scholarly journals Duration of one-lung ventilation stage, POSSUM value and the quality of post-operative analgesia significantly affect survival and length of stay on intensive care unit of patients undergoing two-stage esophagectomy

2013 ◽  
Vol 7 (3) ◽  
pp. 238 ◽  
Author(s):  
YasinSaid AlMakadma ◽  
TamerHunein Riad ◽  
IsmaeiI Ayad ◽  
TamerHussein Ibrahim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Two Stage

The Effect of a Critical Pathway on Patients’ Outcomes After Carotid Endarterectomy

2002 ◽  
Vol 11 (3) ◽  
pp. 250-258 ◽  
Author(s):  
Daleen Aragon ◽  
Virginia Burton ◽  
Jacqueline F. Byers ◽  
Michael Cohen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Carotid Endarterectomy ◽  
Diagnostic Procedures ◽  
Critical Pathway ◽  
Lengths Of Stay ◽  
Implementation Costs

• Background In 1996, an integrated plan of care was implemented to improve quality of care for patients undergoing elective carotid endarterectomy. Goals were to reduce length of stay, costs, number of preoperative and intensive care unit admissions, and use of diagnostic procedures yet maintain good outcomes.• Objectives To determine whether use of the integrated plan of care met the goals.• Methods Data on financial and process outcomes, use of angiographic diagnostic procedures, and demographics were retrieved from the hospital’s database for all patients who had elective carotid endarterectomy without cerebral infarction.• Results A total of 783 patients met inclusion criteria: 129 before implementation of the plan of care, 66 during the 6-month transition, and 588 after implementation. Preoperative angiography was done in 32% of patients before implementation, 11% during the transition, and 4% after implementation. Percentages of patients admitted to the intensive care unit were 77% before implementation, 24% during transition, and 9% after implementation. Mean lengths of stay were 2.93 days before implementation, 2.12 days during transition, and 1.68 days after implementation. Costs per case were $7798 before implementation, $5750 during transition, and $5387 after implementation. Analysis of variance revealed significant differences between groups in total length of stay (P=.001), preoperative length of stay (P<.001), and costs (P<.001).• Conclusion Use of the integrated plan of care reduced length of stay, costs, admissions to intensive care units, and use of cerebral angiography. Use of the plan improved resource utilization while maintaining quality of care.

scholarly journals The adherence of the multi-professional team to preventive measures of ventilator-associated pneumonia

2021 ◽  
Vol 10 (13) ◽  
pp. e424101321554
Author(s):  
Angela Maria Chastay ◽  
Janaini Brunoski ◽  
Arthur Garani Narciso ◽  
Elder Dalazoana Filho ◽  
João Pedro Gambetta Polay ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Medical Records ◽  
Healthcare Professionals ◽  
Preventive Measures ◽  
Ventilator Associated Pneumonia ◽  
Reducing Costs ◽  
Gathering Data

Objective: The main purpose of this paper was to evaluate the incidence of Ventilator-Associated Pneumonia (VAP) in an Intensive Care Unit (ICU) and the adherence of the bundles by healthcare professionals. Methodology: This study was prospective, observational, and quantitative, performed in an ICU located in Ponta Grossa (Paraná, Brazil) gathering data from December 2018 to February 2019 through medical records and bedside observations. Results: This study included 56 patients, of whom 3 acquired VAP. The multi-professional team performed several procedures that met the prevention bundles in that UCI, writing them down in medical records, but some of them were not being applied in practice or were not performed properly, exposing divergences between annotations and bedside observations. Conclusion: It is noted that bundles are effective in preventing VAP, reduces risks of HAI and, consequently, deaths. However, there is a need to guide the applicability and registration by the multidisciplinary team, optimizing the adherence of these measures, in order to improve the quality of health of patients and reducing costs and the length of stay in the ICU related to VAP.

scholarly journals Reducing Length of Stay and Improving Quality of Care by Implementation of Informatics System and Care Bundle in the Intensive Care Unit

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Yang Kai-Hsuan ◽  
Wei-Fong Kao ◽  
Lin Yen-Kuang ◽  
Wang Pei-Ling ◽  
Huang Tsung-Jen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Care Bundle ◽  
Informatics System

Long-term survival and quality of life in cardiac surgical patients with prolonged intensive care unit length of stay

