scholarly journals Intensive Care Unit design; from advance to basic

2019 ◽  
pp. S17-S20
Author(s):  
Mohsin Nazir Butt ◽  
Muhammad Faisal Khan

Optimum ICU design has pivotal role in critical care delivery that has major impact on physical and psychological health of the patients, physicians and other related staff. Its structure formation is complex and demands the dedicated involvement of not only care providers but also a trained and multi-professional team of architect, engineer and information technologists, etc. This paper tracks the journey from traditional design to recent advances in building the intensive care unit. The limitations in ICU design observed in the lower to middle income countries will also be discussed in this review. Specialist hospital architects are scarce in these countries and the ordinary civil engineering does not impart adequate coaching on matters related to lay-out plans as well as the various minute details about fittings and provisions. Hence, it becomes imperative for the anesthesiologists and other healthcare providers to come to guide and assistance to the architects involved in designing the blue prints. It may only be possible if they have adequate knowledge and professional experience.Citation: Butt MN, Khan MF. Intensive Care Unit design; from advance to basic. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S17-S20

2016 ◽  
Vol 32 (2) ◽  
pp. 116-123 ◽  
Author(s):  
John Loughran ◽  
Tauqir Puthawala ◽  
Brad S. Sutton ◽  
Lorrel E. Brown ◽  
Peter J. Pronovost ◽  
...  

Prior to the advent of the coronary care unit (CCU), patients having an acute myocardial infarction (AMI) were managed on the general medicine wards with reported mortality rates of greater than 30%. The first CCUs are believed to be responsible for reducing mortality attributed to AMI by as much as 40%. This drastic improvement can be attributed to both advances in medical technology and in the process of health care delivery. Evolving considerably since the 1960s, the CCU is now more appropriately labeled as a cardiac intensive care unit (CICU) and represents a comprehensive system designed for the care of patients with an array of advanced cardiovascular disease, an entity that reaches far beyond its early association with AMI. Grouping of patients by diagnosis to a common physical space, dedicated teams of health care providers, as well as the development and implementation of evidence-based treatment algorithms have resulted in the delivery of safer, more efficient care, and most importantly better patient outcomes. The CICU serves as a platform for an integrated, team-based patient care delivery system that addresses a broad spectrum of patient needs. Lessons learned from this model can be broadly applied to address the urgent need to improve outcomes and efficiency in a variety of health care settings.


2017 ◽  
Vol 33 (5) ◽  
pp. 279-287 ◽  
Author(s):  
Jim Q. Ho ◽  
Christopher D. Nguyen ◽  
Richard Lopes ◽  
Stephen C. Ezeji-Okoye ◽  
Ware G. Kuschner

Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients’ spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.


2019 ◽  
pp. bmjspcare-2018-001561 ◽  
Author(s):  
Susan DeSanto-Madeya ◽  
Dan Willis ◽  
Julie McLaughlin ◽  
Aristotle Boslet

ObjectivesFamily caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.MethodsSemi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Qualitative analysis techniques were used to identify common themes central to the experience of healing across all interviews.ResultsSeven themes were interpreted from the data: searching for clarity from a time of uncertainty; riding an emotional rollercoaster; seeking peace in one’s decisions; moving forward with each new day; taking comfort in the memories; valuing layers of support; and discovering life on one’s own.ConclusionBy identifying and gaining an understanding of healing following the death of a loved one in the ICU, nursing and other healthcare providers have an opportunity to promote healing and positively impact family caregiver’s bereavement.


2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.


2018 ◽  
Vol 38 (6) ◽  
pp. e1-e4 ◽  
Author(s):  
Christina Canfield ◽  
Sandra Galvin

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as tele-ICU. In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Despite the successes, acceptance of tele-ICU varies. Known barriers to acceptance include perceptions of intrusiveness and invasion of privacy.


1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission


2011 ◽  
Vol 5 (5) ◽  
pp. 1187
Author(s):  
Francislene Fátima Cordeiro ◽  
Ana Maria Dyniewicz ◽  
Luísa Canestraro Kalinowski

