Journal of critical care
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Journal of critical care · Mar 2005
When critical illness becomes chronic: informational needs of patients and families.
A large and growing group of intensive care unit survivors are "chronically critically ill," with ongoing respiratory failure and poor outcomes for postdischarge survival and functional recovery. In this qualitative study, we investigated what information is relevant and important for clinician-patient/family communication when critical illness becomes chronic, as indicated by tracheotomy for prolonged mechanical ventilation. ⋯ Given poor outcomes for most patients and high costs and burdens of treatment, effective communication is essential when critical illness enters a chronic phase. Our findings provide a framework for such communication and a basis for further research.
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Journal of critical care · Mar 2005
Comparative StudyInfrared ear thermometry in the critically ill patient.
The purpose of this clinical study was to determine the accuracy of infrared tympanic membrane thermometry compared to axillary temperature (tempAx) for detecting body temperature reliably in critically ill patients in the daily practice. ⋯ In adult intensive care unit patients, the infrared tympanic thermometer (ThermoScan 07) produced highly reliable measurements when compared to tempAx measured using a conventional mercury-in-glass thermometer. Both methods correlated positively and significantly.
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Estimating the required sample size for a study is necessary during the design phase to ensure that it will have maximal efficiency to answer the primary question of interest. Clinicians require a basic understanding of the principles underlying sample size calculation to interpret and apply research findings. This article reviews the critical components of sample size calculation, including the selection of a primary outcome, specification of the acceptable types I and II error rates, identification of the minimal clinically important difference, and estimation of the error associated with measuring the primary outcome. The relationship among confidence intervals, precision, and study power is also discussed.
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Journal of critical care · Mar 2005
Multicenter StudyDeath rounds: end-of-life discussions among medical residents in the intensive care unit.
We introduced "Death Rounds," a monthly discussion of the issues and emotions surrounding the care of dying patients, into the intensive care unit (ICU) rotations for medical house staff. We surveyed participating residents to evaluate their satisfaction with these discussions. ⋯ Death Rounds provide a unique opportunity for residents to discuss the issues raised in caring for dying patients. This conference can be easily incorporated into the ICU curriculum. Most residents who participated in the survey indicated that they valued Death Rounds and believed that it should be included in all ICU rotations.
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Journal of critical care · Mar 2005
Multicenter StudyCanadian nurses' and respiratory therapists' perspectives on withdrawal of life support in the intensive care unit.
To describe perspectives of nurses (RNs) and respiratory therapists (RTs) related to end-of-life care for critically ill patients. ⋯ Most RNs and RTs were comfortable with decision making and the process of life support withdrawal, but they suggested several ways to improve end-of-life care.