Journal of critical care
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Journal of critical care · Oct 2014
Cost savings with interventions to reduce aerosolized bronchodilator use in mechanically ventilated patients.
The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). ⋯ Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.
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Journal of critical care · Oct 2014
Low tissue oxygen saturation at emergency center triage is predictive of intensive care unit admission.
Timely recognition of critical patients by emergency center triage is an ongoing challenge. Peripheral tissue oxygen saturation (StO2) measurement has been used to monitor shock patients' responses to resuscitation. Interest has developed in evaluating StO2 as a triage tool, but limited studies have addressed critically ill patients. ⋯ In this patient population, an StO2 less than 70% significantly increased the risk of ICU admission. Tissue oxygen saturation at triage identifies critical patients who may not be recognized by vital signs alone. Tissue oxygen saturation measurement could help providers make earlier decisions regarding hospital resource allocation.
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Journal of critical care · Oct 2014
Accelerometer-based devices can be used to monitor sedation/agitation in the intensive care unit.
Monitoring sedation/agitation levels in patients in the intensive care unit (ICU) are important to direct treatment and to improve outcomes. This study was designed to determine the potential use of accelerometer-based sensors/devices to objectively measure sedation/agitation in patients admitted to the ICU. ⋯ Accelerometer data correlate strongly with the sedation/agitation levels of patients in the ICUs, and appropriately designed accelerometer-based sensors/devices have the potential to be used for automating objective and continuous monitoring of sedation/agitation levels in patients in the ICU.
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Journal of critical care · Oct 2014
Observational StudyInterruptions experienced by cardiovascular intensive care unit nurses: An observational study.
Intensive care unit (ICU) nurses get interrupted frequently. Although interruptions take cognitive resources from a primary task and may hinder performance, they may also convey critical information. Effective management of interruptions in ICUs requires the understanding of interruption characteristics, the context in which interruption happens, and interruption content. ⋯ Mitigation strategies other than blocking should also be explored. In addition, interrupters might have evaluated primary task severity before interrupting. Therefore, making task severity more transparent may help others modulate when and how they interrupt a nurse.
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Journal of critical care · Oct 2014
Platelet indices are novel predictors of hospital mortality in intensive care unit patients.
Platelet volume indices (PVIs) are inexpensive and readily available in intensive care units (ICUs). However, their association with mortality has never been investigated in a critical care setting. Our study aimed to investigate the association of PVI and mortality in unselected ICU patients. ⋯ Higher MPV and PDW are associated with increased risk of death, whereas the decrease in plateletcrit is associated with increased mortality risk.