Medication errors in an intensive care unit.
Bohomol, E., Ramos, L.H., D'Innocenzo, M.
Report of a study to investigating the incidence types and causes of medication errors (MEs) and the consequences for patients. Background. Medication errors are a common problem in hospitals around the world, including those in Brazil.Method. An exploratory, quantitative survey design was used and 44 adult inpatients were studied over a 30-day period in 2006. Findings. A total of 305 MEs was observed. Conclusion. There is a need to develop a culture of safety and quality in patient care. An understanding of the profile of ME types and frequencies in an institution is fundamental to raise awareness and implement measures to avoid them. Structural and procedural changes in hospital organization, with a focus on the efficacy, efficiency, and effectiveness of the medication system are needed to reduce MEs.
Thursday, 30 April 2009
Infection, prevention and control
Infection, prevention and control
Theory and practice for healthcare professionals [Book]
Debbie Wilson
614.48 Macc HS Library
Theory and practice for healthcare professionals [Book]
Debbie Wilson
614.48 Macc HS Library
Tuesday, 28 April 2009
End of life treatment and care: good practice in decision-making - a consultation
End of life treatment and care: good practice in decision-making - a consultation
The General Medical Council (GMC) is consulting on new draft guidance, 'End of life treatment and care: good practice in decision-making'. The guidance is intended mainly for doctors but may also help patients and the public and other health and social care staff to understand what they can expect from doctors involved in caring for patients who are dying. The consultation runs until 13 July 2009. (GMC - news)
The General Medical Council (GMC) is consulting on new draft guidance, 'End of life treatment and care: good practice in decision-making'. The guidance is intended mainly for doctors but may also help patients and the public and other health and social care staff to understand what they can expect from doctors involved in caring for patients who are dying. The consultation runs until 13 July 2009. (GMC - news)
Hand hygiene adherence is influenced by the behavior of role models.
Pediatr Crit Care Med. 2009 Mar 25. [Epub ahead of print] LinkOut
Hand hygiene adherence is influenced by the behavior of role models.
Schneider J, Moromisato D, Zemetra B, Rizzi-Wagner L, Rivero N, Mason W, Imperial-Perez F, Ross L.
From the Department of Anesthesiology Critical Care Medicine (JS, DM, BZ, LR-W, NR, FI-P); Division of Infectious Diseases (WM, LR); Department of Pediatric Critical Care Medicine (JS), Childrens Hospital Los Angeles, Los Angeles, CA.
OBJECTIVE:: Proper hand hygiene (HH) reduces nosocomial infections. Therefore, factors that influence HH behavior of healthcare workers are of great interest. We hypothesized that strict HH adherence by supervisor role models would improve the HH behavior of junior staff.
DESIGN:: Prospective observational study.
SETTING:: Pediatric and cardiac intensive care units of a tertiary care children's hospital. SUBJECTS:: Two critical care fellows and four nurse orientees.
INTERVENTIONS:: First, we observed and recorded HH adherence of the fellows and nurse orientees and their respective supervising attending physician or nurse preceptor during daily patient care. Subsequently, we paired the same fellows and nurse orientees with a different supervisor who maintained strict HH adherence, and again noted HH adherence. We used measures of HH opportunities and HH adherence consistent with guidelines set by the Centers for Disease Control and Association for Professionals in Infection Control and Epidemiology.
MEASUREMENTS AND MAIN RESULTS:: HH adherence by fellows and nurse orientees at baseline was 22% of 200 HH opportunities, and improved to 56% of 234 opportunities as a result of role modeling-an average increase of 34% points (95% confidence interval, 18.7-51; p < 0.01 by linear regression), representing a HH adherence rate greater than 1.5 times that of the baseline. The control senior practitioners' HH adherence rate was 20% of 180 opportunities compared with the study senior practitioners' HH adherence of 94% of 187 opportunities-an average difference of 72%points higher compared with the control senior practitioners (95% confidence interval, 56-88.3; p < 0.01 by linear regression).
CONCLUSIONS:: HH adherence of junior practitioners improved under the supervision of adherent role models. These results suggest that HH behavior of senior practitioners plays a crucial influence on other staff. Senior healthcare practitioners should consider the important role they may play in reinforcing or weakening a culture of patient safety and proper HH.
PMID: 19325501 [PubMed - as supplied by publisher]
Hand hygiene adherence is influenced by the behavior of role models.
Schneider J, Moromisato D, Zemetra B, Rizzi-Wagner L, Rivero N, Mason W, Imperial-Perez F, Ross L.
From the Department of Anesthesiology Critical Care Medicine (JS, DM, BZ, LR-W, NR, FI-P); Division of Infectious Diseases (WM, LR); Department of Pediatric Critical Care Medicine (JS), Childrens Hospital Los Angeles, Los Angeles, CA.
OBJECTIVE:: Proper hand hygiene (HH) reduces nosocomial infections. Therefore, factors that influence HH behavior of healthcare workers are of great interest. We hypothesized that strict HH adherence by supervisor role models would improve the HH behavior of junior staff.
