scholarly journals Good practice issues in psychiatric intensive-care units

1999 ◽  
Vol 23 (7) ◽  
pp. 397-400 ◽  
Author(s):  
Stephen Pereira ◽  
M. Dominic Beer ◽  
Carol Paton
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
High Risk ◽  
Intensive Care Units ◽  
Clinical Care ◽  
Good Practice ◽  
Clinical Implications ◽  
Clinical Leadership ◽  
Risk Areas ◽  
Areas Of Concern

Aims and methodTo survey some aspects of care relevant to good practice in psychiatric intensive-care units.ResultsA number of areas of concern were identified, including care issues for informal and female patients, a lack of uniform clinical leadership and a paucity of policies/guidelines for high-risk areas of clinical practice.Clinical implicationsIn an attempt to provide a service for the most disturbed patients from widely varying sources, psychiatric intensive-care units are at risk of compromising the ability to provide good-quality clinical care.

scholarly journals Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future

2021 ◽  
pp. archdischild-2020-320962
Author(s):  
Ruchi Sinha ◽  
Angela Aramburo ◽  
Akash Deep ◽  
Emma-Jane Bould ◽  
Hannah L Buckley ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Clinical Care ◽  
Adult Patients ◽  
Paediatric Intensive Care ◽  
Critically Ill Adults ◽  
Care Capacity ◽  
Ill Adults ◽  
Paediatric Intensive Care Units

ObjectiveTo describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.DesignDescriptive study.SettingSeven PICUs in England.Main outcome measures(1) Modelling using historical Paediatric Intensive Care Audit Network data; (2) space, staff, equipment, clinical care, communication and governance considerations during repurposing of PICUs; (3) characteristics, interventions and outcomes of adults cared for in repurposed PICUs.ResultsSeven English PICUs, accounting for 137 beds, repurposed their space, staff and equipment to admit critically ill adults. Neighbouring PICUs increased their bed capacity to maintain overall bed numbers for children, which was informed by historical data modelling (median 280–307 PICU beds were required in England from March to June). A total of 145 adult patients (median age 50–62 years) were cared for in repurposed PICUs (1553 bed-days). The vast majority of patients had COVID-19 (109/145, 75%); the majority required invasive ventilation (91/109, 85%). Nearly, a third of patients (42/145, 29%) underwent a tracheostomy. Renal replacement therapy was provided in 20/145 (14%) patients. Twenty adults died in PICU (14%).ConclusionIn a rapid and unprecedented effort during the first wave of the COVID-19 pandemic, seven PICUs in England were repurposed to care for adult patients. The success of this effort was underpinned by extensive local preparation, close collaboration with adult intensivists and careful national planning to safeguard paediatric critical care capacity.

scholarly journals Use of psychotropic medication in seven English psychiatric intensive care units

2010 ◽  
Vol 34 (4) ◽  
pp. 130-135 ◽  
Author(s):  
Steve Brown ◽  
Navjyoat Chhina ◽  
Stephen Dye
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Antipsychotic Drug ◽  
Antipsychotic Medication ◽  
Psychotropic Medication ◽  
Intramuscular Injection ◽  
Case Note ◽  
Clinical Implications ◽  
High Dose ◽  
Prescribing Practices

Aims and methodTo describe the psychotropic medication given to 332 patients admitted consecutively to seven English psychiatric intensive care units (PICUs) by prospective, multicentre case-note analysis.ResultsOverall, 104 (32%) patients received rapid tranquillisation or zuclopenthixol acetate by intramuscular injection; 72 (23%) received more than one regular antipsychotic drug simultaneously. It was reported that 20 patients received high-dose antipsychotic medication, which was probably an underestimate. The use of these interventions varied significantly between different units.Clinical implicationsPotentially risky treatments such as forcible intramuscular medication are a standard part of PICU activity. Further work is needed to clarify the reasons behind the differences in prescribing practices between different PICUs.

Do Intensive Care Units in Poland Need Recommendations for “Good Practice” in Labeling Intravenous Medicines?

