scholarly journals The Effects of Care Team Roles on Situation Awareness in the Pediatric Intensive Care Unit: A Prospective Cross-Sectional Study

2020 ◽  
Vol 15 (10) ◽  
pp. 594-597
Author(s):  
Blaise T Soberano ◽  
Patrick Brady ◽  
Toni Yunger ◽  
Rhonda Jones ◽  
Erin Stoneman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
High Risk ◽  
Situation Awareness ◽  
Pediatric Intensive Care ◽  
Care Team ◽  
Cross Sectional ◽  
Risk Status ◽  
High Risk Patients ◽  
Respiratory Therapists ◽  
Risk Patients

Improved situation awareness (SA) decreases rates of clinical deterioration in the pediatric inpatient setting. We used a prospective, cross-sectional, observational study to measure interprofessional care team SA for a pediatric intensive care unit (PICU) patients. The resident, bedside nurse, and respiratory therapist for each patient were surveyed regarding high clinical deterioration risk status as defined by clinical criteria identified by the PICU fellow or attending and mitigation plan. From March 2018 to July 2019, we surveyed 400 care team trios caring for 73 high-risk patients. Nurses identified the patient’s risk status correctly for 375 of 400 patients (94%), respiratory therapists, 380 (95%; P = .4), and residents, 349 (87%; P = .002). For the 73 high-risk patients, nurses were correct 82% of the time, respiratory therapists, 85%, P = .7, and residents, 67%, P = .04. Interventions targeting resident SA are needed within the PICU, especially for high-risk patients.

scholarly journals Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice

2019 ◽  
Author(s):  
Suzanne J Faber ◽  
Nynke Scherpbier ◽  
Hans Peters ◽  
Annemarie Uijen
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
High Risk ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Fluid Loss ◽  
Cross Sectional ◽  
High Risk Patients ◽  
Risk Patients ◽  
Raas Inhibitors

Abstract Background Elderly, patients with chronic kidney disease (CKD) and patients with heart failure who continue using renin-angiotensin-aldosterone-system (RAAS) inhibitors, diuretics, or non-steroidal-anti-inflammatory drugs (NSAIDs) during times of fluid loss have a high risk of developing complications like acute kidney injury (AKI). The aim of this study was to assess how often advice to discontinue high-risk medication was offered to high-risk patients consulting the general practitioner (GP) with increased fluid loss. Furthermore, we assessed the number and nature of the complications that occurred after GP consultation. Methods We performed a cross-sectional study with patients from seven Dutch general practices participating in the Family Medicine Network between 1-6-2013 and 1-7-2018. We included patients who used RAAS-inhibitors, diuretics, or NSAIDs, and had at least one of the following risk factors: age ≥70 years, CKD, or heart failure. From this population, we selected patients with a ‘dehydration-risk’ episode (vomiting, diarrhoea, fever, chills, or gastrointestinal infection). We manually checked their electronic patient files and assessed the percentage of episodes in which advice to discontinue the high-risk medication was offered and whether a complication occurred in three months after the ‘dehydration-risk’ episode. Results We included 3607 high-risk patients from a total of 44.675 patients (8.1%). We found that patients were advised to discontinue the high-risk medication in 38 (4.6%) of 816 ‘dehydration-risk’ episodes. In 59 of 816 episodes (7.1%) complications (mainly AKI) occurred. Conclusions Dutch GPs do not frequently advise high-risk patients to discontinue high-risk medication during ‘dehydration-risk’ episodes. Complications occur frequently. Timely discontinuation of high-risk medication needs attention.

scholarly journals Noninvasive ventilation versus conventional oxygen therapy after extubation failure in high-risk patients in an intensive care unit: a pragmatic clinical trial

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Alberto Belenguer-Muncharaz ◽  
Maria-Lidón Mateu-Campos ◽  
Bárbara Vidal-Tegedor ◽  
María- Desamparados Ferrándiz-Sellés ◽  
Maria-Luisa Micó-Gómez ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Noninvasive Ventilation ◽  
Oxygen Therapy ◽  
Extubation Failure ◽  
Pragmatic Clinical Trial ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Diabetic foot and its serial treatment in high-risk patients: focusing on the individual

2020 ◽  
Vol 66 (11) ◽  
pp. 1542-1547
Author(s):  
Eli Ávila Souza Júnior ◽  
Raul Silva Simões de Camargo ◽  
Tiago Soares Baumfeld ◽  
Daniel Soares Baumfeld ◽  
Benjamin Dutra Macedo
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
High Risk Group ◽  
Foot Care ◽  
Cross Sectional ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Individual

SUMMARY Objectives: To assess knowledge about diabetic foot, care measures, and the importance attached to serial treatment in a group of high-risk diabetic foot patients. METHODS: This is a cross-sectional study, carried out in a tertiary hospital, with 25 patients undergoing serial treatment for diabetic foot. The tabulation of the data occurred through the use of three methodological figures: core idea, key expressions, and the collective subject discourse. RESULTS: It became evident that even among high-risk patients with diabetic foot, there is no complete knowledge about the definition of the disease. Despite this, all participants reported practicing daily care measures, including frequent inspection of the feet, food care, and attention to footwear. Regarding the importance of serial treatment, there was unanimous recognition of the relevance of this practice, which improves self-care discipline, optimizes the understanding of the disease, and helps to prevent progression. CONCLUSIONS: Authentic speeches in the context of a pathology of considerable prevalence manifested, in an unprecedented way, with conceptions about its definition, care measures, and importance of serial treatment in a high-risk group.

Proactive palliative care in the medical intensive care unit: Effects on length of stay for selected high-risk patients

2007 ◽  
Vol 35 (6) ◽  
pp. 1530-1535 ◽  
Author(s):  
Sally A. Norton ◽  
Laura A. Hogan ◽  
Robert G. Holloway ◽  
Helena Temkin-Greener ◽  
Marcia J. Buckley ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
High Risk ◽  
Length Of Stay ◽  
Medical Intensive Care Unit ◽  
High Risk Patients ◽  
Risk Patients ◽  
Medical Intensive Care

scholarly journals Effects of the proportion of high-risk patients and control strategies on the prevalence of methicillin-resistant Staphylococcus aureus in an intensive care unit

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Farida Chamchod ◽  
Prasit Palittapongarnpim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Risk Group ◽  
Control Strategies ◽  
High Risk Group ◽  
High Risk Patients ◽  
Risk Patients ◽  
Mrsa Infection ◽  
And Control

Abstract Background The presence of nosocomial pathogens in many intensive care units poses a threat to patients and public health worldwide. Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen endemic in many hospital settings. Patients who are colonized with MRSA may develop an infection that can complicate their prior illness. Methods A mathematical model to describe transmission dynamics of MRSA among high-risk and low-risk patients in an intensive care unit (ICU) via hands of health care workers is developed. We aim to explore the effects of the proportion of high-risk patients, the admission proportions of colonized and infected patients, the probability of developing an MRSA infection, and control strategies on MRSA prevalence among patients. Results The increasing proportion of colonized and infected patients at admission, along with the higher proportion of high-risk patients in an ICU, may significantly increase MRSA prevalence. In addition, the prevalence becomes higher if patients in the high-risk group are more likely to develop an MRSA infection. Our results also suggest that additional infection prevention and control measures targeting high-risk patients may considerably help reduce MRSA prevalence as compared to those targeting low-risk patients. Conclusions The proportion of high-risk patients and the proportion of colonized and infected patients in the high-risk group at admission may play an important role on MRSA prevalence. Control strategies targeting high-risk patients may help reduce MRSA prevalence.

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