Implementation of a pet visitation program in critical care

1999 ◽  
Vol 19 (3) ◽  
pp. 43-50 ◽  
Author(s):  
KK Giuliano ◽  
E Bloniasz ◽  
J Bell
Keyword(s):  
Critically Ill ◽  
Emotional Support ◽  
Critically Ill Patients ◽  
Quantitative Research ◽  
Therapeutic Option ◽  
Healthcare Providers ◽  
Research Data ◽  
Staff Members ◽  
Common Problems ◽  
Patients Experience

We have no quantitative research data to document that these visits are actually helpful to patients in any measurable way, although we certainly hope to have some soon. However, observations of staff members and evaluations from participants in the program have been quite positive thus far. The program has been in place for more than 2 years, and about 30 pets have visited so far, including 28 dogs and 2 cats. Implementing a pet visitation program for critically ill patients affords healthcare providers the opportunity to offer a unique and humanistic therapeutic intervention to appropriate patients. Although it is a time-consuming endeavor, it has been well received by those patients and families that have participated in pet visits. Critically ill patients are often denied many simple pleasures because they are in physiological crisis. Such patients experience loneliness, isolation, depression, and lack of emotional support. Pet visitation is one way to address these common problems of ICU patients. For this reason, pet visitation will remain a therapeutic option for the support of our critically ill patients.

scholarly journals The Efficacy of Convalescent Plasma Use in Critically Ill COVID-19 Patients

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 257
Author(s):  
Livius Tirnea ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Bianca Cerbu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Therapeutic Option ◽  
White Blood Cells ◽  
The United States ◽  
Plasma Therapy ◽  
Reactive Protein ◽  
United States Food ◽  
States Food

Background and Objectives: On 24 March 2020, the United States Food and Drug Administration (FDA) announced the approval of convalescent plasma therapy for critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergency investigational new drug. This pilot study from Romania aimed to determine if convalescent plasma transfusion can be beneficial in the treatment of selected critically ill patients diagnosed with a SARS-CoV-2 infection. Materials and Methods: Donor and receiver eligibility for critically ill coronavirus disease 2019 (COVID-19) patients was based on Romanian guidelines issued at the time of the study. Here, we describe the evolution of a total of five eligible patients diagnosed with COVID-19 who received convalescent plasma (CP) in Romania. Results: In spite of our efforts and convalescent plasma administration, three of the five patients did not survive, while the other two recovered completely. Over the course of our five-day laboratory record, the surviving patients had significantly lower values for C-reactive protein, interleukin-6, and white blood cells. Conclusions: This pilot study provides insufficient evidence to determine the efficacy of convalescent plasma use as a therapeutic option for critically ill COVID-19 patients.

scholarly journals Do Aspirin and Other Antiplatelet Drugs Reduce the Mortality in Critically Ill Patients?

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Wolfgang Lösche ◽  
Janina Boettel ◽  
Björn Kabisch ◽  
Johannes Winning ◽  
Ralf A. Claus ◽  
...  
Keyword(s):  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Therapeutic Option ◽  
Bleeding Risk ◽  
Antiplatelet Drugs ◽  
Beneficial Effects ◽  
Prospective Trials ◽  
High Bleeding Risk

Platelet activation has been implicated in microvascular thrombosis and organ failure in critically ill patients. In the first part the present paper summarises important data on the role of platelets in systemic inflammation and sepsis as well as on the beneficial effects of antiplatelet drugs in animal models of sepsis. In the second part the data of retrospective and prospective observational clinical studies on the effect of aspirin and other antiplatelet drugs in critically ill patients are reviewed. All of these studies have shown that aspirin and other antiplatelet drugs may reduce organ failure and mortality in these patients, even in case of high bleeding risk. From the data reviewed here interventional prospective trials are needed to test whether aspirin and other antiplatelet drugs might offer a novel therapeutic option to prevent organ failure in critically ill patients.

Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry

2020 ◽  
Vol 40 (4) ◽  
pp. 66-72
Author(s):  
Michelle M. Fernald ◽  
Nicholas A. Smyrnios ◽  
Joan Vitello
Keyword(s):  
Quality Improvement ◽  
Critically Ill ◽  
Appreciative Inquiry ◽  
Critically Ill Patients ◽  
Staff Members ◽  
Before And After ◽  
Trained Facilitator ◽  
Improvement Method ◽  
And Performance ◽  
Staff Commitment

Background Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. Objectives To explore whether appreciative inquiry would reinvigorate an early progressive mobility initiative in a medical intensive care unit and improve and sustain staff commitment to providing regular mobility therapy at the bedside. Secondary goals were to add to the literature about appreciative inquiry in health care and to determine whether it can be adapted to critical care. Methods Staff participated in appreciative inquiry workshops, which were conducted by a trained facilitator and structured with the appreciative inquiry 4-D cycle. Staff members’ attitudes toward and knowledge of early progressive mobility were evaluated before and after the workshops. Performance of early progressive mobility activities was recorded before and 3 and 10 months after the workshops. Results Sixty-seven participants completed the program. They rated the workshops as successfully helping them to understand the importance of early progressive mobility (98%), explain their responsibility to improve patient outcomes (98%), and engender a greater commitment to patients and the organization (96%). Regarding mobility treatments, at 3 months orders had improved from 62% to 88%; documentation, from 52% to 89%; and observation, from 39% to 87%. These improvements were maintained at 10 months. Conclusion Participation in the workshops improved the staff’s attitude toward and performance of mobility treatments. Appreciative inquiry may provide an adjunct to problem-based quality improvement techniques.

scholarly journals Identifying the effects of an upgraded ‘fever clinic’ on COVID-19 control and the workload of emergency department: retrospective study in a tertiary hospital in China

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039177
Author(s):  
Jiangshan Wang ◽  
Liang Zong ◽  
Jinghong Zhang ◽  
Han Sun ◽  
Joseph Harold Walline ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Disease Transmission ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
College Hospital ◽  
Upper Respiratory Infection ◽  
Number Of Patients ◽  
Screening And Prevention

ObjectiveCOVID-19 started spreading widely in China in January 2020. Outpatient fever clinics (FCs), instituted during the SARS epidemic in 2003, were upgraded to serve for COVID-19 screening and prevention of disease transmission in large tertiary hospitals in China. FCs were hoped to relieve some of the healthcare burden from emergency departments (EDs). We aimed to evaluate the effect of upgrading the FC system on rates of nosocomial COVID-19 infection and ED patient attendance at Peking Union Medical College Hospital (PUMCH).DesignA retrospective cohort study.ParticipantsA total of 6365 patients were screened in the FC.MethodsThe FC of PUMCH was upgraded on 20 January 2020. We performed a retrospective study of patients presenting to the FC between 12 December 2019 and 29 February 2020. The date when COVID-19 was declared an outbreak in Beijing was 20 January 2020. Two groups of data were collected and subsequently compared with each other: the first group of data was collected within 40 days before 20 January 2020; the second group of data was collected within 40 days after 20 January 2020. All necessary data, including patient baseline information, diagnosis, follow-up conditions and the transfer records between the FC and ED, were collected and analysed.Results6365 patients were screened in the FC, among whom 2912 patients were screened before 21 January 2020, while 3453 were screened afterward. Screening results showed that upper respiratory infection was the major disease associated with fever. After the outbreak of COVID-19, the number of patients who were transferred from the FC to the ED decreased significantly (39.21% vs 15.75%, p<0.001), and patients generally spent more time in the FC (55 vs 203 min, p<0.001), compared with before the outbreak. For critically ill patients waiting for their screening results, the total length of stay in the FC was 22 min before the outbreak, compared with 442 min after the outbreak (p<0.001). The number of in-hospital deaths of critically ill patients in the FC was 9 out of 29 patients before the outbreak and 21 out of 38 after the outbreak (p<0.05). Nineteen cases of COVID-19 were confirmed in the FC during the period of this study. However, no other patients nor any healthcare providers were cross-infected.ConclusionThe workload of the FC increased significantly after the COVID-19 outbreak. New protocols regarding the use of FC likely helped prevent the spread of COVID-19 within the hospital. The upgraded FC also reduced the burden on the ED.

