Physician and Nurse Research in Multidisciplinary Intensive Care Units

2020 ◽  
Vol 29 (6) ◽  
pp. 450-457
Author(s):  
Kevin B. Laupland ◽  
Fiona Coyer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interprofessional Collaboration ◽  
Clinical Care ◽  
Journal Articles ◽  
Medical Journals ◽  
Medical Study ◽  
Nurse Research ◽  
Study Participants ◽  
Study Designs

Background Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses. Methods One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed. Results Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines. Conclusions Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.

Qua pote quisque, in ea conterat arte diem: COVID-19 and Australian and New Zealand intensive care

2020 ◽  
Vol 22 (2) ◽  
pp. 103-104
Author(s):  
Andrew Udy ◽  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
New Zealand ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Care ◽  
Public Health Emergency ◽  
Care Practice ◽  
Health Care Practice

The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has thrust intensive care medicine to the forefront of health care practice in Australia and New Zealand. Indeed, reports from other countries and jurisdictions convey highly confronting statistics about the scale of this public health emergency, particularly in terms of the demand on intensive care unit (ICU)services. Whether this occurs here remains to be seen, although if such a scenario does eventuate, it will represent an unprecedented challenge to our community. In parallel, these events offer the opportunity for greater coordination, improved communication, and innovation in clinical care, which are principles that in many ways define our specialty.

Clinical Decision Making in the ICU: Dysphagia Screening, Assessment, and Treatment

2019 ◽  
Vol 40 (03) ◽  
pp. 170-187 ◽  
Author(s):  
Martin B. Brodsky ◽  
Emily B. Mayfield ◽  
Roxann Diez Gross
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Clinical Decision ◽  
Level Of Care ◽  
Assessment And Treatment ◽  
Proper Training ◽  
Screening Assessment

AbstractClinicians often perceive the intensive care unit as among the most intimidating environments in patient care. With the proper training, acquisition of skill, and approach to clinical care, feelings of intimidation may be overcome with the great rewards this level of care has to offer. This review—spanning the ages of birth to senescence and covering oral/nasal endotracheal intubation and tracheostomy—presents a clinically relevant, directly applicable review of screening, assessment, and treatment of dysphagia in the patients who are critically ill for clinical speech–language pathologists and identifies gaps in the clinical peer-reviewed literature for researchers.

Integrating intensive care unit (ICU) surveillance into an ICU clinical care electronic system

2015 ◽  
Vol 89 (4) ◽  
pp. 271-275 ◽  
Author(s):  
J.S. Reilly ◽  
J. McCoubrey ◽  
S. Cole ◽  
A. Khan ◽  
B. Cook
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Care ◽  
Electronic System

scholarly journals Methodology for Low-Field, Portable Magnetic Resonance Neuroimaging at the Bedside

2021 ◽  
Vol 12 ◽  
Author(s):  
Anjali M. Prabhat ◽  
Anna L. Crawford ◽  
Mercy H. Mazurek ◽  
Matthew M. Yuen ◽  
Isha R. Chavva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Magnetic Resonance ◽  
Brain Injuries ◽  
Massachusetts General Hospital ◽  
Clinical Care ◽  
Mri Imaging ◽  
Specific Patient ◽  
Secondary Injuries ◽  
Patients At Risk

Neuroimaging is a critical component of triage and treatment for patients who present with neuropathology. Magnetic resonance imaging and non-contrast computed tomography are the gold standard for diagnosis and prognostication of patients with acute brain injuries. However, these modalities require intra-hospital transport to strict, access-controlled environments, which puts critically ill patients at risk for complications and secondary injuries. A novel, portable MRI (pMRI) device that can be deployed at the patient's bedside provides a needed solution. In a dual-center investigation, Yale New Haven Hospital has obtained regular neuroimaging on patients using the pMRI as part of routine clinical care in the Emergency Department and Intensive Care Unit (ICU) since August of 2020. Massachusetts General Hospital has begun using pMRI in the Neuroscience Intensive Care Unit since January 2021. This technology has expanded the population of patients who can receive MRI imaging by increasing accessibility and timeliness for scan completion by eliminating the need for transport and increasing the potential for serial monitoring. Here we describe our methods for screening, coordinating, and executing pMRI exams and provide further detail on how to scan specific patient populations.

scholarly journals Survival among patients admitted in PICU (Pediatric Intensive Care Unit) of tertiary childcare hospital.

