scholarly journals What is new in critical illness and injury science? Patient safety amidst chaos: Are we on the same team during emergency and critical care interventions?

2015 ◽  
Vol 5 (3) ◽  
pp. 135 ◽  
Author(s):  
Susan Moffatt-Bruce ◽  
JenniferL Hefner ◽  
MichelleC Nguyen
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Critical Illness

Advances in critical care for the older patient

2013 ◽  
Vol 23 (2) ◽  
pp. 118-130 ◽  
Author(s):  
Diane Monkhouse
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Critical Illness ◽  
General Population ◽  
Acute Illness ◽  
Limited Resources ◽  
Care Practice ◽  
Older Patient ◽  
Life Sustaining Treatment

SummaryAs the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.

Perceived Patient Safety Culture in a Critical Care Transport Program

2013 ◽  
Vol 32 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Cheryl Erler ◽  
Nancy E. Edwards ◽  
Steve Ritchey ◽  
Daniel J. Pesut ◽  
Laura Sands ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture

Training fellows and residents in paediatric cardiac critical care

2016 ◽  
Vol 26 (8) ◽  
pp. 1531-1536 ◽  
Author(s):  
Sarah Tabbutt ◽  
Nancy Ghanayem ◽  
Melvin C. Almodovar ◽  
John Charpie ◽  
Stephen J. Roth ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Cardiac Disease ◽  
Pediatric Patients ◽  
Multidisciplinary Care ◽  
Improve Quality ◽  
Training Curriculum ◽  
Specific Patient ◽  
Cardiac Critical Care

AbstractAs pediatric cardiac critical care becomes more sub-specialized it is reasonable to assume that dedicated units may provide a better infrastructure for improved multidisciplinary care, cardiac-specific patient safety initiatives, and dedicated training of fellows and residents. The knowledge base required to optimally manage pediatric patients with critical cardiac disease has evolved sufficiently to consider a standardized training curriculum and board certification for pediatric cardiac critical care. This strategy would potentially provide consistency of training and healthcare and improve quality of care and patient safety.

scholarly journals Patient Safety Events during Critical Care Transport

2018 ◽  
Vol 37 (4) ◽  
pp. 253-258 ◽  
Author(s):  
Scott Swickard ◽  
Chris Winkelman ◽  
Fredric M. Hustey ◽  
Mary Kerr ◽  
Andrew P. Reimer
Keyword(s):  
Critical Care ◽  
Patient Safety

scholarly journals Critical Care Pharmacists and Medication Management in an ICU Recovery Center

2018 ◽  
Vol 52 (8) ◽  
pp. 713-723 ◽  
Author(s):  
Joanna L. Stollings ◽  
Sarah L. Bloom ◽  
Li Wang ◽  
E. Wesley Ely ◽  
James C. Jackson ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Influenza Vaccination ◽  
Medication Review ◽  
Preventive Measures ◽  
Tertiary Care ◽  
Pneumococcal Vaccination ◽  
Median Number ◽  
Drug Event

Background: Many patients experience complications following critical illness; these are now widely referred to as post–intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known as a PICS clinic, is one potential approach to promoting patient and family recovery following critical illness. Objectives: To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors. Methods: A prospective, observational cohort study was conducted of all outpatient appointments of a tertiary care hospital’s ICU-RC between July 2012 and December 2015. The pharmacist completed a full medication review, including medication reconciliation, interview, counseling, and resultant interventions, during the ICU-RC appointment. Results: Data from all completed ICU-RC visits were analyzed (n = 62). A full medication review was performed in 56 (90%) of these patients by the pharmacist. The median number of pharmacy interventions per patient was 4 (interquartile range = 2, 5). All 56 patients had at least 1 pharmacy intervention; 22 (39%) patients had medication(s) stopped at the clinic appointment, and 18 (32%) patients had new medication(s) started. The pharmacist identified 9 (16%) patients who had an adverse drug event (ADE); 18 (32%) patients had ADE preventive measures instituted. An influenza vaccination was administered to 13 (23%) patients despite an inpatient protocol to ensure influenza vaccination prior to discharge. A pneumococcal vaccination was administered to 2 (4%) patients. Conclusions: Use of a critical care pharmacist resulted in the identification and treatment of multiple medication-related problems in an ICU-RC as well as implementation of preventive measures.