ABSTRACT Objectives: to analyze nursing reports at the Intensive Care Unit (ICU) of a private hospital and indentify nursing report features at the ICU. Method: descriptive study held between October/2009 and January/2010, applying a data-collection instrument to 100 nursing reports in patients’ records of an adult ICU of a private hospital in the municipality of Curitiba, Paraná State/Brazil. The criteria for record inclusion in the study were adult patients of both sexes, regardless the pathology and/or complications and health insurance plans, longer than three-day admission in the ICU. This research followed the procedures recommended by Resolution nº 196/96, and was approved by the Research Ethics Committee from Universidade Tuiuti do Paraná (Opinion 000124/2009). Results: among the results, it can be pointed out: missing patients’ identification tags; reports presenting blanks, scratches or correction fluid erasures; missing signing; incorrect checking and incomplete records from Systematization of Nursing Care. Conclusion: as nursing reports mean safety to patients and institutions and reflect the quality of care delivery, it was perceived the need to steady improvement in this recording process. Descriptors: nursing audit; quality of health care; nursing. RESUMOObjetivos: analisar as anotações de enfermagem em Unidade de Terapia Intensiva – UTI de um hospital privado e identificar as características dos registros de enfermagem na UTI. Método: estudo descritivo realizado de outubro de 2009 a janeiro de 2010, aplicando um instrumento de coleta de dados a 100 anotações de enfermagem em prontuários de pacientes de uma UTI geral adulto de um hospital privado do município de Curitiba-PR. Os critérios de inclusão de prontuários no estudo foram: pacientes adultos, de ambos os sexos, independente da patologia e/ou complicações e plano de saúde, com mais de três dias de internação na UTI. Esta pesquisa seguiu os procedimentos recomendados pela Resolução nº 196/96 e foi aprovada pelo Comitê de Ética em Pesquisa em Humanos da Universidade Tuiuti do Paraná, sob o número 000124/2009. Resultados: dentre os resultados destacam-se: falta de etiquetas de identificação de pacientes; anotações com espaços em branco, rasuras e utilização de corretor ortográfico; falta de assinatura; checagem incorreta e registros da Sistematização da Assistência de Enfermagem incompletos. Conclusão: como as anotações de enfermagem representam segurança ao paciente e à instituição e refletem a qualidade da assistência prestada, percebeu-se a necessidade de melhoria contínua desse processo de registros. Descritores: auditoria de enfermagem; qualidade da assistência à saúde; enfermagem.RESUMEN Objetivos: analizar los apuntes de enfermería en Unidad de Terapia Intensiva – UTI de un hospital particular e identificar las características de los registros de enfermería en UTI. Método: estudio descriptivo hecho de octubre de 2009 a enero de 2010, con instrumento de 100 apuntes de enfermería en prontuarios de pacientes de una UTI general para adultos de un hospital de Curitiba-PR. Los criterios de inclusión de registros solicitaban que fuesen pacientes adultos de ambos sexos, independientemente de la patología y/o complicaciones y el plan de la salud, con más de tres días en la UTI. Este estudio dio seguimiento a los procedimientos recomendados por la Resolución 196/96 y aprobado por la Ética en la Investigación Humana de la Universidad Tuiuti con el número 000124/2009. Resultados: entre los resultados, se destacan: ausencia de etiquetas de identificación de pacientes; apuntes con espacios en blanco, tachones y utilización de corrector ortográfico; falta de firma; chequeo incorrecto y registros de la Sistematización da Asistencia de Enfermería incompletos. Conclusión: como los apuntes de enfermería representan seguridad para el paciente y para la institución y reflejan la cualidad de la asistencia prestada, se ha percibido la necesidad de mejoría continua de ese proceso de registros. Descriptores: auditoria de enfermería; calidad de la atención de salud; enfermería.


2021 ◽  
Vol 27 (6) ◽  
pp. 303-315
Author(s):  
Marzieh Hasanpour ◽  
Mamak Tahmasebi ◽  
Masoud Mohammadpour ◽  
Batool Pouraboli ◽  
Fahimeh Sabeti

Background: The integration of paediatric palliative care into the Iranian health system is essential. Aims: The aim of this study was to identify the challenges of palliative care in the paediatric intensive care unit during COVID-19 through the experiences of healthcare providers. Methods: A qualitative study with content analysis approach was conducted. Fifteen physicians and nurses were selected by purposeful sampling. The semi-structured, in-depth interviews were applied in the data collection. Findings: Ten main categories were extracted from data analysis, including ‘caring in COVID-19’, ‘communication and family centre care’, ‘breaking bad news’, palliative care training’, ‘pain and symptom management’, ‘support of the child, family and clinical team’, ‘physical environment’, ‘guidelines’, ‘specialised staff’ and ‘home based palliative care’. Conclusion: Palliative care in the PICU faces several challenges, especially during COVID-19, but the clinical team are making every attempt to improve the comprehensive care of children and their families. Telehealth is important in COVID-19, and education is also a key component to improve palliative care in the PICU in Iran.


Sign in / Sign up

Export Citation Format

Share Document