2018 ◽  
Vol 14 (3) ◽  
pp. e49-e50 ◽  
Author(s):  
Katarzyna Kwiecień-Jaguś ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Katarzyna Czyż-Szypenbeil ◽  
Katarzyna Lewandowska
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Good Practice

The emotion: A crucial component in the care of critically ill patients

2016 ◽  
Vol 25 (3) ◽  
pp. 346-358 ◽  
Author(s):  
Maria Sagrario Acebedo-Urdiales ◽  
Maria Jiménez-Herrera ◽  
Carme Ferré-Grau ◽  
Isabel Font-Jiménez ◽  
Alba Roca-Biosca ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Phenomenological Study ◽  
Good Practice ◽  
Family Members ◽  
Three Dimensions ◽  
Nursing Ethics ◽  
Nursing Clinical Practice ◽  
Emotion Memory

Background: The acquisition of experience is a major concern for nurses in intensive care units. Although the emotional component of the clinical practice of these nurses has been widely studied, greater examination is required to determine how this component influences their learning and practical experience. Objective: To discover the relationships between emotion, memory and learning and the impacts on nursing clinical practice. Research design: This is a qualitative phenomenological study. The data were collected from open, in-depth interviews. A total of 22 intensive care unit nurses participated in this research between January 2012 and December 2014. Ethical considerations: The School of Nursing Ethics Committee approved the study, which complied with ethical principles and required informed consent. Findings: We found a clear relationship between emotion, memory and the acquisition of experience. This relationship grouped three dimensions: (1) satisfaction, to relieve the patient’s pain or discomfort, give confidence and a sense of security to the patient, enable the presence of family members into the intensive care unit and provide family members with a realistic view of the patient’s situation; (2) error experience, which nurses feel when a patient dies, when they fail to accompany a patient in his or her decision to abandon the struggle to live or when they fail to lend support to the patient’s family; and (3) the feel bad–feel good paradox, which occurs when a mistake in the patient’s care or handling of his or her family is repaired. Conclusion: Emotion is a capacity that impacts on nurses’ experience and influences improvements in clinical practice. Recalling stories of satisfaction helps to reinforce good practice, while recalling stories of errors helps to identify difficulties in the profession and recognise new forms of action. The articulation of emotional competencies may support the development of nursing ethics in the intensive care unit to protect and defend their patients and improve their relationships with families in order to maximise the potential for patient care.

Results of a survey on albumin use in clinical practice in intensive care units

2014 ◽  
Vol 38 (7) ◽  
pp. 403-412
Author(s):  
M.B. Estébanez-Montiel ◽  
M. Quintana-Díaz ◽  
A. García de Lorenzo y Mateos ◽  
R. Blancas Gomez-Casero ◽  
J. Acosta-Escribano ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
Intensive Care Units

scholarly journals Police involvement, characteristics and outcomes of place of safety referrals in the Scottish Highlands

2020 ◽  
Vol 44 (6) ◽  
pp. 244-250
Author(s):  
Struan Simpson ◽  
Jude Eze
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
High Risk ◽  
Personality Disorder ◽  
Emergency Management ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Factors Associated ◽  
Scottish Highlands ◽  
Risk Areas

Aims and methodTo characterise police involvement with those detained under place of safety legislation and determine factors associated with admission to hospital. Place of safety referrals over a 1-year period were identified retrospectively and evaluated.ResultsPlace of safety legislation is generally used with regard to concerns about suicide. Individuals are often removed from high-risk areas and referrals to police are frequently initiated by individuals themselves. A diagnosis of mental illness or personality disorder predicted hospital admission. Presence of senior nursing staff at assessment, but not the seniority of the doctor, was associated with discharge.Clinical implicationsCloser multiagency working is required as police are currently being recruited to fill a void between mental health services and the population they serve. Junior doctors require more senior support in making complex, and often risky, emergency management decisions with this population.

scholarly journals COVID-19: from epidemiology to treatment

2020 ◽  
Vol 41 (22) ◽  
pp. 2092-2112 ◽  
Author(s):  
J M Pericàs ◽  
M Hernandez-Meneses ◽  
T P Sheahan ◽  
E Quintana ◽  
J Ambrosioni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
Health Services ◽  
Clinical Review ◽  
Intensive Care Units ◽  
Health Workers ◽  
Daily Clinical Practice ◽  
Operating Theatres

Abstract The COVID-19 pandemic has greatly impacted the daily clinical practice of cardiologists and cardiovascular surgeons. Preparedness of health workers and health services is crucial to tackle the enormous challenge posed by SARS-CoV-2 in wards, operating theatres, intensive care units, and interventionist laboratories. This Clinical Review provides an overview of COVID-19 and focuses on relevant aspects on prevention and management for specialists within the cardiovascular field.

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