A Novel Approach for More Effective Emergency Equipment Storage: The Task-Based Package-Organized Neonatal Emergency Backpack

Objectives: To evaluate a new task-based package-organized (TPO) neonatal emergency backpack and to compare it to the classical (ABC- and material-based) backpack.Methods: Simulation-based assessment of time to retrieve equipment for three different tasks [intraosseous access (IO), intubation and adrenaline administration] using the TPO and the classical emergency backpack was compared.Results: Equipment retrieval times for the three tasks were assessed for 24 nurses (12 intermediate care, 12 intensive care) and were significantly faster in the TPO than in the classical backpack (IO 33 vs. 75 s, p < 0.001; intubation 53 vs. 70 s, p = 0,001; adrenaline 22 vs. 45 s, p < 0.001). The number of missing items was significantly lower using the TPO backpack for IO and adrenaline retrieval (IO 0,9 vs. 2,3 items, p < 00001, adrenaline 0.04 vs. 1, p < 0.001) but not for intubation equipment (0.9 vs. 1, not significant). The subjective rating of overall clearness was significantly higher for the TPO compared with the classical backpack (5,9 vs. 3,5, p < 0.001).Conclusion: Task-based package organization of neonatal emergency backpacks is feasible and might be superior to ABC-/material-oriented storage.

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Risk factors for transfer from respiratory intermediate CARE unit to INTENSIVE CARE unit in COVID-19

Respiratory Investigation ◽

10.1016/j.resinv.2021.05.002 ◽

2021 ◽

Author(s):

Enrico Buonamico ◽

Vitaliano Nicola Quaranta ◽

Esterina Boniello ◽

Michela Dimitri ◽

Valentina Di Lecce ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Intermediate Care ◽

Intermediate Care Unit

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Quality improvement of delirium status communication and documentation for intensive care unit patients during daily multidisciplinary rounds

BMJ Open Quality ◽

10.1136/bmjoq-2017-000239 ◽

2018 ◽

Vol 7 (2) ◽

pp. e000239 ◽

Cited By ~ 2

Author(s):

Krishna Aparanji ◽

Shreedhar Kulkarni ◽

Megan Metzke ◽

Yvonne Schmudde ◽

Peter White ◽

...

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Tertiary Care ◽

Care Hospital ◽

Icu Patients ◽

Quality Metric ◽

Risk Of Mortality ◽

Simulation Based ◽

Multidisciplinary Rounds

Delirium is a key quality metric identified by The Society of Critical Care Medicine for intensive care unit (ICU) patients. If not recognised early, delirium can lead to increased length of stay, hospital and societal costs, ventilator days and risk of mortality. Clinical practice guidelines recommend ICU patients be assessed for delirium at least once per shift. An initial audit at our urban tertiary care hospital in Illinois, USA determined that delirium assessments were only being performed 31% of the time. Nurses completed simulation based education and were trained using delirium screening videos. After the educational sessions, delirium documentation increased from 40% (12/30) to 69% (41/59) (two-proportion test, p<0.01) for dayshift nurses and from 27% (8/30) to 61% (36/59) (two-proportion test, p<0.01) during the nightshift. To further increase the frequency of delirium assessments, the delirium screening tool was standardised and a critical care progress note was implemented that included a section on delirium status, management strategy and discussion on rounds. After the documentation changes were implemented, delirium screening during dayshift increased to 93% (75/81) (two-proportion test, p<0.01). Prior to this project, physicians were not required to document delirium screening. After the standardised critical care note was implemented, documentation by physicians was 95% (106/111). Standardising delirium documentation, communication of delirium status on rounds, in addition to education, improved delirium screening compliance for ICU patients.

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Intermediate Care to Intensive Care Triage: A Quality Improvement Project

CHEST Journal ◽

10.1016/j.chest.2016.08.226 ◽

2016 ◽

Vol 150 (4) ◽

pp. 213A

Author(s):

Pranav Chandrashekar ◽

Ali Abdel-Halim ◽

David Hager

Keyword(s):

Intensive Care ◽

Quality Improvement ◽

Quality Improvement Project ◽

Intermediate Care ◽

Improvement Project

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526: DO INTERMEDIATE CARE UNITS ALTER INTENSIVE CARE UTILIZATION FOR CHILDREN WITH MEDICAL COMPLEXITY?

