A New View: Tele–Intensive Care Unit Competencies

2011 ◽  
Vol 31 (5) ◽  
pp. 17-29 ◽  
Author(s):  
Susan F. Goran
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Performance Appraisal ◽  
Professional Practice ◽  
Competency Assessment ◽  
Self Assessment ◽  
Convenience Sample ◽  
Assessment Program ◽  
Effective Use ◽  
Question Survey

Background Many hospitals have well-planned nursing competency assessment programs, but these are meant to measure competency in traditional bedside roles, not in tele–intensive care unit (tele-ICU) nurses practicing remotely. Objective To determine whether current tele-ICU programs have a formal competency assessment program and to determine when and how competency of tele-ICU nurses is assessed. Method A 20-question survey was provided to a convenience sample of the 44 known tele-ICU programs nationally. Results Of the surveys distributed, 75% were completed and returned. A formal competency assessment policy for assessing nurses’ competency at the time of hire, during orientation, and ongoing was in place at the workplaces of 85% of respondents. The most common methods for competency validation were performance appraisal and observation, although peer review and self-assessment also were used. Respondents identified the following competencies as the highest priorities for defining tele-ICU nurse practice: effective listening, prioritization, collaboration, and effective use of tele-ICU application tools. Conclusion Although awaiting development of professional practice standards, many tele-ICU programs currently measure the competence of tele-ICU nurses through competency programs.

scholarly journals The training of neonatologists and the paradigms implied in their relationship with the parents of babies in the Neonatal Intensive Care Unit

2014 ◽  
Vol 32 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Ethel Cukierkorn Battikha ◽  
Maria Teresa de M. Carvalho ◽  
Benjamin Israel Kopelman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Professional Practice ◽  
Neonatal Intensive Care ◽  
Structured Interview ◽  
Public Institutions ◽  
Training And Education ◽  
Resident Physicians ◽  
Child's Death

Objective: To analyze and to interpret the psychological repercussions generated by the presence of parents in the Neonatal Intensive Care Unit for residents in Neonatology. Methods: Study based on the psychoanalytic theory, involving a methodological interface with qualitative surveys in Health Sciences. Twenty resident physicians in Neonatology, from five public institutions of São Paulo state, responded to a single semi-structured interview. Based on several readings of the material, achieving the core of emergent meanings that would be significant to the object of the survey, six categories were elected for analysis and interpretation: parents' staying at the Neonatal Intensive Care Unit and its effects on the neonatologists' professional practice; communication of the diagnosis and what parents should know; impasses between parents and doctors when the diagnosis is being communicated; doctor's identification with parents; communication of the child's death and their participation in the interview. Results: The interpretation of the categories provided an understanding of the psychic mechanisms mobilized in doctors in their relationships with the children's parents, showing that the residents experience anguish and suffering when they provide medical care and during their training process, and also that they lack psychological support to handle these feelings. Conclusions: There is a need of intervention in neonatologists training and education, which may favor the elaboration of daily experiences in the Unit, providing a less anguishing and defensive way out for young doctors, especially in their relationship with patients and parents.

Pressure ulcer risk factors in an ICU population

1995 ◽  
Vol 4 (5) ◽  
pp. 361-367 ◽  
Author(s):  
MK Jiricka ◽  
P Ryan ◽  
MA Carvalho ◽  
J Bukvich
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Motor Vehicle ◽  
Convenience Sample ◽  
Medical Diagnoses ◽  
Trauma Population ◽  
Braden Scale

BACKGROUND: Although it is well known that pressure ulcers are associated with negative patient outcomes and increased hospital cost, there is little research related to pressure ulcers in an intensive care unit population. OBJECTIVE: To determine the relative contribution of risk factors in the development of pressure ulcers in intensive care unit patients. METHOD: In an exploratory descriptive design, a convenience sample of 85 adults was used. Patients were enrolled in the study within 24 hours of admission to the intensive care unit; data were collected every other day until discharge from the intensive care unit. Instruments included a demographic data form, Braden Scale for Predicting Pressure Sore Risk, Skin Assessment Tool, and Decubitus Ulcer Potential Analyzer. RESULTS: The most common reasons for admission to the intensive care unit included multiple trauma from motor vehicle accidents, gunshot and stab wounds, and gastrointestinal bleeding. A pressure ulcer developed in 48 subjects. There were no significant differences in age, gender, history of diabetes or smoking, or medical diagnoses between patients in whom a pressure ulcer developed and those in whom it did not. Data analysis indicated that a Braden Scale score of 11, rather than the recommended score of 16, was statistically significant for predicting pressure ulcer risk. CONCLUSIONS: The results suggest that a cut-off score on the Braden Scale could be specific to an intensive care unit trauma population.

