scholarly journals Variability of DKA Management Among Pediatric Emergency Room and Critical Care Providers: A Call for More Evidence-Based and Cost-Effective Care?

2014 ◽  
pp. 190-191 ◽  
Author(s):  
Matthew G Clark ◽  
Abdallah Dalabih
Keyword(s):  
Critical Care ◽  
Emergency Room ◽  
Cost Effective ◽  
Pediatric Emergency ◽  
Evidence Based ◽  
Care Providers ◽  
Effective Care

Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

scholarly journals Referrals to a pediatric emergency room of a tertiary care teaching hospital before and after introduction of a referral education module- a qualitative study 

2020 ◽  
Author(s):  
Gopalakrishnan Ezhumalai ◽  
Jayashree Muralidharan ◽  
Arun Bansal ◽  
Karthi Nallasamy ◽  
Bhavneet Bharti
Keyword(s):  
Emergency Room ◽  
Tertiary Care ◽  
Geographical Area ◽  
Pediatric Emergency ◽  
Critically Ill Children ◽  
Care Hospital ◽  
Care Providers ◽  
Post Intervention ◽  
Intervention Phase

Abstract Background: Provision of timely care to critically ill children is essential for good outcome. With development of specialized pediatric critical care units, referral from community and smaller peripheral hospitals has received greater impetus. Our tertiary care hospital caters to referrals from a wide geographical area. Since there is no standard referral and feedback system in India, we decided to evaluate the quality of referrals coming to our Emergency Room (ER) with respect to their demography, association with severity of illness and mortality. We plan to use this data to establish a standard referral and feedback process to streamline our ER referrals. Methods: Our study was completed in three phases in Pediatric ER;Pre-intervention, Intervention and Post intervention phases. Quality of referrals was graded by granting one score to presence of each item when matched with a quality checklist performa. A referral was graded ‘good’, ‘fair’ and ‘poor’ if it scored >7, 5 –7 and < 5 points respectively. Case studies, expert opinions, and lacunae observed in first phase were taken into consideration while preparing the referral education module, that was administered to health care providers of referring hospitals. Quality of referrals was compared between pre and post intervention phases. Results: Majority of inpatient admissions were ‘referred’ patients (99.3%). Most referrals belonged to the neighboring states of Punjab (48.2%) and Haryana (22.4%). Major referrals were from public sector hospitals (80.9%) of which the teaching hospitals topped the list (53.6%). Most common mode of transport was government run ambulance services(85.5%) and the common reason for referral was need for PICU bed and/or mechanical ventilation (50.4%). The post intervention phase saw a significant decline in the proportion of poor referrals (93.2 vs.78.2%;p=0.001) and a significant increase in the proportion of fair(6.1 vs 18%; p=0.001)and good referrals (0.7 vs 18%;p=0.001) Proportion of children presenting to triage with physiological decompensation with respect to poor referrals had significantly decreased in post intervention phase [580(79.8%) vs 1025(93.7%); p=0.0001]. Conclusion:Referral education had significantly improved the quality of referrals coming to our ER. Continuing education will be required for sustained and increased benefits. Key words: Quality of referral, Pediatric emergency, Triage

scholarly journals Telenursing-an emerging concept in reducing COVID-19 hospital occupancy

2021 ◽  
Vol 9 (1) ◽  
pp. 414
Author(s):  
Hrushikesh Das ◽  
Sasmita Panigrahi ◽  
Dharitri Swain
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cost Effective ◽  
Cost Of Care ◽  
Care Providers ◽  
Care Needs ◽  
Effective Care ◽  
Care Workers ◽  
Information And Communication ◽  
Hospital Occupancy

Tele-information and communication have led a global revolution in solving the scarcity of health care workers. In the vision of health for all, different global leaders have initiated many public health reforms to address the health care needs of citizens, like e-Sanjeevani in India. COVID-19 created an acute shortage of nurses, as well as the rising cost of care and hospital occupancy which are major hurdles to address basic health needs. Telenursing is a novel field that utilizes innovative technologies to offer safe, effective, and ethical care promptly by providing. Telenursing may provide a means to overcome some of the challenges faced by patients by providing easier access to cost-effective care and equitable distribution of health care providers. Globally, telenursing is an emerging and rapidly expanding area for professionals and offers unlimited opportunities for its members.

