Journal of critical care
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Journal of critical care · Apr 2017
Clinical utility of methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction assay in critically ill patients with nosocomial pneumonia.
This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. ⋯ In critically ill patients, an MRSA nasal PCR assay has a high NPV for nosocomial pneumonia and can be used to guide vancomycin de-escalation.
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Journal of critical care · Apr 2017
Practice GuidelineEvidence-based guidelines for the use of tracheostomy in critically ill patients.
To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. ⋯ Percutaneous techniques are associated with a lower risk of infections compared with surgical tracheostomy. Early tracheostomy only seems to reduce the duration of ventilator use but not the incidence of pneumonia, the length of stay, or the long-term mortality rate. The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure. Finally, proper prior training is as important or even a more significant factor in reducing complications than the technique used.
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Journal of critical care · Apr 2017
Opportunities for interprofessional input into nurse and physician hand-off communication.
Hand-offs are vulnerable times for hospitalized patients. Nurses and physicians routinely engage in hand-off communication but their communications remains siloed. Our objectives were to identify key information from each profession that would be of use to the other's hand-off process, and to identify facilitators and barriers to obtaining that input. ⋯ There are key areas of content that both physicians and nurses would like from the other profession to enhance intensive care unit hand-off communication. Interventions designed to increase interdisciplinary communication should focus on these key areas of content.
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Journal of critical care · Apr 2017
Perspectives of patients and family members regarding psychological support using intensive care diaries: An exploratory mixed methods study.
Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what information delivery method is preferred. ⋯ Patient and relative preferences of receiving a diary are not related to psychological distress. Diverse opinions around common themes suggest the need for a range of interventions to aid psychological recovery.
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Journal of critical care · Apr 2017
Sepsis in Haiti: Prevalence, treatment, and outcomes in a Port-au-Prince referral hospital.
Developing countries carry the greatest burden of sepsis, yet few descriptive data exist from the Western Hemisphere. We conducted a retrospective cohort study to elucidate the presentation, treatment, and outcomes of sepsis at an urban referral hospital in Port-au-Prince, Haiti. ⋯ This is the first descriptive study of sepsis in Haiti. Our findings contribute to the knowledge base of global sepsis and reveal similarities in independent predictors of mortality between high- and low-income countries.