scholarly journals Quality improvement in pre-hospital critical care: increased value through research and publication

2014 ◽  
Vol 22 (1) ◽  
Author(s):  
Marius Rehn ◽  
Andreas J Krüger
Keyword(s):  
Critical Care ◽  
Quality Improvement

Evaluation of the safety of inter-hospital transfers of critically ill patients led by advanced critical care practitioners

2021 ◽  
Vol 30 (8) ◽  
pp. 470-476
Author(s):  
Gavin Denton ◽  
Lindsay Green ◽  
Marion Palmer ◽  
Anita Jones ◽  
Sarah Quinton ◽  
...  
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Critically Ill ◽  
Process Of Care ◽  
Related Complication ◽  
Improvement Project ◽  
Hospital Transfer ◽  
The Uk ◽  
Critically Ill Adults ◽  
Ill Adults

Introduction: Ten thousand inter-hospital transfers of critically ill adults take place annually in the UK. Studies highlight deficiencies in experience and training of staff, equipment, stabilisation before departure, and logistical difficulties. This article is a quality improvement review of an advanced critical care practitioner (ACCP)-led inter-hospital transfer service. Methods: The tool Standards for Quality Improvement Reporting Excellence was used as the format for the review, combined with clinical audit of advanced critical care practitioner-led transfers over a period of more than 3 years. Results: The transfer service has operated for 8 years; ACCPs conducted 934 critical care transfers of mechanically ventilated patients, including 286 inter-hospital transfers, between January 2017 and September 2020. The acuity of transfer patients was high, 82.2% required support of more than one organ, 49% required more than 50% oxygen. Uneventful transfer occurred in 81.4% of cases; the most common patient-related complication being hypotension, logistical issues were responsible for half of the complications. Conclusion: This quality improvement project provides an example of safe and effective advanced practice in an area that is traditionally a medically led domain. ACCPs can provide an alternative process of care for critically ill adults who require external transfer, and a benchmark for audit and quality improvement.

scholarly journals Assessing Nurses’ Knowledge of Noise in the Intensive Care Unit: An Educational Intervention Project

2021 ◽  
Author(s):  
Jennifer Fortes
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
Quality Improvement Project ◽  
Minimal Risk ◽  
Improvement Project ◽  
Staff Members ◽  
Nurses Knowledge

Noise in the intensive care unit (ICU) has been studied for over thirty years, but it continues to be a significant problem and a top complaint among patients. Staff members are now reporting detrimental health effects from excessive noise. One of the significant factors of inadequate noise control in the ICU is that nurses have insufficient awareness regarding the hospital noise issue and its negative impact on health status. The level of knowledge of clinical staff on the topic of noise is not known. A quality improvement project to explore noise in the ICU could facilitate better understanding of the phenomenon and formulation of new ways to continue to reduce noise at a community hospital in Massachusetts. The purpose of this quality improvement project was to evaluate nurses’ knowledge of the potentially harmful effects of noise on patients as well as on nurses, to identify opportunities for improvement of the environment, and to conduct an educational intervention aimed at reducing noise in the intensive care unit. The methodology for this project included a pre-test, followed by an educational session, and completion of a post-test. The participants included registered nurse staff members in the Intensive Care Unit (ICU) and the Critical Care Unit (CCU). Exclusion criteria included staff members who are not registered nurses. The project posed minimal risk. No identifying or biographical data was collected, and results included analysis of aggregate data. Descriptive statistics were used to assist with analysis. Results were disseminated to the staff of the ICU and CCU, posted on a bulletin board in the critical care area, presented as a poster presentation at the Spring RIC MSN Symposium, and available as a manuscript on the RIC Digital Commons.

Assessing data accuracy in a large multi-institutional quality improvement registry: an update from the Pediatric Cardiac Critical Care Consortium (PC4)

2021 ◽  
pp. 1-6
Author(s):  
Jennifer Schuette ◽  
Hayden Zaccagni ◽  
Janet Donohue ◽  
Julie Bushnell ◽  
Kelly Veneziale ◽  
...  
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Institutional Quality ◽  
Data Accuracy ◽  
Broad Array ◽  
Major Discrepancy ◽  
Discrepancy Rate ◽  
Data Auditing ◽  
High Level ◽  
Cardiac Critical Care

Abstract Background: The Pediatric Cardiac Critical Care Consortium (PC4) is a multi-institutional quality improvement registry focused on the care delivered in the cardiac ICU for patients with CHD and acquired heart disease. To assess data quality, a rigorous procedure of data auditing has been in place since the inception of the consortium. Materials and methods: This report describes the data auditing process and quantifies the audit results for the initial 39 audits that took place after the transition from version one to version two of the registry’s database. Results: In total, 2219 total encounters were audited for an average of 57 encounters per site. The overall data accuracy rate across all sites was 99.4%, with a major discrepancy rate of 0.52%. A passing score is based on an overall accuracy of >97% (achieved by all sites) and a major discrepancy rate of <1.5% (achieved by 38 of 39 sites, with 35 of 39 sites having a major discrepancy rate of <1%). Fields with the highest discrepancy rates included arrhythmia type, cardiac arrest count, and current surgical status. Conclusions: The extensive PC4 auditing process, including initial and routinely scheduled follow-up audits of every participating site, demonstrates an extremely high level of accuracy across a broad array of audited fields and supports the continued use of consortium data to identify best practices in paediatric cardiac critical care.

Critical Care Nurse–Led Quality Improvement Hyperglycemia Reduction Initiative

2018 ◽  
pp. 1
Author(s):  
Lisa Neelon ◽  
Kim Basawil ◽  
Laura Whitney ◽  
Evelyn Kneblewicz ◽  
Sharon A. Watts ◽  
...  
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Care Nurse ◽  
Critical Care Nurse

Quality Improvement or Research—Deciding Which Road to Take

2014 ◽  
Vol 34 (6) ◽  
pp. 58-63 ◽  
Author(s):  
Julie M. Stausmire
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Clinical Research ◽  
Low Cost ◽  
Critical Care Nurses ◽  
Evidence Based Practices ◽  
Care Nurse ◽  
Scarce Resources ◽  
Quality Patient Care ◽  
Broad Overview

Critical care nurses are constantly challenged to provide safe, high-quality patient care at a low cost with increasingly scarce resources while implementing the latest evidence-based practices into their own clinical practice. This article is the first in a 4-part series to provide a practical quality improvement guide for critical care nurses interested in implementing system process or performance improvement projects within their own units. Part 1 is designed to answer the question “What method is better for measuring real-world patient outcomes—quality improvement or clinical research?” A broad overview of the differences between quality improvement and clinical research is provided. A newly published checklist to differentiate between attributes of each process is introduced, and readers can test their own knowledge between quality improvement and research with a quick quiz of studies recently published in Critical Care Nurse.

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