Reducing Unnecessary Sleep Disruption for Neonatal Patients

2013 ◽  
Vol 2 (1) ◽  
pp. 154-159
Author(s):  
Swaroop Rajaraman ◽  
Thomas Ferris
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Physical Development ◽  
Sleep Disruption ◽  
Future Research ◽  
Metropolitan Hospital ◽  
The Relationship ◽  
Wake State ◽  
Do So

This research addresses a major issue that is receiving growing attention in neonatal intensive care: the importance of uninterrupted sleep to promote healthy cognitive and physical development for NICU patients. This issue is addressed by targeting classic human factors problems with alarms in critical care environments. The focus of this research is in the intersection between alarm problems and problems related to unnecessary disruption of patients’ sleep. An observational study is currently underway at a major metropolitan hospital to document the relationship between alarms and sleep/wake state, highlighting characteristics of alarms and contexts when sleep is disrupted due to clinically insignificant/inactionable alarms and also when nurses’ response to the alarms leads to them intentionally waking the patients when it is unnecessary to do so. Methods for this work are discussed in detail, and preliminary anecdotal findings suggest that apnea and bradycardia are some of the more problematic alarms for unnecessary sleep disruption. Future research plans to address these and other problematic alarms are also discussed.

scholarly journals Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 238
Author(s):  
Lauren Culbertson ◽  
Dmitry Dukhovny ◽  
Wannasiri Lapcharoensap
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Neonatal Intensive Care Unit ◽  
Patient Outcomes ◽  
Neonatal Intensive Care ◽  
Future Research ◽  
The Relationship

There is tremendous variation in costs of delivering health care, whether by country, hospital, or patient. However, the questions remain: what costs are reasonable? How does spending affect patient outcomes? We look to explore the relationship between cost and quality of care in adult, pediatric and neonatal literature. Health care stewardship initiatives attempt to address the issue of lowering costs while maintaining the same quality of care; but how do we define and deliver high value care to our patients? Ultimately, these questions remain challenging to tackle due to the heterogeneous definitions of cost and quality. Further standardization of these terms, as well as studying the variations of both costs and quality, may benefit future research on value in health care.

Pain and Delirium in Critical Illness: An Exploration of Key 2018 SCCM PADIS Guideline Evidence Gaps

2019 ◽  
Vol 40 (05) ◽  
pp. 604-613 ◽  
Author(s):  
Margaret A. Pisani ◽  
John W. Devlin ◽  
Yoanna Skrobik
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critical Care Medicine ◽  
Sleep Disruption ◽  
Future Research ◽  
Critically Ill Adults ◽  
Ill Adults

AbstractManaging pain and delirium are crucial to patients, families, and caregivers in intensive care units. The Society of Critical Care Medicine 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep disruption (PADIS) guidelines reviewed literature until October 2015 and made its recommendations for critically-ill adults. This chapter addresses evidence gaps, identified during the guideline process, most relevant to clinicians, adds newer evidence published after the PADIS 2018 guidelines were produced, describes hindsight-driven PADIS process or content-related gaps, and reflects on how these considerations may help inform future research investigations and new guideline efforts.

YENİDOĞAN YOĞUN BAKIM ÜNİTELERİNDE İŞ KAZALARI RİSKLERİ VE NEDENLERİNE YÖNELİK BİR ARAŞTIRMA

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Haluk Tanrıverdi ◽  
Orhan Akova ◽  
Nurcan Türkoğlu Latifoğlu
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Physical Environment ◽  
Neonatal Intensive Care ◽  
Organizational Factors ◽  
Occupational Accidents ◽  
Neonatal Intensive Care Units ◽  
Work Related ◽  
Physical Conditions ◽  
The Relationship

This study aims to demonstrate the relationship between the qualifications of neonatal intensive care units of hospitals (physical conditions, standard applications, employee qualifications and use of personal protective equipment) and work related causes and risks, employee related causes and risks when occupational accidents occur. Accordingly, a survey was prepared and was made among 105 nurses working in 3 public and 3 private hospital's neonatal intensive care units, in the January of 2010. The survey consists of questions about the qualifications of neonatal intensive care units, work related causes and risks, and employee related causes and risks. From the regression analysis conducted, it has been found that confirmed hypotheses in several studies in the literature were not significant in this study. The sub-dimensions in which relationships has been found show that the improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications can reduce the rate of occupational accidents. According to the results of this study management should take care of the organizational factors besides to improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications.

