scholarly journals Measurement Properties and Implementation of a Checklist to Assess Leadership Skills during Interdisciplinary Rounds in the Intensive Care Unit

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Elsbeth C. M. Ten Have ◽  
Raoul E. Nap ◽  
Jaap E. Tulleken
Keyword(s):  
Intensive Care Unit ◽  
Factor Analysis ◽  
Intensive Care ◽  
Internal Consistency ◽  
Interrater Reliability ◽  
Leadership Behavior ◽  
Leadership Skills ◽  
Measurement Properties ◽  
Interdisciplinary Rounds ◽  
Wide Range

The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. A daily recurrent situation in ICUs in which both leadership behavior and interdisciplinary teamwork are integrated concerns the interdisciplinary rounds (IDRs). Although IDRs are recommended to provide optimal interdisciplinary and patient-centered care, there are no checklists available for leading physicians. We tested the measurement properties and implementation of a checklist to assess the quality of leadership skills in interdisciplinary rounds. The measurement properties of the checklist, which included 10 essential quality indicators, were tested for interrater reliability and internal consistency and by factor analysis. The interrater reliability among 3 raters was good (κ, 0.85) and the internal consistency was acceptable (α, 0.74). Factor analysis showed all factor loadings on 1 domain (>0.65). The checklist was further implemented during videotaped IDRs which were led by senior physicians and in which 99 patients were discussed. Implementation of the checklist showed a wide range of “no” and “yes” scores among the senior physicians. These results may underline the need for such a checklist to ensure tasks are synchronized within the team.

scholarly journals Enablers and challenges of caring in the Intensive Care Unit--Part 2: In relation to nurses

2021 ◽  
Vol 12 (2) ◽  
pp. 18
Author(s):  
Hanan Subhi Al-Shamaly
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Care ◽  
Optimal Level ◽  
Ethnographic Study ◽  
Personal Factors ◽  
Team Members ◽  
Educational Backgrounds ◽  
Wide Range ◽  
Different Sources

The concept of caring is vague and complex, especially in critical environments such as the intensive care unit (ICU), where technological dehumanisation is a challenge for nurses. ICU nursing care includes not only patients but also extends to patients’ families, nurses, other health team members and the unit’s environment. Caring in critical care settings is affected by enabling and impeding factors. To explore these enablers and challenges factors, a focused ethnographic study was conducted in an Australian ICU. The data was collected from 35 registered nurses through various resources: participants' observations, documents reviews, interviews, and additional participants’ notes. Data were analysed inductively and thematically. The study outlines comprehensively and widely a wide range of enablers and challenges affecting caring in the ICU - which originate from different sources such as patients, families, nurses, and the ICU environment. This paper is the second in a two-part series which explores the ICU nurses’ experiences and perspectives of the enablers and challenges of caring in the ICU. Part 1 was concerned with the enablers and challenges to caring that are related to ICU patients, families, and environment. While Part 2 introduces readers to the enablers and challenges factors that are concerned with the nurses in ICU. These factors include nurses’ educational backgrounds and professional experience, employment working factors, leadership styles, relationships, and personal factors. Nurses and other stakeholders such as clinicians, educators, researchers, managers, and policymakers need to recognize these factors and their implications for providing quality care, in order to enhance and maintain the optimal level of caring in the ICU.

Mitigating emotional responses to stressors: coping strategies, modifiers and support

2021 ◽  
pp. 103985622110472
Author(s):  
D. Dennis ◽  
P.V van Heerden ◽  
C. Knott ◽  
R. Khanna
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coping Strategies ◽  
Emotional Responses ◽  
Well Being ◽  
Environmental Stressors ◽  
Professional Help ◽  
Wide Range ◽  
Audio Recordings ◽  
Emerging Themes