DESIGN:: Prospective observational study.
SETTING:: Pediatric and cardiac intensive care units of a tertiary care children's hospital. SUBJECTS:: Two critical care fellows and four nurse orientees.
INTERVENTIONS:: First, we observed and recorded HH adherence of the fellows and nurse orientees and their respective supervising attending physician or nurse preceptor during daily patient care. Subsequently, we paired the same fellows and nurse orientees with a different supervisor who maintained strict HH adherence, and again noted HH adherence. We used measures of HH opportunities and HH adherence consistent with guidelines set by the Centers for Disease Control and Association for Professionals in Infection Control and Epidemiology.
MEASUREMENTS AND MAIN RESULTS:: HH adherence by fellows and nurse orientees at baseline was 22% of 200 HH opportunities, and improved to 56% of 234 opportunities as a result of role modeling-an average increase of 34% points (95% confidence interval, 18.7-51; p < 0.01 by linear regression), representing a HH adherence rate greater than 1.5 times that of the baseline. The control senior practitioners' HH adherence rate was 20% of 180 opportunities compared with the study senior practitioners' HH adherence of 94% of 187 opportunities-an average difference of 72%points higher compared with the control senior practitioners (95% confidence interval, 56-88.3; p < 0.01 by linear regression).
CONCLUSIONS:: HH adherence of junior practitioners improved under the supervision of adherent role models. These results suggest that HH behavior of senior practitioners plays a crucial influence on other staff. Senior healthcare practitioners should consider the important role they may play in reinforcing or weakening a culture of patient safety and proper HH.
PMID: 19325501 [PubMed - as supplied by publisher]
Monday, 20 April 2009
Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensiv
Surgery Today. 2009;39(4):295-9. Epub 2009 Mar 25. LinkOut
Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit.
Chan KS, Tan CK, Fang CS, Tsai CL, Hou CC, Cheng KC, Lee MC.
Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
PURPOSE: To investigate the characteristics and outcomes of surgical patients who were readmitted to the intensive care unit (ICU).
METHODS: The data were collected for all readmissions to the surgical ICUs in a tertiary hospital in the year 2003.
RESULTS: Of all the 945 ICU discharges, 110 patients (11.6%) were readmitted. They had a longer initial ICU stay (8.05 +/- 7.17 vs 5.22 +/- 4.95, P < p =" 0.049)." p =" 0.001)" p =" 0.010).">
Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit.
Chan KS, Tan CK, Fang CS, Tsai CL, Hou CC, Cheng KC, Lee MC.
Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
PURPOSE: To investigate the characteristics and outcomes of surgical patients who were readmitted to the intensive care unit (ICU).
METHODS: The data were collected for all readmissions to the surgical ICUs in a tertiary hospital in the year 2003.
RESULTS: Of all the 945 ICU discharges, 110 patients (11.6%) were readmitted. They had a longer initial ICU stay (8.05 +/- 7.17 vs 5.22 +/- 4.95, P < p =" 0.049)." p =" 0.001)" p =" 0.010).">
CONCLUSION: The mortality of surgical patients with ICU readmission was high with respiratory complications being the most important issue.
PMID: 19319635 [PubMed - in process]
PMID: 19319635 [PubMed - in process]
Considerations in Caring for the Critically Ill Older Patient.
JOURNAL OF INTENSIVE CARE MEDICINE
VOL 24; NUMB 2; 2009
ISSN 0885-0666
pp. 83-95
Considerations in Caring for the Critically Ill Older Patient.
Pisani, M.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247950331&field=zid
VOL 24; NUMB 2; 2009
ISSN 0885-0666
pp. 83-95
Considerations in Caring for the Critically Ill Older Patient.
Pisani, M.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247950331&field=zid
Comparison of acceptability, skin tolerance, and compliance between handwashing and alcohol-based handrub in ICUs: results of a multicentric study.
Comparison of acceptability, skin tolerance, and compliance between handwashing and alcohol-based handrub in ICUs: results of a multicentric study.
Souweine B, Lautrette A, Aumeran C, Bénédit M, Constantin JM, Bonnard M, Guélon D, Amat G, Aublet B, Bonnet R, Traoré O.
Intensive Care Med. 2009 Apr 15. [Epub ahead of print]PMID: 19367395 [PubMed - as supplied by publisher]
Related Articles
Souweine B, Lautrette A, Aumeran C, Bénédit M, Constantin JM, Bonnard M, Guélon D, Amat G, Aublet B, Bonnet R, Traoré O.
Intensive Care Med. 2009 Apr 15. [Epub ahead of print]PMID: 19367395 [PubMed - as supplied by publisher]
Related Articles
Articles: Current Opinion in Critical Care
pp. 139-143
When should stress ulcer prophylaxis be used in the ICU?.
Quenot, J.-P.; Thiery, N.; Barbar, S.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812438&field=zid
pp. 144-148
Probiotics in the intensive care unit.
