The Effect of Two Bed Bath Practices in Cost and Vital Signs of Critically Ill Patients

By promoting personal hygiene and improving comfort, bed baths can decrease the risk of infection and help maintain skin integrity in critically ill patients. Current bed-bathing practices commonly involve the use of either soap and water (SAW) or disposable wipes (DWs). Previous research has shown both bed-bathing methods are equally effective in removing dirt, oil, and microorganisms. This experimental study compared the cost, staff satisfaction, and effects of two bed-bathing practices on critically ill patients’ vital signs. We randomly assigned 138 participants into 2 groups: an experimental group that received bed baths using DWs and a control group that received bed baths using SAW. We compared the bath duration, cost, vital sign trends, and nursing staff satisfaction between the two groups. We used the chi-square test and t-test for the statistical analysis, and we expressed the quantitative data as mean and standard deviation. Our results showed the bed baths using DWs had a shorter duration and lower cost than those using SAW. There were no significant differences in the vital sign trends between the two groups. The nursing staff preferred to use DWs over SAW. This study can help clinical nursing staff decide which method to use when assisting patients with bed baths.

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HUBUNGAN STATUS VAKSINASI BCG, RIWAYAT KONTAK DAN PERSONAL HYGIENE DENGAN KUSTA DI KOTA PEKALONGAN

Unnes Journal of Public Health ◽

10.15294/ujph.v5i2.10121 ◽

2016 ◽

Vol 5 (2) ◽

pp. 130 ◽

Cited By ~ 1

Author(s):

Kurnia Ningrum Susanti ◽

Mahalul Azam

Keyword(s):

Public Health Problem ◽

Vaccination Status ◽

Epidemiological Surveillance ◽

Personal Hygiene ◽

Control Group ◽

Case Group ◽

Confounding Variable ◽

Chi Square ◽

Bcg Vaccination ◽

Chi Square Test

Kusta masih menjadi masalah kesehatan masyarakat di berbagai negara umumnya negara berkembang, termasuk Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara status vaksinasi BCG, riwayat kontak dan personal hygiene dengan kejadian kusta. Penelitian ini merupakan penelitian analitik observasional dengan pendekatan kasus kontrol secara retrospektif. Pada penelitian ini menggunakan total sampling pada kelompok kasus dan accidental sampling pada kelompok kontrol, dengan jumlah masing-masing 64 orang. Analisis data dilakukan secara univariat, bivariat dan berstrata dengan uji chi square (α=0,05) dan menghitung nilai Odds Ratio (OR). Dari hasil penelitian didapatkan bahwa faktor yang berhubungan dengan kejadian kusta adalah status vaksinasi BCG (p=0,000;OR=3,621), riwayat kontak (p=0,000;OR=5,800) dan lama kontak (p=0,000; OR=15,815). Sedangkan personal hygiene (p=0,077) tidak berhubungan dengan kejadian kusta. Variabel umur, tingkat pendidikan dan status sosial ekonomi tidak terbukti sebagai variabel perancu dalam hubungan antara status vaksinasi BCG. Akan tetapi pendidikan merupakan variabel perancu dalam hubungan antara personal hygiene dengan kejadian kusta. Saran bagi petugas bagian P2PL adalah meningkatkan kegiatan surveilans epidemiologi penyakit kusta. Bagi kepala puskesmas diharapkan untuk meningkatkan penemuan penderita secara aktif, meningkatkan penyuluhan kepada masyarakat tentang penyakit kusta dan meningkatkan cakupan vaksinasi BCG. Bagi peneliti selanjutnya untuk menghindari bias recall dan bias seleksi. Leprosy remains a public health problem in many developing countries, including Indonesia. The purpose of this study was to determine the relation between BCG vaccination status, contact with patient, and personal hygiene and leprosy. This study was an observational analytic study with approach case control restropectively. This study used total sampling in case group and accidental sampling in control group, in total 64 peoples each group. Data analysis used univariate, bivariate and stratified by chi square test (α = 0,05) and calculated the odd ratio (OR). The result showed that the factors related with the leprosy were BCG vaccination status (p=0,000;OR=3,621), contact with patient (p=0,000;OR=5,800) and duration of contact (p=0,000; OR=15,815). While personal hygiene was not associated with the leprosy (p=0,077). Variables of age, education and socioeconomic status did not proven as a confounding variable in relation between BCG vaccination status and leprosy. But education was confounding variable in relation between personal hygiene and leprosy. Recommendation for P2PL officer is to improve epidemiological surveillance of leprosy. For the head of the health center is expected to increase active case detection, improving counseling to society about leprosy defect and increasing the coverage of BCG vaccination. For the other researchers to avoid recall bias and selection bias.

