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Showing posts with label patient safety. Show all posts
Showing posts with label patient safety. Show all posts

Thursday, 6 July 2023

 

Human-centered visualization technologies for patient monitoring are the future: a narrative review

 

by Greta Gasciauskaite, Justyna Lunkiewicz, Tadzio R. Roche, Donat R. Spahn, Christoph B. Nöthiger and David W. Tscholl 

 

Critical Care volume 27, Article number: 254 Published: 28 June 2023

 

Medical technology innovation has improved patient monitoring in perioperative and intensive care medicine and continuous improvement in the technology is now a central focus in this field. Because data density increases with the number of parameters captured by patient-monitoring devices, its interpretation has become more challenging. Therefore, it is necessary to support clinicians in managing information overload while improving their awareness and understanding about the patient’s health status. Patient monitoring has almost exclusively operated on the single-sensor–single-indicator principle—a technology-centered way of presenting data in which specific parameters are measured and displayed individually as separate numbers and waves. An alternative is user-centered medical visualization technology, which integrates multiple pieces of information (e.g., vital signs), derived from multiple sensors into a single indicator—an avatar-based visualization—that is a meaningful representation of the real-world situation. Data are presented as changing shapes, colors, and animation frequencies, which can be perceived, integrated, and interpreted much more efficiently than other formats (e.g., numbers). The beneficial effects of these technologies have been confirmed in computer-based simulation studies; visualization technologies improved clinicians’ situation awareness by helping them effectively perceive and verbalize the underlying medical issue, while improving diagnostic confidence and reducing workload. This review presents an overview of the scientific results and the evidence for the validity of these technologies.

Sunday, 7 January 2018

Perceptions of Risk and Safety in the ICU: A Qualitative Study of Cognitive Processes Relating to Staffing

Perceptions of Risk and Safety in the ICU: A Qualitative Study of Cognitive Processes Relating to Staffing
D’Lima, D et al

Critical Care Medicine: January 2018 - Volume 46 - Issue 1 - p 60–70

Objectives: The aims of this study were to 1) examine individual professionals’ perceptions of staffing risks and safe staffing in intensive care and 2) identify and examine the cognitive processes that underlie these perceptions. 

Design: Qualitative case study methodology with nurses, doctors, and physiotherapists. Setting: Three mixed medical and surgical adult ICUs, each on a separate hospital site within a 1,200-bed academic, tertiary London hospital group. Subjects: Forty-four ICU team members of diverse professional backgrounds and seniority. Interventions: None. Main Results: Four themes (individual, team, unit, and organizational) were identified. Individual care provision was influenced by the pragmatist versus perfectionist stance of individuals and team dynamics by the concept of an “A” team and interdisciplinary tensions. Perceptions of safety hinged around the importance of achieving a “dynamic balance” influenced by the burden of prevailing circumstances and the clinical status of patients. Organizationally, professionals’ risk perceptions affected their willingness to take personal responsibility for interactions beyond the unit. 
Conclusions: This study drew on cognitive research, specifically theories of cognitive dissonance, psychological safety, and situational awareness to explain how professionals’ cognitive processes impacted on ICU behaviors. Our results may have implications for relationships, management, and leadership in ICU. First, patient care delivery may be affected by professionals’ perfectionist or pragmatic approach. Perfectionists’ team role may be compromised and they may experience cognitive dissonance and subsequent isolation/stress. Second, psychological safety in a team may be improved within the confines of a perceived “A” team but diminished by interdisciplinary tensions. Third, counter intuitively, higher “situational” awareness for some individuals increased their stress and anxiety. Finally, our results suggest that professionals have varying concepts of where their personal responsibility to minimize risk begins and ends, which we have termed “risk horizons” and that these horizons may affect their behavior both within and beyond the unit.