scholarly journals Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
M. Ostermann ◽  
A. Schneider ◽  
T. Rimmele ◽  
I. Bobek ◽  
M. van Dam ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critical Care ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Future Research ◽  
Knowledge Gaps ◽  
Blood Pressure Targets

Abstract Purpose Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research. Methods International Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research. Results The following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT). Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT. Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities. Conclusion Consensus was reached on a future research agenda for the AKI section of the ESICM.

scholarly journals Lactate dehydrogenase level as an early predictor of transient tachypnea of the newborn duration and complications

2020 ◽  
Author(s):  
Mada Osefori ◽  
Leen Jamel Doya ◽  
Bana Nezha ◽  
Adnan Dayoub
Keyword(s):  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Neonatal Intensive Care ◽  
Lactate Dehydrogenase Level ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
University Hospital ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
The Relationship

Abstract Background: Transient tachypnea of the newborn(TTNB) is a common cause of respiratory distress in the postnatal period. It is rarely associated with serious complications that need intensive care. Prediction of the complications during the first hours of hospitalization is very difficult, so the purpose of the current study is to investigate the relationship between lactate dehydrogenase (LDH) level in blood and the course of Transient tachypnea of the newborn (the duration of hospitalization, and the incidence of complications).Material and methods: In a cross-sectional study design included 120 neonates with Transient tachypnea of the newborn who had referred to the Neonatal Intensive Care Unit (NICU) at Tishreen University Hospital over 1 year period from January 2018 to January 2019. The neonates were classified according to Lactate dehydrogenase measurement as normal or high lactate dehydrogenase level in blood.Results: The results showed that there was a significant relationship between the level of lactate dehydrogenase and the duration of hospitalization, the incidence of complications, and the frequency of complications.Conclusions: lactate dehydrogenase might be useful for clinicians to predict the duration of hospitalization and the incidence of complications in neonates with TTNB.

Procedures in the Adult and Neonatal Intensive Care Units

2018 ◽  
Author(s):  
Matthew Read ◽  
Christopher V. Maani
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
Intensive Care Units ◽  
Surgical Procedures ◽  
Neonatal Intensive Care ◽  
Critical Care Medicine ◽  
Neonatal Intensive Care Units ◽  
Anesthesia Practice ◽  
Urgent Procedure

Bedside procedures in the ICU are an integral component of critical care medicine. Anesthesiologists who are assigned to the ICU must adapt principles of safe and effective anesthesia practice to this novel outside-of-the-operating-room environment. There are several reasons for surgical procedures to sometimes be performed at the bedside in the ICU, such as the avoidance of transporting unstable patients from the ICU to the OR, or the lack of adequate time to mobilize resources to perform an urgent procedure in the OR. Readiness of the entire ICU team is essential to avoid compromising care due to production pressure or lack of standards routine to the OR environment. This chapter discusses the types of procedures performed in the ICU and reviews the requirements of performing them successfully.

The Chasm in Neonatal Outcomes in Relation to Time of Birth in Lebanon

2007 ◽  
Vol 26 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Lina Kurdahi Badr ◽  
Bahia Abdallah ◽  
Sossi Balian ◽  
Hala Tamim ◽  
Mirvat Hawari
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Night Shift ◽  
Neonatal Intensive Care Units ◽  
Maternal Risk Factors ◽  
Mortality And Morbidity ◽  
Maternal Risk ◽  
The Relationship

Purpose:The purpose of this study was to investigate the relationship between the time of birth and the mortality and morbidity of infants admitted to neonatal intensive care units.Design:This prospective, cohort study examined the records of women and infants admitted to the NICUs of four hospitals in Beirut, Lebanon, between July 1, 2002, and June 30, 2003. The hospitals selected were university affiliated and had a large number of deliveries (5,152 total for the year 2002–2003).Main Outcome Variables:Neonatal mortality and morbidity for infants admitted to the NICU were evaluated in relation to time of birth.Results:For the whole sample, mortality was higher for infants born during the night shift than for those born during the day shift. Mortality, morbidity, and brain asphyxia rates were also higher for infants born during the night shift and admitted to the NICU. Maternal risk factors and delivery complications were not consistently higher on the night shift.

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