Nurse–nurse collaboration and performance among nurses in intensive care units

2021 ◽  
Author(s):  
Dalia O. Al‐Ajarmeh ◽  
Ahmad H. Rayan ◽  
Nidal F. Eshah ◽  
Zaid M. Al‐Hamdan
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
And Performance

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 21 adult intensive-care units from 10 cities in India: findings of the International Nosocomial Infection Control Consortium (INICC)

2013 ◽  
Vol 141 (12) ◽  
pp. 2483-2491 ◽  
Author(s):  
Y. MEHTA ◽  
N. JAGGI ◽  
V. D. ROSENTHAL ◽  
C. RODRIGUES ◽  
S. K. TODI ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Intensive Care Units ◽  
Ventilator Associated Pneumonia ◽  
Multidimensional Approach ◽  
Time Period ◽  
Control And Prevention ◽  
Quasi Experimental ◽  
And Performance

SUMMARYWe report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divided into baseline and intervention periods. During baseline, prospective surveillance of VAP was performed applying the Centers for Disease Control and Prevention/National Healthcare Safety Network definitions and INICC methods. During intervention, our approach in each ICU included a bundle of interventions, education, outcome and process surveillance, and feedback of VAP rates and performance. Crude stratified rates were calculated, and by using random-effects Poisson regression to allow for clustering by ICU, the incidence rate ratio for each time period compared with the 3-month baseline was determined. The VAP rate was 17·43/1000 mechanical ventilator days during baseline, and 10·81 for intervention, showing a 38% VAP rate reduction (relative risk 0·62, 95% confidence interval 0·5–0·78, P = 0·0001).

scholarly journals Impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates

2019 ◽  
Vol 9 (10) ◽  
pp. 15
Author(s):  
Safaa Abdel Fattah Abou Zed ◽  
Amira Adel Mohammed
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Ventilator Associated Pneumonia ◽  
And Performance ◽  
Nursing Guidelines ◽  
The Impact ◽  
Nurses Knowledge

Background: Ventilator Associated Pneumonia (VAP) is a common syndrome in pediatrics primarily in infants and early childhood. Mechanical ventilation is one of the leading supportive modalities of management in the intensive care unit, but it conveys a lot of threats and complications. This study aimed to assess the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates through the following: 1) Assessment of nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. 2) Designing, implementing and evaluating the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates.Methods: Research design: A quasi-experimental design was utilized to conduct this study.  Settings: The study was convoyed at Maternity & Gynecological and Children’s Hospitals affiliated to Ain shams University Hospitals from neonatal intensive care units. Sample: A convenient sample method of forty three (43) nurses, and fifty (50) neonates’ infants on mechanical ventilation was included in the study as a single study group. Tools: The questionnaire format, the observation checklist and implementation of nursing guidelines was assessed the nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. The implementation of nursing guidelines was premeditated as reference guidelines for nurses.Results: There were statistically significant differences between mean scores of the pre and post test as regards nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates.Conclusions: Application of the nursing guidelines has a positive outcome on improving nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Recommendations: The current study recommended that directing a written protocol for prevention of ventilator associated pneumonia in neonates to support satisfactory knowledge, and competent practices are actually required at neonatal intensive care units.

scholarly journals PROBABILISTIC GLYCEMIC CONTROL DECISION SUPPORT IN ICU: PROOF OF CONCEPT USING BAYESIAN NETWORK

2019 ◽  
Vol 81 (2) ◽  
Author(s):  
Asma Abu-Samah ◽  
Normy Norfiza Abdul Razak ◽  
Fatanah Mohamad Suhaimi ◽  
Ummu Kulthum Jamaludin ◽  
Azrina Md. Ralib
Keyword(s):  
Intensive Care ◽  
Decision Support ◽  
Glycemic Control ◽  
Bayesian Network ◽  
Intensive Care Units ◽  
Physiological Model ◽  
Proof Of Concept ◽  
Therapy Outcomes ◽  
Intensive Care Patients ◽  
And Performance