Critical Care Medicine ◽

10.1097/01.ccm.0000509204.07833.df ◽

2016 ◽

Vol 44 (12) ◽

pp. 208-208

Author(s):

Melanie Silverman ◽

Danielle DeCourcey

Keyword(s):

Intensive Care ◽

Care Utilization ◽

Intermediate Care ◽

Children With Medical Complexity ◽

Medical Complexity

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Paraconsistent Reasoning in Cops and Robber Game with Uncertain Information: A Simulation-Based Analysis

International Journal of Uncertainty Fuzziness and Knowledge-Based Systems ◽

10.1142/s021848851950020x ◽

2019 ◽

Vol 27 (03) ◽

pp. 429-455

Author(s):

Jacek Szklarski ◽

Łukasz Białek ◽

Andrzej Szałs

Keyword(s):

Paraconsistent Logic ◽

Smooth Transition ◽

Uncertain Information ◽

Paraconsistent Reasoning ◽

Novel Approach ◽

Simulation Based ◽

Real World Applications ◽

The Given ◽

Random Failures ◽

Cops And Robber

We apply a non-classical four-valued logic in the process of reasoning regarding strategies for cops in a modified game of “Cops and Robber” played on a graph. We extend the game by introducing uncertainty in a form of random failures of detecting devices. This is realized by allowing that a robber can be detected in a node only with the given probability PA. Additionally, with the probability PF, cops can be given a false-positive, i.e., they are informed that the robber is located at some node, whereas it is located somewhere else. Consequently, non-zero PFintroduces a measurement noise into the system. All the cops have access to information provided by the detectors and can communicate with each other, so they can coordinate the search. By adjusting the number of detectors, PA, and PFwe can achieve a smooth transition between the two well-known variants of the game: “with fully visible robber” and “with invisible robber”. We compare a simple probabilistic strategy for cops with the non-parametric strategy based on reasoning with a four-valued paraconsistent logic. It is shown that this novel approach leads to a good performance, as measured by the required mean catch-time. We conclude that this type of reasoning can be applied in real-world applications where there is no knowledge about the underlying source of errors which is particularly useful in robotics.

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In Situ Simulation-based Team Training for Post-cardiac Surgical Emergency Chest Reopen in the Intensive Care Unit

Anaesthesia and Intensive Care ◽

10.1177/0310057x0903700109 ◽

2009 ◽

Vol 37 (1) ◽

pp. 74-78 ◽

Cited By ~ 22

Author(s):

L. Nunnink ◽

A.-M. Welsh ◽

M. Abbey ◽

C. Buschel

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Multiple Choice ◽

Surgical Patient ◽

Multiple Choice Questions ◽

In Situ Simulation ◽

Video Training ◽

Surgical Emergency ◽

Simulation Based ◽

The Impact

Emergency chest reopen of the post cardiac surgical patient in the intensive care unit is a high-stakes but infrequent procedure which requires a high-level team response and a unique skill set. We evaluated the impact on knowledge and confidence of team-based chest reopen training using a patient simulator compared with standard video-based training. We evaluated 49 medical and nursing participants before and after training using a multiple choice questions test and a questionnaire of self-reported confidence in performing or assisting with emergency reopen. Both video- and simulation-based training significantly improved results in objective and subjective domains. Although the post-test scores did not differ between the groups for either the objective (P=0.28) or the subjective measures (P=0.92), the simulation-based training produced a numerically larger improvement in both domains. In a multiple choice question out of 10, participants improved by a mean of 1.9 marks with manikin-based training compared to 0.9 with video training (P=0.03). On a questionnaire out of 20 assessing subjective levels of confidence, scores improved by 3.9 with manikin training compared to 1.2 with video training (P=0.002). Simulation-based training appeared to be at least as effective as video-based training in improving both knowledge and confidence in post cardiac surgical emergency resternotomy.

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