Monday, 18 September 2017

Clinical Practice Guideline: Safe Medication Use in the ICU

Clinical Practice Guideline: Safe Medication Use in the ICU

Kane-Gill, S L et al
Critical Care Medicine:  September 2017 - Volume 45 - Issue 9 - p e877–e915

Objective: To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. Data Sources: PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015.
Study Selection: Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed.
Data Extraction: Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation.
Data Synthesis: The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. Conclusions: This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed considerations to an active surveillance system that includes reporting, identification, and evaluation are discussed. Also, highlighted is the need for future research for safe medication practices that is specific to critically ill patients.

Friday, 16 September 2016

Incidence and Etiology of Potentially Preventable ICU Readmissions

Incidence and Etiology of Potentially Preventable ICU Readmissions

Critical Care Medicine:
September 2016 - Volume 44 - Issue 9 - p 1704–1709


 Al-Jaghbeer, Mohammed J

Objectives: The rate of unplanned ICU readmissions is often considered a measure of hospital performance. However, the degree to which these readmissions are preventable and the causes of preventable readmissions are unknown, creating uncertainty about the feasibility and value of reducing ICU readmission rates. To inform this issue, we sought to determine the frequency and underlying causes of potentially preventable ICU readmissions. Design: Retrospective cohort study. Setting: Urban, academic medical center in the mid-Atlantic United States. Patients: Adult patients discharged alive from their first ICU admission with an unplanned readmission within 48 hours of discharge. Measurements and Main Results: Each patient’s medical chart was reviewed by two independent investigators who rated each readmission’s preventability according to standardized scale and assessed the etiology of both preventable and nonpreventable readmissions. We assessed concordance between raters using the κ statistic and resolved disagreements through iterative discussion. Of 136 readmissions in the final analysis, 16 (11.8%; 95% CI, 6.9–18.4) were considered preventable and 120 (88.2%; 95% CI, 81.5–93.1) were considered nonpreventable. Of nonpreventable readmissions, 67 were due to a new clinical problem and 53 were due to an existing clinical problem. Among preventable readmissions, six were attributable to system errors, six were attributable to management errors, two were attributable to procedural events, one was attributable to a diagnostic error, and one was attributable to a medication error. Compared to nonpreventable readmissions, preventable readmissions tended to have shorter index ICU lengths of stay (2 vs 3 d; p = 0.05) and a shorter duration of time on the ward prior to readmission (16.6 vs 23.6 hr; p = 0.05). Conclusions: The majority of early ICU readmissions are nonpreventable, raising important concerns about ICU readmission rates as a measure of hospital performance.

Monday, 29 September 2008

Journal of Advanced Nursing: September 2008, Volume 63, Issue 6

REVIEW PAPER 540–549
nurses' responses to ethical dilemmas in nursing practice: meta-analysis
Bernadette Dierckx de Casterlé; Shigeko Izumi; Nelda S. Godfrey; Kris Denhaerynck

REVIEW SUMMARY: EVIDENCE FOR NURSING PRACTICE
563–564
Effects of music listening on adult patients' preprocedural state anxiety in hospital.
Cindy Stern, BHSc

RESEARCH PAPER: ORIGINAL RESEARCH
567–575
Making patients safer: nurses' responses to patient safety alerts
Annette Lankshear; Karen Lowson; Jane Harden; Paula Lowson; Ruth C Saxby

607–618
Benchmarking nurse staffing levels: the development of a nationwide feedback tool
Koen Van den Heede; Luwis Diya; Emmanuel Lesaffre; Arthur Vleugels; Walter Sermeus

619–625
nurses' perceptions of preoperative teaching for ambulatory surgical patients
Kar-yee Tse; Winnie Kwok-wei So

THEORETICAL PAPER
634–643
Adherence: a concept analysis
Janice M. Bissonnette

FORTHCOMING CONTENTS
644
Volume 64, Number 1, October 2008

Monday, 28 July 2008

Monday, 14 July 2008

Nurses have been asked to sign up to a two-year campaign to improve patient safety.

Nurses are being asked to sign up to a new two-year campaign designed to boost patient safety.