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Deep-Learning Approaches to Identify Critically Ill Patients at Emergency Department Triage Using Limited Information

10.1101/2020.05.02.20089052 ◽

2020 ◽

Author(s):

Joshua W. Joseph ◽

Evan L. Leventhal ◽

Anne V. Grossestreuer ◽

Matthew L. Wong ◽

Loren J. Joseph ◽

...

Keyword(s):

Neural Network ◽

Deep Learning ◽

Critically Ill ◽

Critically Ill Patients ◽

Vital Sign ◽

Vital Signs ◽

Structured Data ◽

Learning Approaches ◽

Limited Information ◽

Textual Data

ImportanceTriage quickly identifies critically ill patients, helping to facilitate timely interventions. Many emergency departments use the emergency severity index (ESI) or abnormal vital sign thresholds to identify critically ill patients. However, both rely on fixed thresholds, and false activations detract from efficient care. Prior research suggests that machine-learning approaches may improve triage accuracy, but have relied on information that is often unavailable during the triage process.ObjectiveWe examined whether deep-learning approaches could identify critically ill patients using data immediately available at triage with greater discriminative power than ESI or abnormal vital sign thresholds.DesignRetrospective, cross-sectional study.SettingAn urban tertiary care hospital in the Northeastern United States.ParticipantsAdult patients presenting to the emergency department from 1/1/2012 - 1/1/2020 were included. Deidentified triage information included structured data (age, sex, initial vital signs, ESI score, and clinical trigger activation due to abnormal vital signs), and textual data (chief complaint) with critical illness (defined as mortality or ICU admission within 24 hours) as the outcome.InterventionsThree progressively complex deep-learning models were trained (logistic regression on structured data, neural network on structured data, and neural network on structured and textual data), and applied to triage information from all patients.Main Outcomes and MeasuresThe primary outcome was the accuracy of the model for predicting whether patients were critically ill using area under the receiver-operator curve (AUC), as compared to ESI, utilizing a 10-fold cross-validation.Results445,925 patients were included, with 60,901 (13.7%) critically ill. Vital sign thresholds identified critically ill patients with AUC 0.521 (95% CI 0.519 -- 0.522), and ESI less than 3 demonstrated AUC 0.672 (95% CI 0.671 -- 0.674), logistic regression classified patients with AUC 0.803 (95% CI 0.802 -- 0.804), neural network with structured data with 0.811 (95% CI 0.807 - 0.815), and the neural network model with textual data with AUC 0.851 (95% CI 0.849 -- 0.852).Conclusions and RelevanceDeep-learning techniques represent a promising method of enhancing the triage process, even when working from limited information. Further research is needed to determine if improved predictions can be translated into meaningful clinical and operational benefits.

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Expressive writing as an intervention to decrease distress in pediatric critical care nurses

Clinical Nursing Studies ◽

10.5430/cns.v6n3p96 ◽

2018 ◽

Vol 6 (3) ◽

pp. 96 ◽

Cited By ~ 2

Author(s):

Julie Ann Perry ◽

Peggy Ward-Smith

Keyword(s):

Critical Care ◽

Critically Ill ◽

Nursing Staff ◽

Critically Ill Patients ◽

Expressive Writing ◽

Cost Effective ◽

Critical Care Nurses ◽

Common Phenomenon ◽

Staff Satisfaction ◽

Pediatric Critical Care

Experiencing distress is a common phenomenon among pediatric critical care nurses. Expressive writing provides a cost-effective and easily implemented intervention nurses can utilize to address distress as a consequence of providing care for critically ill patients. This intervention may decrease the array of consequences of distress and improve nursing staff satisfaction and retention.