Objective: The stressful nature of the intensive care unit (ICU) environment is increasingly well characterised. The aim of this paper was to explore modifiers, coping strategies and support pathways identified by experienced Intensivists, in response to these stressors. Method: Prospective qualitative study employing interviews with Intensivists in two countries. Participants were asked how they mitigated their emotional responses to the stressors of the ICU. Audio-recordings were transcribed and analysed by all researchers who agreed upon emerging themes and subthemes. Results: A wide range of strategies were reported. Although several participants had sought professional help and all supported its utility, few disclosed accessing such help to others indicating stigma. Many felt a sense of responsibility for the well-being of other staff but identified barriers that suggest alternate support pathways are required. Further implications of these findings to training considerations are described. Conclusions: Several approaches were described as regularly employed by Intensivists to mitigate ICU environmental stressors. Intensivists perceive themselves to have limited training to provide support to others; they also perceive stigma in seeking professional help.

The “Flipped Classroom” Model for Teaching in the Intensive Care Unit

2016 ◽  
Vol 32 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Christopher R. Tainter ◽  
Nelson L. Wong ◽  
Gaston A. Cudemus-Deseda ◽  
Edward A. Bittner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Learning Environment ◽  
Flipped Classroom ◽  
Point Of Care ◽  
Perceived Usefulness ◽  
Successful Implementation ◽  
Education Curriculum ◽  
Patient Acuity ◽  
Wide Range

Introduction: The intensive care unit (ICU) is a dynamic and complex learning environment. The wide range in trainee’s experience, specialty training, fluctuations in patient acuity and volume, limitations in trainee duty hours, and additional responsibilities of the faculty contribute to the challenge in providing a consistent experience with traditional educational strategies. The “flipped classroom” is an educational model with the potential to improve the learning environment. In this paradigm, students gain exposure to new material outside class and then use class time to assimilate the knowledge through problem-solving exercises or discussion. The rationale and pedagogical foundations for the flipped classroom are reviewed, practical considerations are discussed, and an example of successful implementation is provided. Methods: An education curriculum was devised and evaluated prospectively for teaching point-of-care echocardiography to residents rotating in the surgical ICU. Results: Preintervention and postintervention scores of knowledge, confidence, perceived usefulness, and likelihood of use the skills improved for each module. The quality of the experience was rated highly for each of the sessions. Conclusion: The flipped classroom education curriculum has many advantages. This pilot study was well received, and learners showed improvement in all areas evaluated, across several demographic subgroups and self-identified learning styles.

scholarly journals Assessing the quality of interdisciplinary rounds in the intensive care unit

2013 ◽  
Vol 28 (4) ◽  
pp. 476-482 ◽  
Author(s):  
Elsbeth C.M. Ten Have ◽  
Mariet Hagedoorn ◽  
Nicole D. Holman ◽  
Raoul E. Nap ◽  
Robbert Sanderman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interdisciplinary Rounds

scholarly journals Epidemiological Study of Mortality Caused by Road Accidents in the Intensive Care Unit of Besat Educational-medical Hospital in Hamadan

2021 ◽  
Author(s):  
Hiva Azami ◽  
Mehrdad Maleki Jamasbi ◽  
Mina Mohammadpour Bayati ◽  
Zahra Bakhtiari ◽  
Shiva Mohammadpour Bayati ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Planning ◽  
Night Shift ◽  
Education Level ◽  
P Value ◽  
Road Accidents ◽  
Cross Sectional ◽  
Wide Range ◽  
Single Men

Introduction: Road accidents are one of the causes of death and it's important to investigate the epidemiological indicators in this context. In this regard, this study aimed to determine the epidemiological causes of road accident mortality in the intensive care unit of Besat Educational-medical Hospital in Hamadan during Nowruz Holidays 2018. Material and Methods: In this descriptive cross-sectional study, data of the patients died for 13 days in Nowruz Holidays in the intensive care unit of Besat Hospital in Hamadan, by census method, was extracted from the medical records of patients by using a checklist from a researcher-made questionnaire. Data were analyzed by Fisher's exact test and SPSS 21 software. Results: Of the 28 Patient admitted to the intensive care unit,16 patients died. Most deaths were in the third decade of life, among single men, with a self-employment job, with diploma education level or cycle education level, with more than 10 days of hospitalization and in the night shift. Based on the results, most of the dead persons were rider (81.25%), suffered head trauma (50%), with head surgery (56.25%), without any underlying illness (93.75%) and without successful experience of cardiopulmonary resuscitation (87.5%). There were no statistically significant differences between the variables and mortality rate (P value > 0/05). Conclusion: Young single men with low level of education are a wide range of road accidents victims. Therefore, it seems it's necessary to reduce mortality from these accidents, health planning such as traffic culture training and driving rules, by using social media, should focus on learning and improving the level of community awareness, especially in this group of people.

