scholarly journals The Middle of the Road - A Safety Net Hospital Pilot Study of Resident Placed Midline Catheters in Critical Care Units

2020 ◽  
Author(s):  
A. Andreev ◽  
S. Khanuja ◽  
M. Gioia ◽  
J.K. Magruder ◽  
S. Sahni
Keyword(s):  
Critical Care ◽  
Pilot Study ◽  
Safety Net ◽  
Critical Care Units ◽  
The Road ◽  
Safety Net Hospital

scholarly journals Implementing target range oxygen in critical care: A quality improvement pilot study

2019 ◽  
pp. 175114371989278
Author(s):  
Rosie Heartshorne ◽  
Jenna Cardell ◽  
Ronan O'Driscoll ◽  
Tim Fudge ◽  
Paul Dark
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Pilot Study ◽  
Care Staff ◽  
Target Range ◽  
Baseline Survey ◽  
Staff Attitudes ◽  
Critical Care Units ◽  
Staff Members

Background Iatrogenic hyperoxaemia is common on critical care units and has been associated with increased mortality. We commenced a quality improvement pilot study to analyse the views and practice of critical care staff regarding oxygen therapy and to change practice to ensure that all patients have a prescribed target oxygen saturation range. Methods A baseline measurement of oxygen target range prescribing was undertaken alongside a survey of staff attitudes. We then commenced a programme of change, widely promoting an agreed oxygen target range prescribing policy. The analyses of target range prescribing and staff survey were repeated four to five months later. Results Thirty-three staff members completed the baseline survey, compared to 29 in the follow-up survey. There was no discernible change in staff attitudes towards oxygen target range prescribing. Fifty-four patients were included in the baseline survey and 124 patients were assessed post implementation of changes. The proportion of patients with an oxygen prescription with a target range improved from 85% to 95% (χ2 = 5.17, p = 0.02) and the proportion of patients with an appropriate prescribed target saturation range increased from 85% to 91% (χ2 = 1.4, p = 0.24). The improvement in target range prescribing was maintained at 96% 12 months later. Conclusions The introduction and promotion of a structured protocol for oxygen prescribing were associated with a sustained increase in the proportion of patients with a prescribed oxygen target range on this unit.

scholarly journals Evaluation of a Pharmacist-Based Intervention to Reduce Readmissions in Geriatric High-Utilizer Patients: A Pilot Study

2019 ◽  
Vol 10 (2) ◽  
pp. 9
Author(s):  
Sara Turbow ◽  
Kruti Shah ◽  
Katherine Penziner ◽  
Michael Knauss
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Hospital Admissions ◽  
Safety Net ◽  
High Risk Population ◽  
Original Research ◽  
Beers Criteria ◽  
Southeastern Us ◽  
Safety Net Hospital ◽  
High Utilizer

Purpose: The goal of this study was to determine if a pharmacist-led intervention to improve medication safety at hospital discharge reduced the number of hospital readmissions among geriatric high-utilizer patients. This study is the first to test a pharmacist-based intervention in a high-utilizer population. Methods: This was a quasi-experimental pilot study done at a safety-net hospital in the southeastern US. Fifty-seven patients 65 years old and older who were in the 95th percentile for number of hospital admissions in a year were included. On the day of discharge, one of the study pharmacists reviewed the discharge medication list and calculated the Medication Appropriateness Index (MAI) for each medication and reviewed for Beers Criteria. Any medication identified as potentially high-risk or inappropriate was flagged by the pharmacist and discussed with the team. The primary outcome was the number of admissions in the year following the intervention in the intervention group versus the control group. Results: There were no statistically significant differences in the number of admissions, the MAI scores, or the number of medications meeting Beers Criteria between the two groups. Conclusion: Although this study did not demonstrate a decrease in hospital admissions, it shows that pharmacist review of medications at discharge can identify potentially unnecessary medications that could lead to confusion or adverse events. Further research is necessary to identify interventions to prevent readmissions in this high-risk population.   Article Type: Original Research

1195-P: Improving Diabetes Self-Management with a Mobile App: Results of a Pilot Program at a Safety Net Hospital System

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1195-P
Author(s):  
ROOPA KALYANARAMAN MARCELLO ◽  
JOHANNA DOLLE ◽  
SHARANJIT KAUR ◽  
SAWKIA R. PATTERSON ◽  
NICHOLA DAVIS
Keyword(s):  
Safety Net ◽  
Mobile App ◽  
Self Management ◽  
Pilot Program ◽  
Hospital System ◽  
Safety Net Hospital

Data-Driven Optimization Methodology for Admission Control in Critical Care Units

2016 ◽  
Author(s):  
Amirhossein Meisami ◽  
Jivan Deglise-Hawkinson ◽  
Mark Cowen ◽  
Mark P. Van Oyen
Keyword(s):  
Critical Care ◽  
Admission Control ◽  
Data Driven ◽  
Critical Care Units ◽  
Optimization Methodology

Embodied Spatial Practices and the Power to Care

2019 ◽  
pp. 360-377
Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Ethnographic Study ◽  
Spatial Practices ◽  
Critical Care Units ◽  
Interprofessional Care ◽  
The Social

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.

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