Morrow, L.E.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812440&field=zid
pp. 149-153
Clostridium difficile infection: current perspectives.
Janka, J.; O Grady, N.P.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812451&field=zid
pp. 163-167
Practical management of acute liver failure in the intensive care unit.
Trotter, J.F.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812476&field=zid
When should stress ulcer prophylaxis be used in the ICU?.
Quenot, J.-P.; Thiery, N.; Barbar, S.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812438&field=zid
pp. 144-148
Probiotics in the intensive care unit.
Morrow, L.E.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812440&field=zid
pp. 149-153
Clostridium difficile infection: current perspectives.
Janka, J.; O Grady, N.P.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812451&field=zid
pp. 163-167
Practical management of acute liver failure in the intensive care unit.
Trotter, J.F.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812476&field=zid
'Pain in the ICU'
'Pain in the ICU' report suggests comprehensive approach Apr 7, 2009 ... However, new reports suggest that taking a comprehensive approach to pain management may be the key to managing pain in the ICU and even ...
http://www.eurekalert.org/pub_releases/2009-04/acoc-it040709.php
http://www.eurekalert.org/pub_releases/2009-04/acoc-it040709.php
Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis
Critical Care
Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis
Bagshaw SM, Webb SA, Delaney A, George C, Pilcher D, Hart GK, Bellomo R Critical Care 2009, 13:R45 (1 April 2009)[Abstract] [Provisional PDF] [PubMed]
A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock Legras A, Giraudeau B, Jonville-Bera A, Camus C, Francois B, Runge I, Kouatchet A, Veinstein A, Tayoro J, Villers D, Autret-Leca E Critical Care 2009, 13:R43 (30 March 2009)[Abstract] [Provisional PDF] [PubMed]
Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis
Bagshaw SM, Webb SA, Delaney A, George C, Pilcher D, Hart GK, Bellomo R Critical Care 2009, 13:R45 (1 April 2009)[Abstract] [Provisional PDF] [PubMed]
A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock Legras A, Giraudeau B, Jonville-Bera A, Camus C, Francois B, Runge I, Kouatchet A, Veinstein A, Tayoro J, Villers D, Autret-Leca E Critical Care 2009, 13:R43 (30 March 2009)[Abstract] [Provisional PDF] [PubMed]
The End of Life Care Horizon Scanning Bulletin
The End of Life Care Horizon Scanning Bulletin has now been published at http://palliativecarenwpctl.wordpress.com/
To subscribe to future issues of the newsletter, visit http://feedburner.google.com/fb/a/mailverify?uri=PalliativeCareHorizonScanning&loc=en_US
McArdle LibraryIntegrated Library Service
Education CentreWirral University Teaching Hospital NHS TrustArrowe Park Hospital Arrowe Park Road Upton Wirral
To subscribe to future issues of the newsletter, visit http://feedburner.google.com/fb/a/mailverify?uri=PalliativeCareHorizonScanning&loc=en_US
McArdle LibraryIntegrated Library Service
Education CentreWirral University Teaching Hospital NHS TrustArrowe Park Hospital Arrowe Park Road Upton Wirral
Death, empathy and self preservation: the emotional labour of caring for families of the critically ill in adult intensive care
Death, empathy and self preservation: the emotional labour of caring for families of the critically ill in adult intensive care
Louise Caroline Stayt
Abstract
Published Online: 8 Apr 2009DOI 10.1111/j.1365-2702.2008.02712.x
Louise Caroline Stayt
Abstract
Published Online: 8 Apr 2009DOI 10.1111/j.1365-2702.2008.02712.x
Incidence and risk factors for pressure ulcers in the intensive care unit
Incidence and risk factors for pressure ulcers in the intensive care unit
Nele Nijs, Adinda Toppets, Tom Defloor, Kris Bernaerts, Koen Milisen, Greet Van Den Berghe
Abstract
Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02554.x
Nele Nijs, Adinda Toppets, Tom Defloor, Kris Bernaerts, Koen Milisen, Greet Van Den Berghe
Abstract
Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02554.x
A critical review of daily sedation interruption in the intensive care unit
Journal of Clinical Nursing Volume18, Issue9,2009. Early View (Articles Available Online in Advance of Print) © 2009 Blackwell Publishing Ltd
p1239-1249
A critical review of daily sedation interruption in the intensive care unit
Mark O'Connor, Tracey Bucknall, Elizabeth Manias
Abstract Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02513.x
p1239-1249
A critical review of daily sedation interruption in the intensive care unit
Mark O'Connor, Tracey Bucknall, Elizabeth Manias
Abstract Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02513.x
Dementia or delirium: Do you know the difference?.
NURSING CRITICAL CARE
VOL 4; NUMB 2; 2009
ISSN 1558-447X
pp. 24-31
Dementia or delirium: Do you know the difference?.
Forrant, J.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247673518&field=zid
VOL 4; NUMB 2; 2009
ISSN 1558-447X
pp. 24-31
Dementia or delirium: Do you know the difference?.
Forrant, J.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247673518&field=zid
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