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Abstract P68: Disrupted Electrophysiological Sleep in Critically ill Stroke Patients: Does it Matter?

Stroke ◽

10.1161/str.52.suppl_1.p68 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Rebecca Dutta ◽

Leslie Markun ◽

Ajay Sampat ◽

Kwan L Ng ◽

Alan H Yee

Keyword(s):

Acute Stroke ◽

Critically Ill ◽

Critically Ill Patients ◽

Sleep Disturbances ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Poor Sleep ◽

Stroke Patients ◽

Chi Square ◽

Chi Square Test ◽

Ich Score

Mounting evidence suggest that poor sleep quality may impact outcome following stroke. While sleep disturbances are common among critically ill patients, little is known about sleep characteristics in neurocritical stroke patients. We examined sleep characteristics in acute stroke patients admitted to an intensive care unit (ICU) compared to those admitted for non-stroke conditions. Methods: Retrospective analysis of critically ill patients who underwent continuous electroencephalographic (cEEG) monitoring in the ICU from 2018-19. Sleep was scored based on American Academy of Sleep Medicine-defined EEG criteria. EEG and clinical characteristics [NIH Stroke Scale (NIHSS), Hunt and Hess (HH) Grade, and ICH Score] were collected. Primary outcomes were based on modified Rankin Scale (mRS) scores of which 2 or less was considered favorable. Differences were assessed using Chi-Square test. Results: 228 ICU patients underwent cEEG; mean age was 58 years (range 18-91) and 57% were male. 61 (27%) were admitted for acute stroke (16 ischemic, 17 aneurysmal subarachnoid hemorrhage (aSAH), 27 non-traumatic intracerebral hemorrhage (ICH)). The other 167 critically ill patients were admitted for medical, surgical, or non-stroke related neurological conditions. In those with stroke, mean NIHSS scores for ischemia, mean ICH Score for ICH, and mean HH for aSAH were 18.78, 2.12, and 3.36, respectively. Rates of attaining any sleep were similar between stroke (27.9%) and non-stroke patients (26.9%). 29.4% of stroke patients who achieved sleep had good outcomes compared to only 9.1% that did not (χ 2 (1)=2.79, p=0.095). In stroke patients that achieved sleep, 52.9% of patients reached Stage N1, 47.1% Stage N2 and none reached Stages N3 or REM. In the non-stroke cohort, 46.6% who achieved sleep had good outcomes compared to 26.2% who did not (χ 2 (1)=6.34, p=0.012). Of these, 37.8% reached Stage N1 sleep, 60% Stage N2, 2.22% Stage N3, and none reached Stage REM. Discussion: Critically ill stroke and non-stroke patients have disrupted electrophysiological sleep, and none reach REM stage. A trend towards improved outcome in stroke survivors was observed in those who slept. The association between sleep variability, stroke mechanism, and functional outcome needs further exploration.

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Determinants of Leprosy Incidence in The Work Area of The Kebon Jeruk Health Center in 2019

Muhammadiyah International Public Health and Medicine Proceeding ◽

10.53947/miphmp.v1i1.147 ◽

2021 ◽

Vol 1 (1) ◽

pp. 867-876

Author(s):

Rizky Aliyani Putri ◽

Deasy Febriyanty

Keyword(s):

Health Center ◽

Healthy Lifestyle ◽

Sampling Technique ◽

Simple Random Sampling ◽

The Body ◽

Personal Hygiene ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Chi Square Test

Leprosy or leprosy is an infectious disease caused by infection with the bacterium Mycobacterium leprae (M. leprae) which attacks various parts of the body including nerves and skin. Based on data obtained from the Kebon Jeruk Health Center, leprosy cases were still found, namely from 2016 5 cases, then there was a very significant increase in 2017 to 16 cases, in 2018 to 14 cases, and 2019 until April 7 cases were found. This study aims to determine the factors related to the incidence of leprosy in the working area of the Kebon Jeruk Public Health Center in 2019. This study used a case-control design with a sample size of 90 respondents. Sampling in this study used a simple random sampling technique for the case group and purposive sampling for the control group and analyzed with the chi-square test which was conducted from December 2019 to January 2020. In the results of this study, there were 30 respondents (33.3%) who suffered from leprosy. There is a significant relationship between age (ρ = 000), personal hygiene (ρ = 0.000) with the incidence of leprosy. It is recommended that respondents maintain personal hygiene and improve a clean and healthy lifestyle (PHBS).

