scholarly journals Physical Restraint in Adult Intensive Care Unit - Why and how are they used?

2016 ◽  
Vol 4 (2) ◽  
pp. 110-113
Author(s):  
Sushil Khanal ◽  
Subhash Prasad Acharya
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Patient Autonomy ◽  
Physical Restraint ◽  
Evidence Based ◽  
Adult Intensive Care Unit ◽  
Risk Of Injury ◽  
Ensure Patient Safety ◽  
Evidence Based Guidelines

Background: Physical restraint is preferred practice in adult critical care to reduce the risk of injury and ensure patient safety. However, data on the extent of restraint practice intensive care unit is unknown in our setting to develop evidence based guidelines to promote the scientific use of this modalityMethods: This observational study was conducted for determining the prevalence, motives and ongoing practices of physical restraint. Data were collected from direct observation of physically restrained patients, review of patients’ record and from the nursing staff.Results: The results revealed that physical restraint was commonly used to prevent device dislodgment and to ensure patient safety. The results illustrated a lack of documentation on initiation and monitoring of use physical restraint.Conclusion: For a better care of patients, it is very important to develop a restraint policy for rational use of physical restrain respecting the patient autonomy and freedom.Bangladesh Crit Care J September 2016; 4 (2): 110-113

Governance in point-of-care ultrasound

2019 ◽  
pp. 273-278
Author(s):  
Peter Macnaughton ◽  
Marcus Peck
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Ultrasound Examination ◽  
Point Of Care ◽  
Good Practice ◽  
Point Of Care Ultrasound ◽  
Equipment Management ◽  
Image Storage ◽  
Ensure Patient Safety

The performance and interpretation of ultrasound examination are very user-dependent that require significant training and experience. This chapter details the processes that should be adopted within an intensive care unit using point-of-care ultrasound to ensure that practitioners are appropriately trained and are able to maintain and develop their skills. The chapter also outlines recommendations regarding good practice in reporting and image storage, together with guidance regarding equipment management, to ensure patient safety.

Reducing Foley Catheter Device Days in an Intensive Care Unit

2006 ◽  
Vol 17 (3) ◽  
pp. 272-283
Author(s):  
Laura Reilly ◽  
Patty Sullivan ◽  
Sharon Ninni ◽  
Denise Fochesto ◽  
Karen Williams ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Foley Catheter ◽  
Hospital Costs ◽  
Evidence Based ◽  
Tract Infections ◽  
Evidence Based Guidelines ◽  
Hospital Acquired

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

Using Evidence and Process Improvement Strategies to Enhance Healthcare Outcomes for the Critically Ill: A Pilot Project

2006 ◽  
Vol 15 (6) ◽  
pp. 549-555 ◽  
Author(s):  
Carol W. Hatler ◽  
Deanna Mast ◽  
Jeannie Corderella ◽  
Gina Mitchell ◽  
Kathleen Howard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Evidence Based Practice ◽  
Care Delivery ◽  
Bloodstream Infections ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Outcomes ◽  
Tertiary Referral Hospital ◽  
Adult Intensive Care Unit

• Background Although the value of evidence-based practice may seem obvious, the process needed to produce more effective delivery of evidence-based healthcare is not obvious. Furthermore, the continuing escalation of healthcare costs fuels the desire of providers and consumers to undertake only those treatments that have benefit. One way to effect necessary changes in healthcare organizations is through focused, interdisciplinary, collaborative projects related to evidence-based practice. • Objectives To reduce rates of ventilator-associated pneumonia and catheter-related bloodstream infection in patients in the medical intensive care unit of a large, urban tertiary referral hospital in the Southwest. • Methods The theory of planned behavior served as the basis for providing staff members with research-based, easily controllable strategies that “fit” with the usual methods of care delivery. Implementation of the strategies and data collection were accomplished through routine rounds on patients and regular reporting of objective information. • Results During a 15-month period, use of the selected strategies resulted in a 54% reduction in ventilator-associated pneumonia, a 78% reduction in catheter-related bloodstream infections, and a 18% reduction in mean length of stay in the unit. Use of a multidisciplinary, environmentally tailored approach to concerns about patients’ care resulted in estimated cost savings of $1.0 million to $2.3 million. • Conclusions Early, consistent communication about the project’s rationale, expected behavior, and outcomes enhanced the manageability and effectiveness of this change in an adult intensive care unit.

Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

Fever Management in Patients With Brain Injury

2012 ◽  
Vol 23 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Laura Mcilvoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elevated Temperature ◽  
Brain Injury ◽  
Acute Brain Injury ◽  
Evidence Based ◽  
Medical Opinion ◽  
Lengths Of Stay ◽  
Evidence Based Guidelines ◽  
Fever Management

Elevated temperature in patients with brain injury has been linked to increased hospital and intensive care unit lengths of stay, increased morbidity, greater disability, and higher mortality. The prevailing medical opinion is that maintaining normothermia in patients with acute brain injury is beneficial. However, little evidence exists to support this recommendation. Nurses are responsible for diagnosing and treating fever, but evidence-based guidelines that would govern fever management for these patients do not exist. This article discusses what evidence is available to support the management of fever in patients with brain injury and in what areas evidence is lacking.

scholarly journals Patient safety culture in the intensive care unit: cross-study

2019 ◽  
Vol 13 (06) ◽  
pp. 496-503
Author(s):  
Mabel Duarte Alves Gomides ◽  
Astrídia Marília de Souza Fontes ◽  
Amanda Oliveira Soares Monteiro Silveira ◽  
Geraldo Sadoyama
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Safety Culture ◽  
Work Experience ◽  
Patient Safety Culture ◽  
University Hospital ◽  
Cross Sectional ◽  
Safety Attitudes ◽  
Adult Intensive Care Unit

Introduction: Patient safety culture has been the reason for great concern for the scientific community due to the high number of failures resulting from the provision of health care. The objective of this study was to evaluate the perception regarding the patient safety culture and their differences between categories, in the professional teams of the adult intensive care unit (ICU). Methodology: This is a cross-sectional descriptive study, with a quantitative approach, to evaluate the patient safety culture developed in the unit adult ICU of a public university hospital. Results: In this survey, 138 employees of the ICU participated, among them: physicians, psychologists, nutritionists, physiotherapists, nurses, nursing technicians, and secretaries. There was a predominance of nursing technicians (76.8%) and work experience time from 5 to ≥ 21 years (62.3%). The overall mean of the safety culture in the ICU was 57.80, and the domains with the best average were stress perception (73.84) and satisfaction at work (72.38) and with the worst mean was the perception of hospital management (42.69). The perception of safety attitudes in the professional category of physicians presented a general average of 61.63, being strengthened to job satisfaction (77,89) and with a higher perception in relation to nurses. Conclusions: The overall ICU average for the patient safety culture was less than 75, which demonstrates a team with weakened safety attitude and, in addition, low perceptions of safety attitudes based on the results of management domains, working conditions and communication failures.

scholarly journals Nutrition in the intensive care unit

2015 ◽  
Vol 3 (10) ◽  
pp. 10 ◽  
Author(s):  
Chase C. Hansen ◽  
Sharmila Dissanaike
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Enteral Feeding ◽  
Surgical Patients ◽  
Evidence Based ◽  
Timing Of Initiation ◽  
Evidence Based Guidelines

Nutrition has evolved into an integral part of modern critical care for both medical and surgical patients. Multiple international societies now issue evidence-based guidelines to help clinician optimize their patients’ Nutrition. However, adherence to these guidelines throughout the country is poor, and education in nutrition is still lagging in medical school.  The authors also highlight four key areas where evidence-based recommendations exist – timing of initiation of enteral feeding, calculating and meeting total daily requirements, use of gastric residual volumes to guide delivery, and interuption of feeding for procedures – but are currently often not followed.  Reasons for this lack of adherence are explored, and potential solutions discussed.

Examination of Ethical Dilemmas Experienced by Adult Intensive Care Unit Nurses in Physical Restraint Practices

2014 ◽  
Vol 28 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Gülendam Hakverdioğlu Yönt ◽  
Esra Akin Korhan ◽  
Berna Dizer ◽  
Fatma Gümüş ◽  
Rukiye Koyuncu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Ethical Dilemmas ◽  
Physical Restraint ◽  
Adult Intensive Care Unit ◽  
Intensive Care Unit Nurses
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