapid Response ◽  
Medical Evacuation ◽  
Critical Patients ◽  
Aeromedical Transport

The Covid-19 emergency requires a shared plan for the longrange helicopter transfer of patients affected by the virus in order to reduce the overload of intensive care units. To date, there is limited peer reviewed literature on aeromedical transport of patients with highly hazardous communicable diseases, most of it is military, and none deals specifically with patients affected by Covid- 19. To meet this need, we propose reference criteria regarding preflight, in-flight and post-flight patient management and helicopter sanitization.

scholarly journals Epidemiology and clinical analysis of critical patients with child maltreatment admitted to the intensive care units

Medicine ◽  
2017 ◽  
Vol 96 (23) ◽  
pp. e7107 ◽  
Author(s):  
En-Pei Lee ◽  
Shao-Hsuan Hsia ◽  
Jing-Long Huang ◽  
Jainn-Jim Lin ◽  
Oi-Wa Chan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Child Maltreatment ◽  
Intensive Care Units ◽  
Clinical Analysis ◽  
Critical Patients

PP156 Risk Assessment Of Equipment Used In Intensive Care Units

2018 ◽  
Vol 34 (S1) ◽  
pp. 127-128
Author(s):  
Juang Horng Jyh ◽  
Loraine Martins Diamente ◽  
César Tadeu Spadella
Keyword(s):  
Adverse Event ◽  
Intensive Care ◽  
Quality Of Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Healthcare Professionals ◽  
Critical Patients ◽  
Process Failures ◽  
Hospital Equipment

Introduction:Knowledge and proper use of hospital equipment are essential for preventing adverse events associated with their use. The risks controls for medical devices and equipment are of major importance in ensuring patient safety and the quality of care delivered by healthcare professionals. Monitoring equipment (ME), infusion pumps (IP), and mechanical ventilators (MV) are frequently used in intensive care units, but they are subject to technical, human, and process failures that may pose harm to and even cause the death of patients. The aim of this study was to evaluate the risks related to the use of ME, IP, and MV in the adult intensive care unit (AICU) of a public hospital in Brazil, and to investigate the causes of technical complaints and the adverse events associated with them. We hope the outcomes may serve as a basis for the facility to create mechanisms to diminish the risk and increase the safety and quality of care delivered to critical patientsMethods:A 12-month prospective, observational descriptive study was conducted using an active and passive search of processes related to: hospital medical equipment use; available human and material resources; training programs and continuing professional education; equipment disinfection, sterilization, and assembly processes; and the hospital risk management measures regarding the reports and actions for technical, human, and process failures and the adverse events and incidents related to them. All the data collected were checked against current Brazilian legislation and the equipment technical manuals. The root cause of every failure and adverse event was investigated.Results:The active search identified seventy-five reports on technical complaints in the study period: sixty-five were related to IP, six to ME, and four to MV. The reasons for the complaints included: deficiencies in the quantity, qualification, training, and capacity of professionals handling the devices; inadequate disinfection of MV accessories; absence of or difficulty in accessing the equipment technical manuals; and a lack of preventive and corrective maintenance programs. One single adverse event caused by an IP medication error was attributed to a programing error.Conclusions:Failures and deficiencies in the knowledge and management of hospital equipment can potentially increase risks to patients and healthcare professionals. Increasing compliance with Brazil's current legislation related to the technical and operational norms of hospital equipment might create safer practices and improve care quality for critical patients.

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