Maternal critical care

2020 ◽  
pp. 2701-2705
Author(s):  
Rupert Gauntlett
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Death Rate ◽  
Critical Care Unit ◽  
Post Partum ◽  
The United Kingdom ◽  
The World ◽  
Resource Poor ◽  
Acute Fatty Liver

Critical illness during pregnancy or after giving birth is rare: in the United Kingdom 0.29% of maternities involve admission to a critical care unit, and the maternal death rate is 0.01%. Over 80% of obstetric admissions to critical care occur in the post-partum phase, mainly due to complications relating to massive haemorrhage. Other pregnancy specific conditions that may require critical care support include pre-eclampsia (typically when diagnosis and treatment have been delayed), amniotic fluid embolism, peri-partum cardiomyopathy, and acute fatty liver of pregnancy. Puerperal sepsis remains a major problem in resource-poor parts of the world. Pregnant women who survive critical illness may be particularly prone to long-term psychological morbidity. It is vital that, once physiological stability has been achieved, no time is wasted before a mother is reunited with her baby.

Nursing Turbulence in Critical Care: Relationships With Nursing Workload and Patient Safety

2020 ◽  
Vol 29 (3) ◽  
pp. 182-191
Author(s):  
Jennifer Browne ◽  
Carrie Jo Braden
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Full Range ◽  
Operational Definition ◽  
Nursing Workload ◽  
Turbulence Scale ◽  
Safety Risk ◽  
Care Relationships

Background Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood. Objectives The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to specify a definition and preliminary measure for turbulence. Methods A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale. Results A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α = .75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P < .001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P = .005). Conclusions Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses’ work will enhance our ability to target resources and improve patients’ outcomes.

Factors behind ethical dilemmas regarding physical restraint for critical care nurses

2019 ◽  
Vol 27 (2) ◽  
pp. 598-608 ◽  
Author(s):  
Zahra Salehi ◽  
Tahereh Najafi Ghezeljeh ◽  
Fatemeh Hajibabaee ◽  
Soodabeh Joolaee
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Intensive Care ◽  
Ethical Dilemmas ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Legal Problems ◽  
Restraint Use ◽  
Conventional Content Analysis

Background: Physical restraint is among the commonly used methods for ensuring patient safety in intensive care units. However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety. Aim: The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients. Design: This is a qualitative study using conventional content analysis approach, as suggested by Graneheim and Lundman, to analyze the data. Methods: Seventeen critical care nurses were purposefully recruited from the four intensive care units in Tehran, Iran. Data were collected through in-depth semi-structured interviews and were concurrently analyzed through conventional content analysis as suggested by Graneheim and Lundman. Ethical consideration: This study was approved by the Ethics Committee of Iran University of Medical Sciences, Tehran, Iran with the code: IR.IUMS.REC.1397.795. Before interviews, participants were provided with explanations about the aim of the study, the confidentiality of the data, their freedom to participate, and the right to withdraw the study, and their free access to the study findings. Finally, their consents were obtained, and interviews were started. Results: Factors behind ethical dilemmas for critical care nurses over using physical restraint were categorized into three main categories, namely the outcomes of using physical restraint, the outcomes of not using physical restraint, and emotional distress for nurses. The outcomes of using physical restraint were categorized into the three subcategories of ensuring patient safety, physical damage to patients, and mental damage to the patient. The outcomes of not using physical restraint fell into two subcategories, namely the risks associated with not using physical restraint and legal problems for nurses. Finally, the two subcategories of the emotional distress for nurses main category were nurses’ negative feelings about restraint use and uncertainty over the decision on physical restraint use. Conclusion: Decision-making for restraint use is often associated with ethical dilemmas, because nurses need to weight the outcomes of its use against the outcomes of not using it and also consider patient safety and autonomy. Health authorities are recommended to develop clear evidence-based guidelines for restraint use and develop and implement educational and counseling programs for nurses on the principles of ethical nursing practice, patient rights, physical restraint guidelines and protocols, and management of emotional, ethical, and legal problems associated with physical restraint use.

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