The Impact of Nurse Experience and Sequential Organ Failure Assessment on Nurses’ Workflow in an Intensive Care Unit

2020 ◽  
Vol 64 (1) ◽  
pp. 603-607
Author(s):  
Alireza Kasaie ◽  
Jung Hyup Kim ◽  
Wenbin Guo ◽  
Laurel Despins
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Real Time ◽  
Process Time ◽  
Workflow Patterns ◽  
Failure Assessment ◽  
Nurse Experience ◽  
The Impact

The purpose of this study is to understand the impact of Nurse Experience (NE) and Sequential Organ Failure Assessment (SOFA) on nurses’ workflow and process time in an Intensive Care Unit (ICU). In this study, a combination of data from the time-motion study observations, ICU nurses’ Real-Time Location System (RTLS), and the Real-Time Measurement System (RTMS) data were used to develop multiple Hierarchical Task Analysis (HTA) charts. HTA chart helped us to identify the ICU nurses’ workflow patterns. The results showed that ICU nurses spent over 47% of their time on performing primary care (in-room activities) and 25% on out-of-room activities. Furthermore, NE levels and SOFA scores had significant impacts on the average process time of nurse handoff, in-room Electronic Medical Record (EMR) charting, and the workflow patterns of out-of-room activities and out-of-room EMR usage. The outcomes of this study will provide a detailed workflow of ICU nurses and might help nurse managers to conduct a better strategy for improving ICU nurse’s workflow.

scholarly journals Establishment of a prognostic model based on the Sequential Organ Failure Assessment score for patients with first-time acute myocardial infarction

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110119
Author(s):  
Shuai Zheng ◽  
Jun Lyu ◽  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Cardiovascular Events ◽  
Failure Assessment ◽  
First Time

Objective This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. Methods We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. Results An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. Conclusion The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.

Evaluation of qSOFA as a Predictor of Mortality Among ICU Patients With Positive Clinical Cultures—A Retrospective Cohort Study

2019 ◽  
Vol 35 (11) ◽  
pp. 1278-1284
Author(s):  
Barry Kelly ◽  
Johann Patlak ◽  
Shahzad Shaefi ◽  
Dustin Boone ◽  
Ariel Mueller ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Assessment Score ◽  
Failure Assessment ◽  
Discriminative Value

Objective: To compare the discriminative value of the quick-sequential organ failure assessment score (qSOFA) to SOFA in a critically ill population, in which a microbial pathogen was isolated within 48 hours of admission to intensive care. Design: Retrospective cohort study. Setting: Academic tertiary referral center from July 2008 to June 2017. Patients: Hospitalized patients admitted to intensive care unit. Interventions: None. Measurements and Main Results: The primary outcome was in-hospital mortality for all patients with confirmed positive microbiological cultures within 48 hours of admission to intensive care unit (ICU). Subgroup analysis was performed on patients with pathogenic bacteremia or positive cultures in cerebrospinal fluid. Of the 11 415 patients analyzed with positive microbiology specimens within 48 hours of admission, 2933 (25.7%) had a qSOFA ≥2. Of these, 16.6% reached the primary outcome of in-hospital mortality. Unsurprisingly, the discriminative value of qSOFA on admission was significantly worse than that of SOFA (0.73 vs 0.76; P = .0004), despite observing a significant association between qSOFA category and in-hospital mortality ( P < .0001). In secondary analyses, similar observations were found using qSOFA within 6 and 24 hours of ICU admission. When analysis was focused on patients with pathogenic bacteremia or positive cerebrospinal fluid (CSF) cultures (n = 1646), there was no significant difference between the discriminative value of qSOFA and SOFA (0.75 vs 0.78; P = .17). Conclusions: Quick-sequential organ failure assessment score at admission was not superior to SOFA in predicting in-hospital mortality in patients with positive clinical cultures within 48 hours of admission to ICU. Quick-sequential organ failure assessment score at admission to the ICU was associated with mortality and showed reasonable calibration and discrimination. When the analysis was focused on patients with pathogenic bacteremia or positive CSF cultures, qSOFA performed similarly to SOFA in discriminatory those who will die from sepsis.

scholarly journals Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216177 ◽  
Author(s):  
Jacob C. Jentzer ◽  
Courtney Bennett ◽  
Brandon M. Wiley ◽  
Dennis H. Murphree ◽  
Mark T. Keegan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Predictive Value ◽  
Cardiac Intensive Care Unit ◽  
Failure Assessment ◽  
Cardiac Intensive Care
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