2021 ◽  
Vol 28 (12) ◽  
pp. 1773-1777
Author(s):  
Fatima Jabeen ◽  
Asim Khurshid ◽  
Maria Saleem
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Care Hospital ◽  
Group Iii ◽  
Group I ◽  
Male Patients ◽  
Study Participants

Objective: To determine the frequency of survival among patients admitted in Paediatric Intensive Care Unit (PICU) of tertiary care hospital according to disease severity score PRISM III. Study Design: Descriptive study. Setting: PICU of The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to April 2020. Material & Methods: A total of 205 admitted children in PICU were recruited. PRISM III forms were filled and PRISM III score was calculated for all study participants. Results: Of these 205 study cases, 124 (60.5 %) were male patients while 81 (39.5 %) were female patients. Mean age of our study cases was 3.64 ± 1.96 years. Mean duration of PICU stay was 4.52 ± 3.59 days and 139 (67.8%) patients had PICU stay for upto 5 days. Mean PRISM III score was 11.25 ± 4.69 and 69 (33.7%) had group I score, 118 (57.6%) had group II score, 14 (6.8%) had group III score and 4 (2%) had group IV score. Of these 205 study cases, mortality was noted in 31 (15.1%). Conclusion: High Frequency of mortality among children admitted to pediatric intensive care unit (PICU) was observed and mortality was found to be increasing with increasing PRISM III score.

scholarly journals Clinical Care Needs of Patients with Severe Traumatic Brain Injury in the Intensive Care Unit

2018 ◽  
Vol 23 (2) ◽  
Author(s):  
Nasrollah Alimohammadi ◽  
Marzieh Ziaeirad ◽  
Alireza Irajpour ◽  
Bahram Aminmansour
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Clinical Care ◽  
Care Needs

scholarly journals Prevalence of Diabetes and Hypertension and Their Associated Risks for Poor Outcomes in Covid-19 Patients

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Francisco J Barrera ◽  
Skand Shekhar ◽  
Rachel Wurth ◽  
Pablo J Moreno-Pena ◽  
Oscar J Ponce ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Relative Risk ◽  
Intensive Care Unit Admission ◽  
Observational Studies ◽  
Risk Of Bias ◽  
Patients With Diabetes ◽  
Registration Number ◽  
Poor Outcomes ◽  
Study Participants

Abstract Coronavirus disease 2019 (Covid-19) has affected millions of people and may disproportionately affect those with hypertension and diabetes. Because of inadequate methods in published systematic reviews, the prevalence of diabetes and hypertension and associated risks of poor outcomes in Covid-19 patients are unknown. We searched databases from December 1, 2019, to April 6, 2020, and selected observational peer-reviewed studies in English of patients with Covid-19. Independent reviewers extracted data on study participants, interventions, and outcomes and assessed risk of bias, and the certainty of evidence. We included 65 (15 794 participants) observational studies at moderate to high risk of bias. Overall prevalence of diabetes and hypertension was 12% (95% confidence interval [CI], 10-15; n = 12 870; I2: 89%), and 17% (95% CI, 13-22; n = 12 709; I2: 95%), respectively. In severe Covid-19, the prevalence of diabetes and hypertension were 18% (95% CI, 16-20; n = 1099; I2: 0%) and 32% (95% CI, 16-54; n = 1078; I2: 63%), respectively. Unadjusted relative risk for intensive care unit admission and mortality were 1.96 (95% CI, 1.19-3.22; n = 8890; I2: 80%; P = .008) and 2.78 (95% CI, 1.39-5.58; n = 2058; I2: 75%; P = .0004) for diabetics; and 2.95 (95% CI, 2.18-3.99; n = 1737; I2: 0%; P < .001) and 2.39 (95% CI, 1.54-3.73; n = 3107; I2: 66%; P < .001) for hypertensives. Neither diabetes (1.50; 95% CI, 0.90-2.50; n = 1991; I2: 74%; P = .119) nor hypertension (1.48; 95% CI, 0.99-2.23; n = 2023; I2: 69%; P = .058) was associated with severe Covid-19. In conclusion, the risk of intensive care unit admission and mortality for patients with diabetes or hypertension who developed Covid-19 is increased compared with those without these comorbidities. PROSPERO registration number CRD42020176582.