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Berat Badan, Panjang Badan dan Faktor Genetik sebagai Prediktor Terjadinya Stunted pada Anak Sekolah

JURNAL NUTRISIA ◽

10.29238/jnutri.v19i2.257 ◽

2017 ◽

Vol 19 (2) ◽

pp. 95

Author(s):

Hetriana Leksananingsih ◽

Slamet Iskandar ◽

Tri Siswati

Keyword(s):

Birth Weight ◽

Nutritional Status ◽

School Children ◽

Genetic Factors ◽

Control Group ◽

Case Group ◽

Normal Birth Weight ◽

Chi Square ◽

Normal Birth ◽

Chi Square Test

Background: Riskesdas in 2013 showed that Yogyakarta (DIY) had a prevalence of stunted new kid in school is less than the national average, which is 14.9% (MOH, 2013). Stunted or short, is a linear growth retardation has been widely used as an indicator to measure the nutritional status of individuals and community groups. Stunted can be influenced by several factors: birth weight, birth length match and genetic factors. Objective: To determine the weight, length of low birth weight and genetic factors as predictors of the occurrence of stunted on elementary school children. Methods: The study was a case control analytic. Research sites in SD Muhammadiyah Ngijon 1 Subdistrict Moyudan. The study was conducted in May and June 2015. The subjects were school children grade 1 to grade 5 the number of cases as many as 47 children and 94 control children. With the inclusion criteria of research subjects willing to become respondents, was present at the time of the study, they have a father and mother, and exclusion criteria have no data BB and PB birth, can not stand upright. The research variables are BBL, PBL, genetic factors and TB / U at this time. Data were analyzed by chi-square test and Odd Ratio (OR) calculation. Results: In case group as much as 91.5% of normal birth weight and length of 80.9% of normal birth weight, most of the height of a normal mother and father as many as 85.1%. In the control group as much as 78.7% of normal birth weight and 61.7% were born normal body length, height mostly normal mom and dad that 96.7% of women and 90.4% normal normal father. Statistical test result is no significant correlation between height mothers with stunted incidence in school children, and the results of chi-square test P = 0.026 with value Odd Ratio (OR) of 3.9 and a range of values from 1.091 to 14.214 Cl95%. Conclusion: High maternal body of mothers can be used as predictors of the occurrence of stunted school children and mothers with stunted nutritional status have 3.9 times the risk of having children with stunted nutritional status.

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46 Effect of the addition of α-tocopherol to in vitro maturation media of bovine oocytes

Journal of Animal Science ◽

10.1093/jas/skz397.005 ◽

2020 ◽

Vol 98 (Supplement_2) ◽

pp. 2-3

Author(s):

Theisy P Acosta Pérez

Keyword(s):

In Vitro Maturation ◽

Cumulus Cells ◽

Control Group ◽

Chi Square ◽

Cumulus Expansion ◽

Minimum Concentration ◽

Maturation Rate ◽

Chi Square Test ◽

System Data

Abstract α-tocopherol is known to be a powerful antioxidant, in this regard, it was added to bovine oocyte in vitro maturation media to evaluate its effect on oocyte maturation. Oocytes (n = 624) aspirated from ovaries of slaughtered cows were classified by quality and divided in four categories according to cytoplasm appearance and cumulus cells layers. Oocytes were washed in TCM-199 supplemented with fetal bovine serum (FBS) and FSH, then distributed in maturation media (TCM-199 supplemented with FBS, FSH and gentamicin). Three experimental groups of α-tocopherol (50, 100 and 200 mM) and a control group without α-tocopherol were used. Maturation was carried 22 h at 38.5°C in a 5% CO2 atmosphere. Oocytes were examined to determine cumulus expansion as categorical data (expansion or no expansion), as well as cumulus expansion Index (CEI). For CEI determination oocytes were graded 0 to 4, being 0 those with null expansion and 4 those with a noticeable cell expansion, then the number of oocytes were multiplied by the grade given and a sum of the totals was obtained, the new total was divided by the total of oocytes in the group and the result obtained corresponded to the CEI of the group. Results were analyzed with Chi Square test (for maturation rates) and an ANOVA (for the CEI) using the SAS system, data are presented as mean ± standard error. There was no statistical difference between control and α-tocopherol groups (P >0.05). Numerically, the control group showed a higher maturation rate (100%) and obtained a higher CEI (2.44±0.20), followed by the 50 mM group (98.16%; 2.39±0.13), the groups 200 mM (97.40%; 2.00±0.14) and 100 mM (96.25%; 2.06±0.24) were the lowest. The addition of the minimum concentration (50 mM) of α-tocopherol to the maturation media could improve maturation rates without exposing oocytes to toxic effects.

