scholarly journals Visiting Policies in the Adult Intensive Care Units in the Netherlands: Survey among ICU Directors

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Kalinka Noordermeer ◽  
Tom A. Rijpstra ◽  
David Newhall ◽  
Aline J. M. Pelle ◽  
Nardo J. M. van der Meer
Keyword(s):  
Intensive Care ◽  
Current Literature ◽  
Anxiety And Depression ◽  
Clinical Routine ◽  
General Hospitals ◽  
Web Based ◽  
Academic Hospitals ◽  
Policy Information ◽  
Reducing Stress ◽  
Visiting Policy

Introduction. Admission to the ICU is a significant event for patients and their families and is often accompanied by stress, anxiety and depression. Literature shows that implementation of “unrestricted visiting policy” (UP) can potentially alleviate psychologically distressing elements of ICU admission. Methods. A web-based questionnaire was sent to all ICU’s concerning three main topics: general ICU information, detailed visiting policy information, and rationale for the chosen policy. Results. 87.1% of ICU’s retain “restricted visiting policies” (RVP; ≤five visiting hours per day). Knowledge about the current literature was overall 60.8%. There is an UP in two academic hospitals and a “partly restricted policy” (PRP; >5 visiting hours per day but <24) in two academic, two large teaching and five general hospitals. Mean permissible duration in ICU’s with a RVP was min versus min in the PRP. Conclusion. Nine out of ten ICU’s still have a restricted visiting policy. The main reasons cited for a restricted visiting policy were potential interference with the daily clinical routine and privacy. A better knowledge of the current literature in combination with infrastructural changes might improve patients’ outcome by reducing stress for the patient and its family.

Framework for Biosignal Interpretation in Intensive Care and Anesthesia

1997 ◽  
Vol 36 (04/05) ◽  
pp. 340-344 ◽  
Author(s):  
I. Korhonen ◽  
M. van Gils ◽  
A. Kari ◽  
N. Saranummi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Data Management ◽  
Clinical Evaluation ◽  
Patient Monitoring ◽  
Research Community ◽  
Clinical Routine ◽  
The Poor ◽  
Outcomes Of Care

Abstract:Improved monitoring improves outcomes of care. As critical care is “critical”, everything that can be done to detect and prevent complications as early as possible benefits the patients. In spite of major efforts by the research community to develop and apply sophisticated biosignal interpretation methods (BSI), the uptake of the results by industry has been poor. Consequently, the BSI methods used in clinical routine are fairly simple. This paper postulates that the main reason for the poor uptake is the insufficient bridging between the actors (i.e., clinicians, industry and research). This makes it difficult for the BSI developers to understand what can be implemented into commercial systems and what will be accepted by clinicians as routine tools. A framework is suggested that enables improved interaction and cooperation between the actors. This framework is based on the emerging commercial patient monitoring and data management platforms which can be shared and utilized by all concerned, from research to development and finally to clinical evaluation.

scholarly journals Ansiedad, depresión y malestar emocional en los profesionales sanitarios de las Unidades de Cuidados Intensivos

2015 ◽  
Vol 31 (2) ◽  
pp. 743
Author(s):  
Sandra Gómez-Martínez ◽  
Rafael Ballester-Arnal ◽  
Beatriz Gil-Juliá ◽  
Ricardo Abizanda-Campos
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Intensive Care ◽  
Health Workers ◽  
Anxiety And Depression ◽  
Subjective Perception ◽  
Depression And Anxiety ◽  
Regression Analyses ◽  
Daily Contact ◽  
Emotional Effects

<p class="textoteoradef">Health Workers (HW) who work in the Intensive Care Units (ICU), are not exempt from emotional effects of coping with suffering and death situations daily. Many studies in HW have focused on the <em>burnout</em> syndrome and have presented anxiety and depression as consequences of this syndrome. The aim of this work is to assess the anxiety and depression problems, as well as the subjective perception of mood of the ICU health workers. Participants were 117 ICU health workers of a Hospital in the Valencian Community (Spain). The descriptive analyses show that between 14.6-20% and a 4-7% of participants have symptoms of anxiety and depression, respectively. Differential analyses, show gender differences in several measures of anxiety, as well as on depression scores. Age and experience are related to depression and anxiety. Furthermore, we performed regression analyses to know the importance of the different variables in the presence of symptoms of anxiety and depression. The results show that working in daily contact with suffering and death, in a Unit in which the demands are many, could have implications for the mental health of professionals.</p>

scholarly journals Bot to the Rescue? Effects of a Fully Automated Conversational Agent on Anxiety and Depression: A Randomized Controlled Trial

