A critical review: a combined conceptual framework of severity of illness and clinical judgement for analysing diagnostic judgements in critical illness

This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9.5% vs. 13.1%), higher discharge rates (80.9% vs. 69.3%), and shorter length of hospital stay (9.3 days vs. 12.2 days). In the first 6 months of the pandemic, antibiotics were prescribed for COVID-19 patients regardless of severity of illness. A large proportion of antibiotic prescribing for mild and moderate COVID-19 patients did not have clinical evidence of a bacterial co-infection. Antibiotics may not be beneficial to COVID-19 patients without clinical evidence of a bacterial co-infection.

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Value co-destruction: Review and conceptualization of interactive value formation

Marketing Theory ◽

10.1177/1470593120983390 ◽

2021 ◽

pp. 147059312098339

Author(s):

Per Echeverri ◽

Per Skålén

Keyword(s):

Conceptual Framework ◽

Critical Review ◽

Reciprocal Relationship ◽

Service Systems ◽

Future Research

The aim of this conceptual article is to both provide a critical review of research into value co-destruction (VCD) and outline a common conceptual framework in order to better understand and guide future research into VCD and value co-creation (VCC). This review finds that the VCD stream of research has followed two lines of enquiry: one that highlights the role of resources and service systems and another that focuses on practices. It further finds that some prior research has argued that a direct and reciprocal relationship exists between VCD and VCC, captured in the concept of interactive value formation (IVF). A synthesizing IVF framework is outlined which suggests that the alignment and misalignment both within practices and in-between different practices determines IVF, that is, VCD and VCC. The framework further suggests that IVF is both enabled and constrained by resources and service systems.

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Severity of Illness Influences the Efficacy of Enteral Feeding Route on Clinical Outcomes in Patients with Critical Illness

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2012.04.013 ◽

2012 ◽

Vol 112 (8) ◽

pp. 1138-1146 ◽

Cited By ~ 28

Author(s):

Hsiu-Hua Huang ◽

Sue-Joan Chang ◽

Chien-Wei Hsu ◽

Tzu-Ming Chang ◽

Shiu-Ping Kang ◽

...

Keyword(s):

Critical Illness ◽

Clinical Outcomes ◽

Enteral Feeding ◽

Severity Of Illness

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Association Between Room Location and Adverse Outcomes in Hospitalized Patients

HERD Health Environments Research & Design Journal ◽

10.1177/1937586718806702 ◽

2018 ◽

Vol 12 (2) ◽

pp. 21-29 ◽

Cited By ~ 1

Author(s):

Anoop Mayampurath ◽

Christopher Ward ◽

John Fahrenbach ◽

Cynthia LaFond ◽

Michael Howell ◽

...

Keyword(s):

Critical Illness ◽

Severity Of Illness ◽

Adverse Outcomes ◽

Sensitivity Analyses ◽

Additional Risk Factor ◽

Inhospital Mortality ◽

Additional Risk ◽

Increased Risk ◽

Euclidean Distances ◽

Time Of Admission

Objective: To investigate whether a patient’s proximity to the nurse’s station or ward entrance at time of admission was associated with increased risk of adverse outcomes. Method: We conducted a retrospective cohort study of consecutive adult inpatients to 13 medical–surgical wards at an academic hospital from 2009 to 2013. Proximity of admission room to the nurse’s station and to the ward entrance was measured using Euclidean distances. Outcomes of interest include development of critical illness (defined as cardiac arrests or transfer to an intensive care unit), inhospital mortality, and increase in length of stay (LOS). Results: Of the 83,635 admissions, 4,129 developed critical illness and 1,316 died. The median LOS was 3 days. After adjusting for admission severity of illness, ward, shift, and year, we found no relationship between proximity at admission to nurse’s station our outcomes. However, patients admitted to end of the ward had higher risk of developing critical illness (odds ratio [ OR] = 1.15, 95% confidence interval [CI] = [1.08, 1.23]), mortality ( OR = 1.16, 95% CI [1.03, 1.33]), and a higher LOS (13-hr increase, 95% CI [10, 15] hours) compared to patients admitted closer to the ward entrance. Similar results were observed in sensitivity analyses adjusting for isolation room patients and considering patients without room transfers in the first 48 hr. Conclusions: Our study suggests that being away from the nurse’s station did not increase the risk of these adverse events in ward patients, but being farther from the ward entrance was associated with increase in risk of adverse outcomes. Patient safety can be improved by recognizing this additional risk factor.