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Behaviour and Anxiety Management of Paediatric Dental Patients through Virtual Reality: A Randomised Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10143019 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3019

Author(s):

Cristina Gómez-Polo ◽

Ana-Aida Vilches ◽

David Ribas ◽

Antonio Castaño-Séiquer ◽

Javier Montero

Keyword(s):

Virtual Reality ◽

Dental Treatment ◽

Randomised Clinical Trial ◽

Control Group ◽

Chi Square ◽

Anxiety Management ◽

Dental Patients ◽

Paediatric Patients ◽

Chi Square Test ◽

Scale Test

Clinicians should appreciate the effectiveness of virtual reality (VR) headsets for managing both the anxiety and the behaviour of non-cooperative paediatric patients who require treatment over several dental appointments. The aim of this study was to assess the effectiveness of using a VR headset as a distraction for managing the anxiety and behaviour of paediatric patients during their dental treatment. Eighty patients, aged between five and ten years old and who required dental treatment over three or more appointments, were randomly allocated into two groups. One group used a VR headset during all their appointments, and the other one did not use any distraction technique. The patients were asked to take a Facial Image Scale Test during their first and last appointments to assess their level of anxiety. Additionally, the dentist completed the Frankl Test to quantify the child’s behaviour at the beginning and the end of their treatment. The results obtained, both from the group using the VR headset and from the control group, were compared using the chi-square test. The use of a VR headset during dental treatment significantly reduced anxiety (95% of the children were happy) and improved behaviour (100% positive behaviour) as compared with the control group (40% and 57.5%, respectively). A VR headset can effectively distract a paediatric patient, helping to reduce anxiety and manage behaviour during dental treatment

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Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n4p72 ◽

2020 ◽

Vol 10 (4) ◽

pp. 72

Author(s):

Mohamed E. Abdelgawad ◽

Nadia T. Ahmed ◽

Ahmed M. Elmenshawy

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Critically Ill ◽

Critically Ill Patients ◽

Improve Patient Care ◽

University Hospital ◽

Treatment Modalities ◽

Control Group ◽

Electrolyte Disturbances ◽

Electrolyte Loss

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.

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Facial Profile Shape, Malocclusion and Palatal Morphology in Malay Obstructive Sleep Apnea Patients

The Angle Orthodontist ◽

10.2319/011509-26.1 ◽

2010 ◽

Vol 80 (1) ◽

pp. 37-42 ◽

Cited By ~ 11

Author(s):

S. M. Banabilh ◽

A. R. Samsudin ◽

A. H. Suzina ◽

Sidek Dinsuhaimi

Keyword(s):

Obstructive Sleep Apnea ◽

Null Hypothesis ◽

Control Group ◽

Class Ii Malocclusion ◽

Chi Square ◽

Facial Profile ◽

Obstructive Sleep ◽

Significant Difference ◽

Chi Square Test ◽

The Mean

Abstract Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean ± standard deviation [SD], 33.2 ± 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m2 ± 6.5) than for the control group (22.7 kg/m2 ± 3.5; P < .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm ± 6.02; 129.1 mm Hg ± 17.55) than for the control group (35.6 cm ± 3.52; 114.1 mm Hg ± 13.67; P < .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P < .05), but no significant difference in palatal shape was found. Conclusion: The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group.

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