Glycemic control in intensive care patients is complex in terms of patients’ response to care and treatment. The variability and the search for improved insulin therapy outcomes have led to the use of human physiology model based on per-patient metabolic condition to provide personalized automated recommendations. One of the most promising solutions for this is the STAR protocol, which is based on a clinically validated insulin-nutrition-glucose physiological model. However, this approach does not consider demographical background such as age, weight, height, and ethnicity. This article presents the extension to intensive care personalized solution by integrating per-patient demographical, and upon admission information to intensive care conditions to automate decision support for clinical staff. In this context, a virtual study was conducted on 210 retrospectives intensive care patients’ data. To provide a ground, the integration concept is presented roughly, but the details are given in terms of a proof of concept using Bayesian Network, linking the admission background and performance of the STAR control. The proof of concept shows 71.43% and 73.90% overall inference precision, and reliability, respectively, on the test dataset. With more data, improved Bayesian Network is believed to be reproduced. These results, nevertheless, points at the feasibility of the network to act as an effective classifier using intensive care units data, and glycemic control performance to be the basis of a probabilistic, personalized, and automated decision support in the intensive care units.

scholarly journals A gap existed between physicians’ perceptions and performance of pain, agitation-sedation and delirium assessments in Chinese intensive care units

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kai Chen ◽  
Yan-Lin Yang ◽  
Hong-Liang Li ◽  
Dan Xiao ◽  
Yang Wang ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Clinical Performance ◽  
Sedation Scale ◽  
Delirium Assessment ◽  
Brain Injured ◽  
Delirium Management ◽  
And Performance ◽  
Injured Patients

Abstract Background Pain, agitation-sedation and delirium management are crucial elements in the care of critically ill patients. In the present study, we aimed to present the current practice of pain, agitation-sedation and delirium assessments in Chinese intensive care units (ICUs) and investigate the gap between physicians’ perception and actual clinical performance. Methods We sent invitations to the 33 members of the Neuro-Critical Care Committee affiliated with the Chinese Association of Critical Care Physicians. Finally, 24 ICUs (14 general-, 5 neuroscience-, 3 surgical-, and 2 emergency-ICUs) from 20 hospitals participated in this one-day point prevalence study combined with an on-site questionnaire survey. We enrolled adult ICU admitted patients with a length of stay ≥24 h, who were divided into the brain-injured group or non-brain-injured group. The hospital records and nursing records during the 24-h period prior to enrollment were reviewed. Actual evaluations of pain, agitation-sedation and delirium were documented. We invited physicians on-duty during the 24 h prior to the patients’ enrollment to complete a survey questionnaire, which contained attitude for importance of pain, agitation-sedation and delirium assessments. Results We enrolled 387 patients including 261 (67.4%) brain-injured and 126 (32.6%) non-brain-injured patients. There were 19.9% (95% confidence interval [CI]: 15.9–23.9%) and 25.6% (95% CI: 21.2–29.9%) patients receiving the pain and agitation-sedation scale assessment, respectively. The rates of these two types of assessments were significantly lower in brain-injured patients than non-brain-injured patients (p = 0.003 and < 0.001). Delirium assessment was only performed in three patients (0.8, 95% CI: 0.1–1.7%). In questionnaires collected from 91 physicians, 70.3% (95% CI: 60.8–79.9%) and 82.4% (95% CI: 74.4–90.4%) reported routine use of pain and agitation-sedation scale assessments, respectively. More than half of the physicians (52.7, 95% CI: 42.3–63.2%) reported daily screening for delirium using an assessment scale. Conclusions The actual prevalence of pain, agitation-sedation and delirium assessment, especially delirium screening, was suboptimal in Chinese ICUs. There is a gap between physicians’ perceptions and actual clinical practice in pain, agitation-sedation and delirium assessments. Our results will prompt further quality improvement projects to optimize the practice of pain, agitation-sedation and delirium management in China. Trial registration ClinicalTrials.gov, identifier NCT03975751. Retrospectively registered on 2 June 2019.

Effect of Education and Performance Feedback on Rates of Catheter-Associated Urinary Tract Infection in Intensive Care Units in Argentina

2004 ◽  
Vol 25 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Victor Daniel Rosenthal ◽  
Sandra Guzman ◽  
Nasia Safdar
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Latin American ◽  
Performance Feedback ◽  
Baseline Period ◽  
And Performance ◽  
Catheter Care

AbstractObjective:To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).Setting:Two level III adult ICUs in a private healthcare facility in Argentina.Patients:All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.Methods:A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after imple-menting education and performance feedback.Results:There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P<.0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI95, 0.39 to 0.86; P = .006).Conclusion:Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.

Sign in / Sign up

Export Citation Format

Share Document