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A conceptual framework to facilitate clinical judgement in nursing: A methodological perspective

Health SA Gesondheid ◽

10.1016/j.hsag.2017.01.004 ◽

2017 ◽

Vol 22 ◽

pp. 275-290 ◽

Cited By ~ 3

Author(s):

Anna Catharina van Graan ◽

Martha Johanna Susanna Williams

Keyword(s):

Conceptual Framework ◽

Clinical Judgement ◽

Methodological Perspective

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Predictors of Delayed Recognition of Critical Illness in Emergency Department Patients and Its Effect on Morbidity and Mortality

Journal of Intensive Care Medicine ◽

10.1177/0885066620967901 ◽

2020 ◽

pp. 088506662096790

Author(s):

Neha N. Goel ◽

Matthew S. Durst ◽

Carmen Vargas-Torres ◽

Lynne D. Richardson ◽

Kusum S. Mathews

Keyword(s):

Emergency Department ◽

Critical Illness ◽

Census Data ◽

Severity Of Illness ◽

Improved Outcomes ◽

Chart Abstraction ◽

System Factors ◽

Delayed Recognition ◽

Emergency Department Patients ◽

Operational Metrics

Purpose: Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to identify potential predictors of delayed recognition. Methods: We conducted a retrospective cohort study of Emergency Department (ED) patients admitted to the Intensive Care Unit (ICU) directly from the ED or within 48 hours of ED departure. Cohort characteristics were obtained through electronic and standardized chart abstraction. Operational metrics to estimate ED workload and volume using census data were matched to patients’ ED stays. Delayed recognition of critical illness was defined as an absence of an ICU consult in the ED or declination of ICU admission by the ICU team. We employed entropy-balanced multivariate models to examine the association between delayed recognition and development of persistent organ dysfunction and/or death by hospitalization day 28 (POD+D), and multivariable regression modeling to identify factors associated with delayed recognition. Results: Increased POD+D was seen for those with delayed recognition (OR 1.82, 95% CI 1.13-2.92). When the delayed recognition was by the ICU team, the patient was 2.61 times more likely to experience POD+D compared to those for whom an ICU consult was requested and were accepted for admission. Lower initial severity of illness score (OR 0.26, 95% CI 0.12-0.53) was predictive of delayed recognition. The odds for delayed recognition decreased when ED workload is higher (OR 0.45, 95% CI 0.23-0.89) compared to times with lower ED workload. Conclusions: Increased POD+D is associated with delayed recognition. Patient and system factors such as severity of illness and ED workload influence the odds of delayed recognition of critical illness and need further exploration.

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A Conceptual Framework for E-Learning in Developing Countries: A Critical Review of Research Challenges

The Electronic Journal of Information Systems in Developing Countries ◽

10.1002/j.1681-4835.2009.tb00271.x ◽

2009 ◽

Vol 38 (1) ◽

pp. 1-16 ◽

Cited By ~ 57

Author(s):

Annika Andersson ◽

Åke Grönlund

Keyword(s):

Developing Countries ◽

Conceptual Framework ◽

Critical Review ◽

Research Challenges ◽

E Learning

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Empowering Learning Ethics Culture in Islamic Education

Global Perspectives on Teaching and Learning Paths in Islamic Education - Advances in Educational Technologies and Instructional Design ◽

10.4018/978-1-5225-8528-2.ch013 ◽

2020 ◽

pp. 244-267

Author(s):

Miftachul Huda ◽

Khoirurrijal Khoirurrijal ◽

M. Ihsan Dacholfany ◽

Susminingsih Susminingsih ◽

Azmil Hashim ◽

...

Keyword(s):

Conceptual Framework ◽

Critical Review ◽

School Context ◽

Islamic Education ◽

Learning Needs ◽

Good Strategy ◽

Capability Development ◽

Learning Achievement ◽

Active Involvement ◽

Skill Performance

Since every deed is an inextricable link to the process which is well prepared with a goal, possessing the initiative of implementing the learning needs to have a good strategy committed into the clear determination in enabling the stakeholder to deal with in the school context. This chapter aims to critically explore learning ethics culture in Islamic education which needs to pay attention to the learning goal. A critical review from referred books and journals that are linked to the topic was employed through searching for google scholar. The finding reveals that learning ethics culture for learning achievement in Islamic education could be indicated into three core paths: achieving divine engagement-based spiritual commitment, assisting skill performance for personal capability development, and applying knowledge for active involvement in the society. This chapter is expected to enrich the conceptual framework of learning acquisition with paying particular attention to learning ethics culture.

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Teachers Conceptions and Approaches to Blended Learning

Online Course Management ◽

10.4018/978-1-5225-5472-1.ch046 ◽

2018 ◽

pp. 912-934

Author(s):

Vicki Caravias

Keyword(s):

Higher Education ◽

Learning Styles ◽

Blended Learning ◽

Conceptual Framework ◽

Critical Review ◽

Research Literature ◽

Personality Types ◽

Learning Needs ◽

Face To Face ◽

Online Technologies

This paper presents a critical review and synthesis of research literature in higher education exploring teachers' conceptions of blended learning and their approaches to both design and teaching. Definitions of blended learning and conceptual frameworks are considered first. Attention is given to Picciano's Blending with Purpose Multimodal framework. This paper builds upon previous research on blended learning and conceptual framework by Picciano by exploring how objectives from Picciano's framework affect teachers' approaches to both design and teaching in face-to-face and online settings. Research results suggest that teachers use multiple approaches including face-to-face methods and online technologies that address the learning needs of a variety of students from different generations, personality types and learning styles.

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