2002 ◽  
Vol 73 (5) ◽  
pp. 1472-1478 ◽  
Author(s):  
Mathew R Williams ◽  
Rachel B Wellner ◽  
Elizabeth A Hartnett ◽  
Barbara Thornton ◽  
Minoo N Kavarana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Unit Length ◽  
Surgical Patients ◽  
Term Survival ◽  
Long Term Survival

scholarly journals 1412. The utility of respiratory viral panel testing for nosocomial fever in the neonatal intensive care unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S713-S713
Author(s):  
Carlo Fopiano Palacios ◽  
Eric Lemmon ◽  
James Campbell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Linear Regression ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Fisher Exact Test ◽  
The Mean ◽  
Pcr Test

Abstract Background Patients in the neonatal intensive care unit (NICU) often develop fevers during their inpatient stay. Many neonates are empirically started on antibiotics due to their fragile clinical status. We sought to evaluate whether the respiratory viral panel (RVP) PCR test is associated with use of antibiotics in patients who develop a fever in the NICU. Methods We conducted a retrospective chart review on patients admitted to the Level 4 NICU of the University of Maryland Medical Center from November 2015 to June 2018. We included all neonates who developed a fever 48 hours into their admission. We collected demographic information and data on length of stay, fever work-up and diagnostics (including labs, cultures, RVP), and antibiotic use. Descriptive statistics, Fisher exact test, linear regression, and Welch’s ANOVA were performed. Results Among 347 fever episodes, the mean age of neonates was 72.8 ± 21.6 days, and 45.2% were female. Out of 30 total RVP samples analyzed, 2 were positive (6.7%). The most common causes of fever were post-procedural (5.7%), pneumonia (4.8%), urinary tract infection (3.5%), meningitis (2.6%), bacteremia (2.3%), or due to a viral infection (2.0%). Antibiotics were started in 208 patients (60%), while 61 neonates (17.6%) were already on antibiotics. The mean length of antibiotics was 7.5 ± 0.5 days. Neonates were more likely to get started on antibiotics if they had a negative RVP compared to those without a negative RVP (89% vs. 11%, p-value < 0.0001). Patients with a positive RVP had a decreased length of stay compared to those without a positive RVP (30.3 ± 8.7 vs. 96.8 ± 71.3, p-value 0.01). On multivariate linear regression, a positive RVP was not associated with length of stay. Conclusion Neonates with a negative respiratory viral PCR test were more likely to be started on antibiotics for fevers. Respiratory viral PCR testing can be used as a tool to promote antibiotic stewardship in the NICU. Disclosures All Authors: No reported disclosures

scholarly journals Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital

2021 ◽  
Author(s):  
Andrea Kirfel ◽  
Jan Menzenbach ◽  
Vera Guttenthaler ◽  
Johanna Feggeler ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Confusion Assessment

Abstract Background Postoperative delirium (POD) is a relevant and underdiagnosed complication after cardiac surgery that is associated with increased intensive care unit (ICU) and hospital length of stay (LOS). The aim of this subgroup study was to compare the frequency of tested POD versus the coded International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis of POD and to evaluate the influence of POD on LOS in ICU and hospital. Methods 254 elective cardiac surgery patients (mean age, 70.5 ± 6.4 years) at the University Hospital Bonn between September 2018 and October 2019 were evaluated. The endpoint tested POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 'A's Test (4AT) or Delirium Observation Scale (DOS) was positive on one day. Results POD occurred in 127 patients (50.0%). LOS in ICU and hospital were significantly different based on presence (ICU 165.0 ± 362.7 h; Hospital 26.5 ± 26.1 days) or absence (ICU 64.5 ± 79.4 h; Hospital 14.6 ± 6.7 days) of POD (p < 0.001). The multiple linear regression showed POD as an independent predictor for a prolonged LOS in ICU (48%; 95%CI 31–67%) and in hospital (64%; 95%CI 27–110%) (p < 0.001). The frequency of POD in the study participants that was coded with the ICD F05.0 and F05.8 by hospital staff was considerably lower than tests revealed by the study personnel. Conclusion Approximately 50% of elderly patients who underwent cardiac surgery developed POD, which is associated with an increased ICU and hospital LOS. Furthermore, POD is highly underdiagnosed in clinical routine.

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