343: COMPARING INTUBATION PRACTICES AND OUTCOMES AMONG PEDIATRIC EMERGENCY AND CRITICAL CARE PROVIDERS

2020 ◽  
Vol 48 (1) ◽  
pp. 153-153
Author(s):  
Christine Capone ◽  
Todd Sweberg ◽  
Beth Emerson ◽  
Lee Polikoff ◽  
David Turner ◽  
...  
Keyword(s):  
Critical Care ◽  
Pediatric Emergency ◽  
Care Providers

Critical Care Considerations in Adult Patients With Influenza-Induced ARDS

2020 ◽  
Vol 40 (5) ◽  
pp. 15-24
Author(s):  
Rachel E. Smith ◽  
Megan M. Shifrin
Keyword(s):  
Critical Care ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Medical Management ◽  
Distress Syndrome ◽  
Adult Patients ◽  
Current Evidence ◽  
Evidence Based ◽  
Care Providers

Topic Acute respiratory distress syndrome is a complex respiratory disease that can be induced by influenza virus infection. Critical care providers are uniquely positioned to manage this pathological progression in adult patients through evidence-based practice. Clinical Relevance Influenza and subsequent acute respiratory distress syndrome are associated with extremely high morbidity and mortality in adult patients in the United States. Although evidence-based medical management strategies can alter the clinical trajectory of acute respiratory distress syndrome and improve outcomes, critical care providers do not always implement these measures. Purpose To provide critical care providers with an overview of the pathological progression of influenza-induced acute respiratory distress syndrome and the current evidence-based strategies for management. Content Covered This article reviews the epidemiology and pathophysiology associated with influenza-induced acute respiratory distress syndrome, the criteria for diagnosis, and the evidence-based medical management.

Removal of femoral sheaths by registered nurses: issues and outcomes

1996 ◽  
Vol 16 (2) ◽  
pp. 32-36 ◽  
Author(s):  
S Schickel ◽  
SN Cronin ◽  
A Mize ◽  
C Voelker
Keyword(s):  
Critical Care ◽  
Knowledge Base ◽  
Cost Effective ◽  
Critical Care Nurses ◽  
Quality Cost ◽  
Adequate Knowledge ◽  
Effective Care ◽  
Margin Of Safety ◽  
Competency Evaluation ◽  
Removal Technique

The results of this evaluation indicate that specially trained critical care nurses can remove femoral sheaths with an acceptable margin of safety. As a result, these nurses can provide quality, cost-effective care to angioplasty patients. However, before this procedure is included as part of the RN's responsibility, written protocols are needed to identify appropriate patients, proper removal technique, and specific actions to take if complications occur. In addition, plans must be developed for initial education and ongoing competency evaluation to ensure that each nurse involved maintains an adequate knowledge base and skill level.

Epidemiological Features of Dog Bites among Children Attending Emergency Room in Al-showmely General Hospital

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Hasan Alwan Baiee ◽  
Weli Hatif
Keyword(s):  
Emergency Room ◽  
General Hospital ◽  
Health Problem ◽  
Lower Limbs ◽  
Care Providers ◽  
Dog Bite ◽  
Female Ratio ◽  
Post Exposure ◽  
Dog Bites ◽  
Bite Injuries

Dog bites are common and can affect victims of different ages.Dog bite injuries in children are a preventable health problem.Dog bites are a serious health problem that cause both physical and emotional damage to victims and considerable cost to communities. Studies on dog bites among Iraqi children were very scarce.This study focuses on theincidence,mechanisms,and epidemiologicalcircumstances ofdog biteinjuriesin a series of pediatric patients who sustained dog bites in emergency Room. MethodologyA cross sectional study was designed to studyall cases of dog bites attending the emergency room in AL-Showmely General Hospital located in the southern district – Babylon province-Iraq, during the period ; from the January, first,2017 through theend of March, 2018.Special constructed were prepared to collect data through interview of victims or their companions who attended the emergency section during this period,ethical clearances were obtained.*A total of 320 children presented to the hospital with dog bite injuries.The incidence rate of dog bites was 275 per 100000 population, the male to female ratio was 3:1.the most common dog bite injuries took place in September44 (13.75%). Injury rates were highest in those aged 0-4,declining thereafter with age. In the 6-10, year age group141 (44.1%), most of cases living in rural district (villages). The most affected location were lower limbs, only 3.4% of the injured children had completed the post exposure anti rabies vaccine. Dog bites are common health problem among children,Children who are younger than 10 years represent the high-risk group for dog attacks. very few of them had complete the prophylactic post exposure vaccine Therefore, prevention strategies should focus on public education,training health care providers and controlling stray dogs.

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