scholarly journals Physician Self-assessment of Shared Decision-making in Simulated Intensive Care Unit Family Meetings

2020 ◽  
Vol 3 (5) ◽  
pp. e205188 ◽  
Author(s):  
Scott T. Vasher ◽  
Ian M. Oppenheim ◽  
Pragyashree Sharma Basyal ◽  
Emma M. Lee ◽  
Margaret M. Hayes ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Self Assessment ◽  
Family Meetings

scholarly journals An observational study using video recordings to explore the first hour after admission to a Neonatal Intensive Care Unit (NICU)

2020 ◽  
Author(s):  
Laurene Aydon ◽  
Andrew Gill ◽  
Margo Zimmer ◽  
Mary Sharp ◽  
Patricia Woods ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Vascular Access ◽  
Neonatal Intensive Care ◽  
Fluid Management ◽  
Video Recording ◽  
Vital Signs ◽  
Quality Improvement Initiative ◽  
Convenience Sample

AIM To explore the admission process to our Neonatal Intensive Care Unit. METHODS A first phase quality improvement initiative was conducted. We utilised observational video recording of a convenience sample of inborn admissions. Two remote GoPro cameras were placed, one giving an overview of activity and the other focussed on the infant. Recordings captured the first hour after admission including transfer to the NICU by the birthing team. The video footage of each case study was reviewed by a multidisciplinary panel using an agreed semi quantitative analysis of events. RESULTS Ten admissions to the NICU were video recorded between June and October 2018. Gestational age 282- 401. A focus on maintaining airway support was inconsistent as was the ability to provide continuous monitoring of vital signs. Overall leadership of the process was lacking, and handover often appeared fragmented. Median temperature on admission was 362 (354-373) oC. Vascular access and fluid management occurred at a median of 36 (13 – 67) minutes. CONCLUSIONS Planning and approval for this study was protracted, particularly negotiating the use of video recording. Anecdotally, this delay is thought to have contributed to an improvement in managing admissions, particularly when maintaining airway support and monitoring. However, our baseline data has highlighted a lack of leadership, fragmented handover, low admission temperatures and broad time frames to achieve vascular access. A guideline to streamline handover and nursery transition is currently being implemented, a subsequent evaluation cycle is planned.

scholarly journals Value of modified Burns Wean Assessment Program scores in the respiratory intensive care unit: An Egyptian study

2020 ◽  
Vol 15 ◽  
Author(s):  
Nermeen A. Abdelaleem ◽  
Sherif A.A. Mohamed ◽  
Azza S. Abd ElHafeez ◽  
Hassan A. Bayoumi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Large Scale ◽  
Area Under The Curve ◽  
Chronic Obstructive ◽  
Multicenter Studies ◽  
Respiratory Disorders ◽  
Assessment Program ◽  
Rapid Shallow Breathing Index ◽  
Respiratory Intensive Care Unit

Background: There is no consensus on the most useful predictive indicator for weaning patients from mechanical ventilation (MV). We aimed to evaluate the utility of the modified Burns Wean Assessment Program (m-BWAP) in predicting the weaning success in patients with respiratory disorders admitted to the respiratory intensive care unit (RICU).Methods: Patients with respiratory failure requiring MV for longer than 48 hours were included. They were weaned by pressure support ventilation and spontaneous breathing trails. Patients were divided into successful and unsuccessful weaning groups according to their outcomes.Results: A total of 91 patients were enrolled. The majority had chronic obstructive pulmonary diseases (COPD); 40%, overlap syndrome (24%), and obesity hypoventilation syndrome (OHS): 15%. The successful group had significantly higher m-BWAP scores than that in the unsuccessful group (median 65; range 35 to 80 vs median 45; range 30 to 65; p=0.000), with area under the curve (AUC) of 0.854; 95% CI 0.766 to 0.919), p<0.001. At cut-off value of ≥55, the sensitivity and specificity of m-BWAP to predict successful weaning were 73.77% and 84.85%, respectively. The AUC for m-BWAP was significantly higher than that for rapid shallow breathing index (RSBI).Conclusion: We conclude that m-BWAP scores represent a good predictor of weaning success among patient with chronic respiratory disorders in the RICU. The m-BWAP checklist has many factors that are closely related to the weaning outcomes of patients with chronic respiratory disorders. Further, large-scale, multicenter studies are warrented.

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