scholarly journals A Model for a Standardized and Sustainable Pediatric Anesthesia-Intensive Care Unit Hand-Off Process

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 123
Author(s):  
Priti G. Dalal ◽  
Theodore J. Cios ◽  
Theodore K. M. DeMartini ◽  
Amit A. Prasad ◽  
Meghan C. Whitley ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Anesthesia ◽  
Venous Access ◽  
Staff Satisfaction ◽  
Additional Time ◽  
Hand Off ◽  
Patient Health ◽  
Transfers Of Care ◽  
The Cost

Background and Objectives: The hand-off process between pediatric anesthesia and intensive care unit (ICU) teams involves the exchange of patient health information and plays a major role in reducing errors and increasing staff satisfaction. Our objectives were to (1) standardize the hand-off process in children’s ICUs, and (2) evaluate the provider satisfaction, efficiency and sustainability of the improved hand-off process. Methods: Following multidisciplinary discussions, the hand-off process was standardized for transfers of care between anesthesia-ICU teams. A pre-implementation and two post-implementation (6 months, >2 years) staff satisfaction surveys and audits were conducted to evaluate the success, quality and sustainability of the hand-off process. Results: There was no difference in the time spent during the sign out process following standardization—median 5 min for pre-implementation versus 5 and 6 min for post-implementation at six months and >2 years, respectively. There was a significant decrease in the number of missed items (airway/ventilation, venous access, medications, and laboratory values pertinent events) post-implementation compared to pre-implementation (p ≤ 0.001). In the >2 years follow-up survey, 49.2% of providers felt that the hand-off could be improved versus 78.4% in pre-implementation and 54.2% in the six-month survey (p < 0.001). Conclusion: A standardized interactive hand-off improves the efficiency and staff satisfaction, with a decreased rate of missed information at the cost of no additional time.

scholarly journals Staff cost in direct nursing care at an intensive care unit

2007 ◽  
Vol 15 (5) ◽  
pp. 1005-1009 ◽  
Author(s):  
Sandra Cristina Ribeiro Telles ◽  
Valéria Castilho
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Staff ◽  
Work Load ◽  
Direct Care ◽  
Personnel Cost ◽  
Simple Method ◽  
Personnel Costs ◽  
Staff Cost ◽  
The Cost

This quantitative case study aimed to learn and analyze the personnel cost in nursing direct care in the intensive care unit. We opted to use a therapeutic intervention score index, TISS-28, for the analysis of the indirect gravity of patients and the dimension of the nursing staff working time. Evaluating the cost by a gravity score presented to be a logical and relatively simple method to allocate costs per patient in the intensive care unit. In this exploratory and descriptive study, the average TISS-28 per patient was 31 points, requiring a daily expenditure of care hours of R$ 298.69. It was evidenced in this study that personnel costs are variable since there are patients with different complexities. Therefore is possible to estimate the nursing staff cost by assessing its work load.

scholarly journals The Cost of ICU Delirium and Coma in the Intensive Care Unit Patient

Medical Care ◽  
2018 ◽  
Vol 56 (10) ◽  
pp. 890-897 ◽  
Author(s):  
Eduard E. Vasilevskis ◽  
Rameela Chandrasekhar ◽  
Colin H. Holtze ◽  
John Graves ◽  
Theodore Speroff ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Patient ◽  
Icu Delirium ◽  
The Cost

scholarly journals THE COST OF ADULT LIVER TRANSPLANTATION IN A REFERRAL CENTER IN SOUTHERN BRAZIL

2019 ◽  
Vol 56 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Adriane B de SOUZA ◽  
Santiago RODRIGUEZ ◽  
Fábio Luís da MOTTA ◽  
Ajacio B de Mello BRANDÃO ◽  
Claudio Augusto MARRONI
Keyword(s):  
Intensive Care Unit ◽  
Liver Transplantation ◽  
Intensive Care ◽  
Liver Disease ◽  
Southern Brazil ◽  
Referral Center ◽  
End Stage Liver Disease ◽  
End Stage ◽  
The Cost ◽  
Surgical Unit

