scholarly journals Synthesis of qualitative research studies regarding the factors surrounding UK critical care trial infrastructure

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030815 ◽  
Author(s):  
Natalie Pattison ◽  
Nishkantha Arulkumaran ◽  
Geraldine O'Gara ◽  
Bronwen Connolly ◽  
Sally Humphreys ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Critical Care ◽  
Intensive Care ◽  
Clinical Practice ◽  
Patient Care ◽  
Human Study ◽  
Qualitative Synthesis ◽  
Research Activity ◽  
Patient Consent ◽  
The Uk

Conducting clinical trials in critical care is integral to improving patient care. Unique practical and ethical considerations exist in this patient population that make patient recruitment challenging, including narrow recruitment timeframes and obtaining patient consent often in time-critical situations. Units currently vary significantly in their ability to recruit according to infrastructure and level of research activity.AimTo identify variability in the research infrastructure of UK intensive care units and their ability to conduct research and recruit patients into clinical trials.DesignWe evaluated factors related to intensive care patient enrolment into clinical trials in the UK. This consisted of a qualitative synthesis carried out with two datasets of in-depth interviews (distinct participants across the two datasets) conducted with 27 intensive care consultants (n=9), research nurses (n=17) and trial coordinators (n=1) from 27 units across the UK. Primary and secondary analyses of two datasets (one dataset had been analysed previously) were undertaken in the thematic analysis.FindingsThe synthesis yielded an overarching core theme of normalising research, characterised by motivations for promoting research and fostering research-active cultures within resource constraints, with six themes under this to explain the factors influencing critical care research capacity: organisational, human, study, practical resources, clinician and patient/family factors. There was a strong sense of integrating research in routine clinical practice, and recommendations are outlined.ConclusionsThe central and transferable tenet of normalising research advocates the importance of developing a culture where research is inclusive alongside clinical practice in routine patient care and is a requisite for all healthcare individuals from organisational to direct patient contact level.

Radiotherapy research activity and radiographer involvement in the UK

2009 ◽  
Vol 8 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Julie Davies ◽  
Christine Rawlings
Keyword(s):  
Clinical Trials ◽  
New Technologies ◽  
Research Process ◽  
Standards Of Care ◽  
Service Development ◽  
Evidence Based ◽  
Research Activity ◽  
Local Initiatives ◽  
The Uk ◽  
Further Development

AbstractIn the UK, radiotherapy research is being conducted at national and international levels which include multi-centre clinical trials. Local initiatives and trials are also ongoing where work is being performed to develop techniques or protocols for new technologies and service development. Active participation within these studies is now leading to a culture change with radiographers (radiation therapists) becoming an integral part of the research process. There are currently 70 radiographers in the UK participating in research. This accounts for 2.5% of the UK profession. With the extension of role diversification, research radiographers are undertaking many new roles; however, there is still scope for further development. The therapists’ role in working within this research environment is to ensure improved standards of care focussed on evidence-based practice.

scholarly journals INDIRECT CALORIMETRY AS AN OBJECTIVE TECHNIQUE FOR ASSESSING ENERGY NEEDS OF PATIENTS IN CRITICAL STATES

2020 ◽  
Vol 23 (6) ◽  
pp. 329-334
Author(s):  
E. S. Glebova ◽  
E. V. Ivanova-Davidova ◽  
Valery G. Amcheslavsky
Keyword(s):  
Clinical Trials ◽  
Intensive Care ◽  
Clinical Practice ◽  
Indirect Calorimetry ◽  
Narrow Range ◽  
Published Data ◽  
Pediatric Practice ◽  
Metabolic Monitoring ◽  
Energy Needs ◽  
Current Calculation

Background. Nutrition is one of the most important aspects of intensive care. While working over the nutritive program, one should take into account patient’s energy needs, which lie in a narrow range - to avoid under- or overfeeding. Purpose. To compare modern approaches to metabolic rate assessment in patients in ICU and to find the most effective one. Material and methods. The researchers have analyzed published data of clinical trials on metabolic monitoring in Russia and abroad. Results. After the scientific articles had been analyzed, it became evident that current calculation approaches cannot be considered reliable in pediatric clinical practice, especially in ICU. Thus, the indirect calorimetry, as an objective technique for calculating energy needs in patients, should be used in pediatric practice.