scholarly journals Monitoring Approach of Fatality Risk Factors for Patients with Severe Acute Pancreatitis Admitted to the Intensive Care Unit. A Retrospective, Monocentric Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2013
Author(s):  
Tudorel Mihoc ◽  
Cristi Tarta ◽  
Ciprian Duta ◽  
Raluca Lupusoru ◽  
Greta Dancu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Fatal Outcome ◽  
Factors Associated ◽  
Reactive Protein ◽  
Wide Range ◽  
Secondary Objective

Acute pancreatitis is an unpredictable disease affecting the pancreas and it is characterized by a wide range of symptoms and modified lab tests, thus there is a continuing struggle to classify this disease and to find risk factors associated with a worse outcome. The main objective of this study was to identify the risk factors associated with the fatal outcome of the intensive care unit’s patients diagnosed and admitted for severe acute pancreatitis, the secondary objective was to investigate the prediction value for the death of different inflammatory markers at the time of their admission to the hospital. This retrospective study included all the patients with a diagnosis of acute pancreatitis admitted to the Intensive Care Unit of the Emergency County Hospital Timisoara between 1 January 2016 and 31 May 2021. The study included 53 patients diagnosed with severe acute pancreatitis, out of which 21 (39.6%) survived and 32 (60.4%) died. For the neutrophils/lymphocytes ratio, a cut-off value of 12.4 was found. When analyzing age, we found out that age above 52 years old can predict mortality, and for the platelets/lymphocytes ratio, a cut-off value of 127 was found. Combining the three factors we get a new model for predicting mortality, with an increased performance, AUROC = 0.95, p < 0.001. Multiple persistent organ failure, age over 50, higher values of C reactive protein, and surgery were risk factors for death in the patients with severe acute pancreatitis admitted to the intensive care unit. The model design from the neutrophils/lymphocytes ratio, platelets/lymphocytes ratio, and age proved to be the best in predicting mortality in severe acute pancreatitis.

scholarly journals Pembrolizumab-induced autoimmune haemolytic anaemia and cholangitis

2019 ◽  
Vol 12 (12) ◽  
pp. e232505 ◽  
Author(s):  
Harriet Williams ◽  
Robin Aitchison
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Haemolytic Anaemia ◽  
De Novo ◽  
Checkpoint Inhibitors ◽  
Autoimmune Haemolytic Anaemia ◽  
Dermatological Disease ◽  
Wide Range ◽  
Life Threatening ◽  
Life Threatening Complication

Increasing numbers of patients are now offered immunotherapy as part of their cancer treatment. These treatments, while often very effective, have a wide range of adverse effects that are distinct from those of traditional chemotherapy regimens. Thyroid disease, dermatological disease, colitis and pneumonitis are some of the most commonly reported immune side effects. We present a case of life-threatening de novo autoimmune haemolytic anaemia (AIHA) complicated by immune cholangitis induced by pembrolizumab. An 81-year-old woman with metastatic melanoma completed a two-year course of pembrolizumab in August 2018 and six weeks later presented to hospital with jaundice. Admission haemoglobin (Hb) was 91 g/L, rapidly decreasing to 31 g/L, at which point she required admission to the intensive care unit. AIHA is a rare but potentially life-threatening complication of checkpoint inhibitors and should be considered in patients presenting with anaemia during or after immunotherapy treatment.

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