The Patient Safety First Campaign was launched last week at the NHS Confederation annual conference in Manchester. Its developers say it is unique in that has been put together 'by the service, for the service, for the benefit of patients'.

The safety drive is focusing on five areas initially – reducing inpatient cardiac arrest and mortality rates by early detection deteriorating patients; introducing care bundles in ICU; reducing harm from high-risk drugs like anticoagulants; improving care for adult patients undergoing elective surgery and ensuring a trust leadership culture that promotes patient safety.

Sunday, 6 July 2008

Medication - related patient safety incidents in critical care : a review of reports to the UK

National Patient Safety Agency
Author(s): A . N . Thomas ; U . Panchagnula
ISSUE: 2008 ; VOL 63 ; PART 7 (July 2008)
Journal Title: Anaesthesia Anaesthesia
Page: 726-733
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Monday, 23 June 2008

Improving patient safety in intensive care units in Michigan

Improving patient safety in intensive care units in Michigan

Peter J. Pronovost, MD, PhD, FCCM; Sean M. Berenholtz, MD, MHS; Christine Goeschel, RN, MPA, MPS; Irie Thom, RN, MSN; Sam R. Watson, MSA, MT(ASCP); Christine G. Holzmueller, BLA; Julie S. Lyon, PhD; Lisa H. Lubomski, PhD; David A. Thompson, DNSc, MSN; Dale Needham, MD, PhD, FRCPC; Robert Hyzy, MD; Robert Welsh, MD; Gary Roth, DO; Joseph Bander, MD; Laura Morlock, PhD; Bryan J. Sexton, PhD

Monday, 21 April 2008

Nursing in Critical Care: 13:3

Nursing in Critical Care: Volume 13, Issue 3, May and June 2008

Guest Editorial
Information sharing, knowledge transfer and patient safety
Wendy Chaboyer, Sandy Blake
pages 121–123

Editors’ Note
John Albarran, Editor.Julie Scholes, Editor.
pages 123–123

Research
Spiritual assessment in intensive and cardiac care nursing
Fiona Timmins Jacinta Kelly
pages 124–131

What factors influence arterial blood gas sampling patterns?
Tom Andrews Heather Waterman
pages 132–137

Reflective Analysis
Therapeutic relationships in critical care nursing: a reflection on practice
Elizabeth O’Connell
pages 138–143
Literature Reviews

Therapeutic hypothermia following cardiac arrest: a review of the evidence
Tim J. Collins Peter J. Samworth
pages 144–151

End-of-life care in UK critical care units a literature review
Jane Morgan
pages 152–161

A dedicated retrieval and transfer service: The QUARTS Project
Sue Andrews, Sue Catlin, Nikki Lamb Martin Christensen
pages 162–168

Evaluation
Evaluating evidence-based practice within critical care
Helen O’Neal, Alison Gray Angela Thompson
pages 169–177

Thinking Outside the Box
Commentary: Nemoto T et al. (1999). Automatic control of pressure support mechanical ventilation using fuzzy logic
Bronagh Blackwood
pages 178–179

BACCN essay competition
Karen HillNational Secretary
pages 180–180

Staffing in critical care standard to be released in 2008
Karen HillNational Secretary
pages 180–180

Monday, 7 April 2008

The impact of offering a relatives' clinic on the satisfaction of the next - of - kin of Critical Care patients

- A prospective time - interrupted trial
Author(s): Steel A . ; Underwood C . ; Notley C . ; Blunt M .
ISSUE: 2008 ; VOL 24 ; PART 2 (04-2008)
Journal Title: Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing ) Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing )
Page: 122-129
ISSN: Print: 0964-3397
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National Patient Safety Agency : Improving patient safety across all critical care areas
Author(s): Keady S . ; Thacker M .
ISSUE: 2008 ; VOL 24 ; PART 2 (04-2008)
Journal Title: Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing ) Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing )
Page: 137-140
ISSN: Print: 0964-3397
Search the Web: [article] [author(s)]