Browsing by Subject "intensive care"

Now showing 1 - 4 of 4
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    Beyond the ICU: The Association Between Post Intensive Care Syndrome and Survivors of Severe COVID-19
    (ATS, 2021) Seyffert, S. A.; Khan, S. H.; Lindroth, H. L.; Wang, S.; Khan, B. A.; Medicine, School of Medicine
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    Communication Between Registered Nurses and Family Members of Intensive Care Unit Patients
    (AACN, 2022-12-01) Dees, Mandy L.; Carpenter, Janet S.; Hoffman-Longtin, Krista; School of Nursing
    Background Effective communication between intensive care unit patients and their families and nurses promotes relationship-centered care and improves nurses’ ability to meet patient and family needs. However, communication with these patients is challenging because of their critical illness. Families often become surrogate decision makers for adult intensive care unit patients. Objective To systematically assess available evidence on communication between adult intensive care unit patients and their families and nurses as the initial step in developing nursing strategies to strengthen communication skills. Methods In this integrative review, the method of Whittemore and Knafl was used to synthesize findings from qualitative and quantitative (descriptive and experimental) research. Results The review revealed a variety of research designs, measurement tools, and types of interventions. The qualitative findings suggest that nurses can strengthen relationship-centered care by regularly updating patients’ families and providing information that can assist with decision-making. The quantitative findings suggest that nurses should be mindful of family members’ needs for assurance, comfort, and support. Providing information on patient status can help alleviate family concerns. Conclusions Improved communication between patients and families and intensive care unit nurses is essential to strengthen relationship-centered care. Additional research is needed to better understand the communication needs of adult patients and their families in the intensive care unit.
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    Infant/Early Childhood Mental Health and Collaborative Partnerships: Beyond the NICU
    (Elsevier, 2016-12) Tomlin, Angela M.; Deloian, Barbara; Wollesen, Linda; Department of Pediatrics, School of Medicine
    The NICU experience impacts all family dynamics not just during the intensive care unit stay but in the months and years afterwards. For each family, the first experiences with their baby, whether in the home or the intensive care unit, can set the trajectory for the long-term parent–child relationship and the parent's perspective of their parent roles. These difficult experiences have the potential to be addressed through infant and early childhood mental health (I/ECMH) methods. In this article we review the need for a wide range of social and emotional supports that present in intensive care and continue as families and infants transition to home and community. The potential for addressing these ongoing issues by a variety of providers within many different settings using Infant and Early Childhood Mental Health (I/ECMH) approaches is discussed and examples of successful programs are provided. Finally, we make recommendations for infusing I/ECMH across programs that serve intensive care unit graduates and their families, from the hospital to the home, with primary care providers and other community support programs.
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    Reducing Unnecessary Nitric Oxide Use: A Hospital-Wide, Respiratory Therapist-Driven Quality Improvement Project
    (Daedalus Enterprises, 2021-01) Rogerson, Colin M.; Tori, Alvaro J.; Hole, Acrista J.; Summitt, Elizabeth; Allen, Jayme D.; Abu-Sultaneh, Samer; Valentine, Kevin M.; Pediatrics, School of Medicine
    BACKGROUND: We sought to evaluate the institutional use of inhaled nitric oxide (INO) and to create a pathway to reduce waste using the Institute for Healthcare Improvement's model for improvement. Our aim was to reduce the use of INO by 20% within 8 months. METHODS: This was a prospective, respiratory therapist-driven, quality improvement project. We implemented a hospital-wide INO utilization protocol that was developed by neonatology, pediatric critical care, cardiac critical care, and respiratory therapy. INO use and respiratory therapist input for protocol failures were derived from the electronic medical record and were used to generate improvement opportunities. Monthly total hospital use of INO (in hours) was used as the primary outcome measure. Median hourly use per subject (evaluated in groups of 7 subjects) was used as a secondary outcome measure. New sildenafil dosing was tabulated for pre- and post-INO weaning protocol intervention as a balancing measure. Subjects included all patients in the hospital who were given INO therapy during the specified timeframe. RESULTS: Hospital-wide total hours were reduced from 1,515 h/month to 930 h/month. This hospital-wide reduction of 39% equates to a cost-avoidance of approximately $912,000 per year based on 2018 costs of INO of $130 per hour. Median hours of INO per subject decreased from 88 h to 50 h. Sildenafil was started in 18 of 98 subjects (18%) in the pre-intervention period and in 12 of 109 subjects (11%) in the post-intervention period (P = .27). CONCLUSIONS: A hospital-wide, multi-professional initiative led to a reduction in unnecessary INO use, resulting in decreased subject exposure and associated cost avoidance.