ABSTRACT BACKGROUND: Liver transplantation (LTx) is the primary and definitive treatment of acute or chronic cases of advanced or end-stage liver disease. Few studies have assessed the actual cost of LTx categorized by hospital unit. OBJECTIVE: To evaluate the cost of LTx categorized by unit specialty within a referral center in southern Brazil. METHODS: We retrospectively reviewed the medical records of 109 patients undergoing LTx between April 2013 and December 2014. Data were collected on demographic characteristics, etiology of liver disease, and severity of liver disease according to the Child-Turcotte-Pugh (CTP) and Model for End-stage Liver Disease (MELD) scores at the time of LTx. The hospital bill was transformed into cost using the full absorption costing method, and the costs were grouped into five categories: Immediate Pretransplant Kit; Specialized Units; Surgical Unit; Intensive Care Unit; and Inpatient Unit. RESULTS: The mean total LTx cost was US$ 17,367. Surgical Unit, Specialized Units, and Intensive Care Unit accounted for 31.9%, 26.4% and 25.3% of the costs, respectively. Multivariate analysis showed that total LTx cost was significantly associated with CTP class C (P=0.001) and occurrence of complications (P=0.002). The following complications contributed to significantly increase the total LTx cost: septic shock (P=0.006), massive blood transfusion (P=0.007), and acute renal failure associated with renal replacement therapy (dialysis) (P=0.005). CONCLUSION: Our results demonstrated that the total cost of LTx is closely related to liver disease severity scores and the development of complications.

Mobile laboratory unit based on the Kodak Ektachem DT system.

1988 ◽  
Vol 34 (11) ◽  
pp. 2313-2315 ◽  
Author(s):  
A R Pettigrew ◽  
J M Orrell ◽  
M H Dominiczak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Throughput ◽  
Outpatient Clinic ◽  
Renal Unit ◽  
Mobile Laboratory ◽  
Laboratory Unit ◽  
The Cost ◽  
Selective Analysis ◽  
Test Profiles

Abstract We evaluated the Kodak Ektachem DT system (DT60, DTE, DTSC modules), using it as a mobile laboratory unit (MLU) in different hospital settings. Imprecision of 19 assays performed with the system and correlation with routine methods in the main laboratory were assessed. The system was then transported to different departments within the hospital, where limited test profiles were offered and the time taken to produce results was recorded. It proved practicable to offer a six-test electrolyte profile to a five-bed intensive-care unit but not to an 18-bed renal unit, where more selective analysis would be required. In a low-throughput outpatient clinic (five patients per hour) it was feasible to provide a six-test on-site profile on every patient, whereas the maximum number of tests was four in a high-throughput clinic (10 patients per hour). The cost of providing a flexible extra-laboratory biochemistry service must be balanced against the benefit of having on-site results, e.g., fewer outpatient-clinic visits.

scholarly journals Ventilator-Associated Tracheobronchitis: To Treat or Not to Treat?

Antibiotics ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 51
Author(s):  
Despoina Koulenti ◽  
Kostoula Arvaniti ◽  
Mathew Judd ◽  
Natasha Lalos ◽  
Iona Tjoeng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Healthcare Costs ◽  
Treatment Duration ◽  
Cost Benefit ◽  
Narrative Review ◽  
Mechanically Ventilated ◽  
Treat All ◽  
The Cost

Ventilator-associated tracheobronchitis (VAT) is an infection commonly affecting mechanically ventilated intubated patients. Several studies suggest that VAT is associated with increased duration of mechanical ventilation (MV) and length of intensive care unit (ICU) stay, and a presumptive increase in healthcare costs. Uncertainties remain, however, regarding the cost/benefit balance of VAT treatment. The aim of this narrative review is to discuss the two fundamental and inter-related dilemmas regarding VAT, i.e., (i) how to diagnose VAT? and (ii) should we treat VAT? If yes, should we treat all cases or only selected ones? How should we treat in terms of antibiotic choice, route, treatment duration?

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