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

2019 ◽  
Vol 15 (2) ◽  
pp. 53-58
Author(s):  
D. Thangam ◽  
S. Deepa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Older Patients ◽  
Statistical Significance ◽  
Geriatric Medicine ◽  
Ventilatory Support ◽  
Cross Sectional ◽  
Duration Of Stay ◽  
Factors Associated ◽  
Study Participants

Objective: To determine the factors associated with the outcome of older patients admitted in Geriatric Intensive Care Unit. Materials and Methods: This cross-sectional, observational study was conducted in the Geriatric Intensive Care Unit of the Department of Geriatric Medicine, Madras Medical College, Chennai. one hundred and seventy two patients, aged 60 and above, admitted in the Geriatric ICU during the period of 6 months, from January 2017 to June 2017, were selected to participate in this study. Data regarding age, sex, number of comorbidities, major organ system involved, duration of stay and procedures underwent in the ICU were collected and analyzed. Results: Out of the 172 samples, 92 were males, and 80 were females. The mean age of the study population was 70.1 ± 8.3 years. We found no association between age and survival (p=0.581), gender and survival (p=0.298). 30.2% of the samples who expired had four comorbidities. We found a statistically significant association between the number of comorbidities and outcome (p<0.008). Around 44 patients (25.6%) had respiratory problems, and it was the commonest cause of admission to ICU in this study. We found no association between major system involved and outcome (p=0.089). Sixty of the study participants (34.9%) needed mechanical ventilatory support. We found a statistical significance between procedure underwent and outcome (p<0.001). 57.5% of the study participants stayed in the GICU up to 1 week. We found a statistical significance between the duration of stay and outcome (p=0.022). In this study, 71.5% of the study participants survived, 3.5% of them went against medical advice, and 25% of them expired. Conclusion: In this study, the outcome of older patients admitted in Geriatric Intensive Care Unit depended on the number of preexisting comorbidities, length of stay and procedure underwent during the ICU stay but not the chronological age. In this study, only one in four died after undergoing treatment in the Geriatric Intensive care unit. Geriatric intensive care services can improve the outcome of older patients admitted with a critical illness.

Enhancing Communication With Family Members in the Intensive Care Unit: A Mixed-Methods Study

2020 ◽  
Vol 40 (6) ◽  
pp. 23-32
Author(s):  
Karen-leigh Edward ◽  
Alessandra Galletti ◽  
Minh Huynh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Methods ◽  
Care Delivery ◽  
Clinical Care ◽  
Family Members ◽  
Staff Members ◽  
Confidence Levels ◽  
Decision Making Model ◽  
Intensive Care Unit Nurses

Background Nurses in the intensive care unit are central to clinical care delivery and are often the staff members most accessible to family members for communication. Family members’ ratings of satisfaction with the intensive care unit admission are affected more by communication quality than by the level of care for the patient. Family members may feel that communication in the intensive care unit is inconsistent. Objectives To use a shared decision-making model to deliver a communication education program for intensive care unit nurses, evaluate the confidence levels of nurses who undertook the education, and examine changes in family members’ satisfaction with communication from intensive care unit nurses after the nurses received the education. Methods A mixed-methods design was used. Seventeen nurses and 81 family members participated. Results Staff members were overall very confident with communicating with family members of critically ill patients. This finding was likely linked to staff members’ experience in the position, with 88% of nurses having more than 11 years’ experience. Family members were happy with care but dissatisfied with the environment. Conclusions Environmental factors can negatively affect communication with family members in the intensive care unit.

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