scholarly journals Original research Prevalence of use of advance directives, health care proxy, legal guardian, and living will in 512 patients hospitalized in a cardiac care unit/intensive care unit in 2 community hospitals

2010 ◽  
Vol 2 ◽  
pp. 188-191 ◽  
Author(s):  
Anil Kumar ◽  
Wilbert S. Aronow ◽  
Margelusa Alexa ◽  
Ritu Gothwal ◽  
Stephen Jesmajian ◽  
...  
2018 ◽  
Vol 24 (8) ◽  
pp. S104-S105
Author(s):  
Fathima F. Jahufar ◽  
William Jakobleff ◽  
Joshua Josephs ◽  
Sandhya Murthy ◽  
Stephen Forest ◽  
...  

2019 ◽  
Vol 74 (4) ◽  
pp. S59
Author(s):  
M. Roth ◽  
K. Okeke-Eweni ◽  
B. Fontenot ◽  
R. Tusa ◽  
S. Rhodes ◽  
...  

2015 ◽  
Vol 8 (2) ◽  
pp. 231-234
Author(s):  
Abigail Flanagan

Discussions about advance directives should begin before a hospitalization occurs, yet are sometimes initiated at the time of imminent death or during a life-altering medical event. A lack of knowledge in the general public perpetuates this practice because most people do not think about end-of-life choices and do not want to discuss the topic. Yet, family members naturally undertake surrogacy but often find themselves ill equipped to handle the moral and ethical situations that arise. Hence, it is important that health care providers engage patients to consider the completion of health care proxy and living will documents. Provider awareness about general perceptions will facilitate the approaches to initiating conversations about advance directives. This case study highlights the ethical dilemma of an octogenarian whose poor prognosis and lack of an advance directive contributed to an uncertain medical course.


2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.


2021 ◽  
pp. 097321792110512
Author(s):  
Suryaprakash Hedda ◽  
Shashidhar A. ◽  
Saudamini Nesargi ◽  
Kalyan Chakravarthy Balla ◽  
Prashantha Y. N. ◽  
...  

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs


2021 ◽  
Vol 5 (2) ◽  
pp. 74
Author(s):  
Nifa Viranda Amelia

Selama pasien dirawat di ruang Intensive Cardiac Care Unit (ICCU), keluarga pasien mengalami kesulitan dan ketidakberdayaan. Bagi keluarga pasien, ruang rawat intensif merupakan tempat yang tidak menyenangkan.  Keluarga masuk dalam kondisi yang tidak terduga dan dibutuhkan ketepatan keluarga dalam mengambil keputusan guna keberlangsungan hidup terkait kondisi pasien yang membutuhkan penanganan.Lama perawatan pasien di ruang ICCU sangat beragam.  Lama rawat pasien ICCU berdampak langsung terhadap kualitas hidup pasien dan keluarga, risiko terjadinya di masa depan, dan besarnya pembiayaan dampak dari perawatan. Selama keluarga mendampingi perawatan pasien di ruang ICCU, keluarga akan mengalami berbagai reaksi emosional seperti kecemasan. Tujuan: Mengetahui hubungan lama hari rawat dengan tingkat kecemasan keluarga pasien di ruang ICCU. Metode: Korelasi dengan pendekatan cross sectional dengan sampel 42 responden di ruang ICCU, yang dipilih dengan menggunakan metode purposive sampling. Instrumen penelitian ini menggunakan kuesioner HARS.  Data dianalisis dengan uji korelasi Spearman. Hasil: Lama hari rawat pasien rata-rata 3,14 hari.  Kecemasan keluarga pasien ICCU paling banyak berada pada tingkat kecemasan berat (33,3%). Terdapat hubungan yang bermakna antara lama hari rawat dengan tingkat kecemasan keluarga pasien (p=0,0003) dengan keeratan hubungan yang sedang (r=0,532) di ruang ICCU. Diskusi: Semakin lama pasien dirawat di ruang ICCU maka semakin tinggi tingkat kecemasan yang dirasakan keluarga pasien karena kondisi pasien yang tidak stabil ataupun semakin parah. Kesimpulan: Keluarga pasien perlu diberikan informasi dan edukasi yang jelas terkait kondisi pasien dalam sehari atau saat ada perburukan kondisi.Kata kunci: kecemasan, keluarga, lama hari rawat, perawatan intensif, perawatan kritis. Correlation Between Length of Stay and Anxiety Levels of Patients’ Family in Intensive Cardiac Care Unit Room ABSTRACTWhile a patient is being treated in the Intensive Cardiac Care Unit (ICCU), the patient's family experiences difficulties and helplessness. For the patient's family, the intensive care unit is an unpleasant place. The family enters into unexpected conditions and is required to make proper decisions for survival related to patient conditions. The patient's length of stay in the ICCU room is very diverse. The length of stay of ICCU patients directly impacts patients' quality of life and their families, the risk of future incidence, and the extent of the treatment cost. While the family accompanies the patient treated in the ICCU room, the family will experience various emotional reactions such as anxiety. Objective: To reveal the correlation between length of stay and the anxiety levels of the patient’s family in the ICCU room. Methods: Correlation with cross-sectional approach with a sample of 42 respondents in the ICCU room, who were selected using a purposive sampling method. The research instrument used the HARS questionnaire. Data were analyzed using the Spearman correlation test. Results: The average length of the patient's stay was 3.14 days. Family anxiety of ICCU patients was mostly at the level of severe anxiety (33.3%). There was a significant correlation between length of stay and anxiety levels of the patient’s family (p=0.0003) with a moderate correlation coefficient (r=0.532) in the ICCU room. Discussion: The longer the patient is treated in the ICCU room, the higher the anxiety level felt by the patient’s family due to the patient's unstable or worsened condition. Conclusion: Clear information and education should be given to the patient's family regarding the patient's condition within one day or when the condition worsens.Keywords: anxiety, family, length of stay, intensive care, critical care


2018 ◽  
Vol 38 (6) ◽  
pp. e1-e4 ◽  
Author(s):  
Christina Canfield ◽  
Sandra Galvin

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as tele-ICU. In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Despite the successes, acceptance of tele-ICU varies. Known barriers to acceptance include perceptions of intrusiveness and invasion of privacy.


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