Infections in critically ill patients: Experience in MICU at a major teaching hospital

Infection ◽  
1994 ◽  
Vol 22 (4) ◽  
pp. 264-270 ◽  
Author(s):  
N. S. Dahmash ◽  
S. C. Arora ◽  
D. F. Fayed ◽  
M. N. H. Chowdhury
Keyword(s):  
Critically Ill ◽  
Teaching Hospital ◽  
Critically Ill Patients ◽  
Major Teaching Hospital ◽  
Major Teaching ◽  
Patients Experience

scholarly journals Back to Basics: Changes to the Residency Curriculum During a Pandemic

2020 ◽  
Vol 15 (3) ◽  
Author(s):  
Alecsa Mackinnon Blair ◽  
Sagar Rohailla ◽  
Alberto Goffi ◽  
Malika Sharma
Keyword(s):  
Critical Care ◽  
Medical Students ◽  
Patient Care ◽  
Critically Ill ◽  
Emotional Support ◽  
Critically Ill Patients ◽  
Medical Systems ◽  
Residency Programs ◽  
Soins Intensifs ◽  
Residency Curriculum

In the height of the COVID-19 pandemic, prompt changes are required from medical systems. Within Canadian academic institutions, this will mean a restructuring of residency programs of all specialties and at all levels of training. Rapid training in critical care procedures and models of patient care will be paramount to contend with the increasing numbers of critically-ill patients. Flexibility from staff physicians, residents, and medical students will be required to fill gaps in patient care. Finally, compassion for our co-workers throughout illness and isolation will be necessary to provide emotional support for one another. ResumeAu plus fort de la pandémie COVID-19, des changements rapides sont nécessaires de la part des systèmes médicaux. Au sein des institutions universitaires canadiennes, cela signifiera la restructuration des programmes de résidence de toutes les spécialités et à tous les niveaux de formation. Une formation rapide aux procédures de soins intensifs et aux modèles de soins aux patients sera primordiale pour faire face au nombre croissant de patients gravement malades. La flexibilité des médecins du personnel, des résidents et des étudiants en médecine sera nécessaire pour combler les lacunes dans les soins aux patients. Enfin, la compassion envers nos collègues tout au long de la maladie et de l’isolement sera nécessaire pour se soutenir mutuellement sur le plan émotionnel.

scholarly journals Electrolytes in the ICU

2021 ◽  
Author(s):  
Syed Zaidi ◽  
Rahul Bollam ◽  
Kainat Saleem
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Healthcare Providers ◽  
Electrolyte Disorders ◽  
Sodium Potassium ◽  
Sodium Homeostasis ◽  
Neurologic Symptoms ◽  
Calcium Bicarbonate ◽  
Cardiac Manifestations

Electrolyte disorders is an imbalance of certain ionized salts (sodium, potassium, calcium, bicarbonate, chloride) in the blood. Healthcare providers should be familiar with the principles of electrolyte physiology and pathophysiology. Disturbances in sodium homeostasis are primarily caused by volume abnormalities leading to primarily neurologic symptoms. Dyskalemias frequently present with cardiac manifestations therefore should be treated promptly before evaluating its cause. Ion deficiencies such as hypocalcemia, hypomagnesemia and hypophosphatemia should be corrected as they are associated with increased adverse events in critically ill patients.

scholarly journals Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

2009 ◽  
Vol 29 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Assad Haneya ◽  
Alois Philipp ◽  
Maik Foltan ◽  
Thomas Mueller ◽  
Daniele Camboni ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Single Institution ◽  
Interhospital Transfer ◽  
Patients Experience
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