Journal of critical care
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Journal of critical care · Feb 2014
Consideration of additional factors in Sequential Organ Failure Assessment score.
The Sequential Organ Failure Assessment (SOFA) score, originally developed to assess organ failure status, is widely used as a prognostic indicator in intensive care unit patients. Additional prognostic factors, such as age and comorbidities, may complement the predictive performance of the SOFA. ⋯ The performance of the SOFA score to predict hospital mortality can be improved by considering age and comorbidity factors.
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Journal of critical care · Feb 2014
Utilization and impact on fellowship training of non-physician advanced practice providers in intensive care units of academic medical centers: a survey of critical care program directors.
Non-physician advanced practice providers (APPs) such as nurse practitioners and physician assistants are being increasingly utilized as critical care providers in the United States. The objectives of this study were to determine the utilization of APPs in the intensive care units (ICU)s of academic medical centers (AMCs) and to assess the perceptions of critical care fellowship program directors (PDs) regarding the impact of these APPs on fellowship training. ⋯ Our survey revealed that APPs are utilized in a large number of US AMCs with critical care training programs. Program director respondents believed that patient care and fellowship training were positively impacted by APPs.
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Journal of critical care · Feb 2014
Teaching and practicing cost-awareness in the intensive care unit: A TARGET to aim for.
Intensive care is one of the main contributors to rising inpatient hospital costs due to frequent use of expensive diagnostics and therapies. With successful track records of team- and protocol-based care, intensive care units are ideal sites to take the lead in reducing overuse and misuse of diagnostic tests and prescribing. We offer a framework for practicing and teaching cost-awareness in the intensive care unit based on the acronym TARGET. The components of the care are as follows: Talk to patients about their preferences for care, Ask for outside tests, avoid Routine and/or Repeated tests, prescribe Generic medications, Educate about costs, and Transfuse appropriately.