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gutu SM ◽  
◽  
Cosmoiu A ◽  
Cojocaru D ◽  
Turturescu D ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Controlled Trial ◽  
Anxiety And Depression ◽  
Conversational Agents ◽  
Web Based ◽  
Time Interaction ◽  
Transdiagnostic Factors ◽  
Secondary Outcomes ◽  
Intent To Treat ◽  
Main Effects

Web-based conversational agents powered by Artificial Intelligence (AI) and rooted in cognitive-behavioral therapy have been proven efficacious in alleviating the symptoms of anxiety and depression, when compared to passive controls. However, the benefits of a fully automated agent vs. active controls have not yet been examined. Furthermore, the potential impact of such interventions on the transdiagnostic factors underlying anxiety and depression is not known. To elucidate this, 95 adults were randomized to receive (1) a 2-week intervention with an AI-powered chatbot (Woebot) (n=39) or (2) regular psychoeducational materials (n=54). In completers’ analyses, significant main effects of time were obtained for one of the primary outcomes, anxiety, and for the secondary outcomes, transdiagnostic factors, with both groups showing decreased anxiety and intolerance of uncertainty and increased rumination, selfcompassion, guilt and shame. No group by time interaction effects were found for either of the primary outcomes, depression and anxiety, or for the secondary outcomes. Intent-to-Treat analyses also revealed no significant effects of group on the primary or secondary outcomes. Our findings point to the necessity of further research to better understand the areas where chatbots might bring benefits superior to those obtained through simple and inexpensive strategies.

Effects of Organizational Characteristics on Outcomes and Resource Use in Patients With Cancer Admitted to Intensive Care Units

2016 ◽  
Vol 34 (27) ◽  
pp. 3315-3324 ◽  
Author(s):  
Marcio Soares ◽  
Fernando A. Bozza ◽  
Luciano C.P. Azevedo ◽  
Ulysses V.A. Silva ◽  
Thiago D. Corrêa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hospital Mortality ◽  
Intensive Care Units ◽  
Resource Use ◽  
Organizational Characteristics ◽  
General Hospitals ◽  
Cancer Centers ◽  
Processes Of Care ◽  
Patients With Cancer ◽  
Efficient Resource

Purpose To investigate the impact of organizational characteristics and processes of care on hospital mortality and resource use in patients with cancer admitted to intensive care units (ICUs). Patients and Methods We performed a retrospective cohort study of 9,946 patients with cancer (solid, n = 8,956; hematologic, n = 990) admitted to 70 ICUs (51 located in general hospitals and 19 in cancer centers) during 2013. We retrieved patients’ clinical and outcome data from an electronic ICU quality registry. We surveyed ICUs regarding structure, organization, staffing patterns, and processes of care. We used mixed multivariable logistic regression analysis to identify characteristics associated with hospital mortality and efficient resource use in the ICU. Results Median number of patients with cancer per center was 110 (interquartile range, 58 to 154), corresponding to 17.9% of all ICU admissions. ICU and hospital mortality rates were 15.9% and 25.4%, respectively. After adjusting for relevant patient characteristics, presence of clinical pharmacists in the ICU (odds ratio [OR], 0.67; 95% CI, 0.49 to 0.90), number of protocols (OR, 0.92; 95% CI, 0.87 to 0.98), and daily meetings between oncologists and intensivists for care planning (OR, 0.69; 95% CI, 0.52 to 0.91) were associated with lower mortality. Implementation of protocols (OR, 1.52; 95% CI, 1.11 to 2.07) and meetings between oncologists and intensivists (OR, 4.70; 95% CI, 1.15 to 19.22) were also independently associated with more efficient resource use. Neither admission to ICUs in cancer centers compared with general hospitals nor annual case volume had an impact on mortality or resource use. Conclusion Organizational aspects, namely the implementation of protocols and presence of clinical pharmacists in the ICU, and close collaboration between oncologists and ICU teams are targets to improve mortality and resource use in critically ill patients with cancer.

scholarly journals Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021249 ◽  
Author(s):  
Ilse van Beusekom ◽  
Ferishta Bakhshi-Raiez ◽  
Nicolette F de Keizer ◽  
Dave A Dongelmans ◽  
Marike van der Schaaf
Keyword(s):  
Intensive Care ◽  
Health Professionals ◽  
Web Based ◽  
Quality Registry ◽  
Email Address ◽  
National Quality ◽  
The Web ◽  
Screening Software ◽  
National Quality Registry

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

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