Cardiothoracic Surgery and Postoperative Intensive Care

2019 ◽  
pp. 417-423
Author(s):  
Juan G. Ripoll Sanz ◽  
Robert A. Ratzlaff
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Cardiothoracic Surgery ◽  
Open Heart ◽  
Postoperative Intensive Care ◽  
Main Factor

Cardiothoracic surgical (CTS) critical care responsibilities have progressively shifted away from surgeons and toward intensivists in the past several decades. CTS patients present unique challenges, and optimal patient care in the intensive care unit is a main factor for the prevention of deaths after any type of open heart surgery.

Intensive care

2016 ◽  
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
Evidence Base ◽  
Cutting Edge ◽  
Direct Impact ◽  
Independent Research ◽  
Everyday Clinical Practice ◽  
Distinct Distance ◽  
Short Space ◽  
The Uk

In the last two decades, intensive care has progressed significantly. The phenomenal developments clinically, academically, organizationally, and professionally during this relatively short space of time have all helped to define a specialty that has not only come of age, but also has established a distinct distance from its parent specialties. Intensive care in the UK now has an established Faculty and continues to forge ahead in expanding an independent research and evidence base. The field is rapidly changing, with cutting-edge ideas driving clinical progress. Through the papers considered in this chapter, various innovations are described that have had a direct impact on everyday clinical practice.

scholarly journals The use of critical care echocardiography in peri-arrest and cardiac arrest scenarios: Pros, cons and what the future holds

2020 ◽  
pp. 175114372093699 ◽  
Author(s):  
Luke Flower ◽  
Olusegun Olusanya ◽  
Pradeep R Madhivathanan
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Core Competence ◽  
Point Of Care ◽  
Response To Treatment ◽  
Monitoring Tool ◽  
Critical Care Echocardiography ◽  
Focused Echocardiography

Echocardiography is being increasingly deployed as a diagnostic and monitoring tool in the critically ill. This rise in popularity has led to its recommendation as a core competence in intensive care, with several training routes available. In the peri-arrest and cardiac arrest population, point of care focused echocardiography has the potential to transform patient care and improve outcomes. Be it via diagnosis of shock aetiology and reversibility or assessing response to treatment and prognostication. This narrative review discusses current and future applications of echocardiography in this patient group and provides a structure with which one can approach such patients.

Infectious diseases and tropical medicine

2016 ◽  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Statistical Analysis ◽  
Infectious Diseases ◽  
Clinical Evidence ◽  
Critical Evaluation ◽  
Duration Of Treatment ◽  
The Uk ◽  
Clinical Problems ◽  
Key Questions

Some of the earliest clinical trials were conducted in infectious diseases. In the 1940s, the development of the first antibiotics for treating tuberculosis coincided with the recognition that rigorous clinical trials were required to determine optimum drug combinations and duration of treatment. The joint efforts of bacteriologists, clinicians, and statisticians promoted the development of clinical trials, acknowledging that clinically valid endpoints and careful statistical analysis are vital for trials to provide evidence of sufficient quality to guide clinical practice. This chapter covers key questions in this field addressed by good-quality trials. It covers clinical evidence important to practitioners both overseas and in the UK. It focuses on trials that have generated key data, while also covering trials which address clinical problems that are important worldwide and less commonly seen in the UK where critical evaluation of current trials might be difficult.

A Focus on Evaluating Major Study Limitations in Order to Apply Clinical Trials to Patient Care: Implications for the Healthcare Team

2020 ◽  
pp. 001857872093175
Author(s):  
Mary J. Ferrill ◽  
Alireza FakhriRavari ◽  
Lisa Hong ◽  
Jody Jacobson Wedret
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Patient Care ◽  
External Validity ◽  
Healthcare Providers ◽  
Internal Validity ◽  
Healthcare Team ◽  
Evidence Based ◽  
Major Study ◽  
Clinically Significant

Background: With more than a million new biomedical articles published annually, healthcare providers must stay up to date in order to provide optimal evidence-based patient care. The concise ROOTs (relevance, observe validity, obtain clinically significant results, and translate results to clinical practice) format is a valuable tool to assist with literature evaluation. Purpose: To illustrate how major study limitations found in clinical trials might inhibit the ability to adopt the findings of such studies to patient care. Methods: Examples from published clinical trials that contain major study flaws were used to illustrate, if taken at face value, would lead to erroneous assumptions, and if adopted, could potentiallly harm patients. Conclusion: When evaluating the literature, it is crucial to identify limitations in the published literature that might reduce the internal validity, affect the results, or limit the external validity of clinical trials, hence affecting the usability of literature for patient care. This article provides examples of clinical trials that contain major study limitations with potentially erroneous assumptions. These illustrations are meant to show how important it is to delve deeper into an article before conclusions are drawn.

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