Journal of critical care
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Journal of critical care · Sep 2007
Multicenter Study Comparative StudyMethodological approach for the evaluation of the performances of medical intensive care units.
The purpose of the study was to present a methodological approach enabling the comparison of clinical and economic performances of intensive care units and a graphical visualization based on these 2 dimensions. ⋯ These graphs enable the identification of the most deviating intensive care units to study, for example, their organizational, technical, or human resource setup accounting for their position.
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Journal of critical care · Sep 2007
Multicenter Study Comparative StudyIntensive care unit safety incidents for medical versus surgical patients: a prospective multicenter study.
The aim of this study is to determine if patient safety incidents and the system-related factors contributing to them systematically differ for medical versus surgical patients in intensive care units. ⋯ Medical and surgical patients in the intensive care unit experience very similar types of safety incidents with similar associated patient harm and system factors. Common initiatives to improve patient safety for medical and surgical patients should be undertaken with a specific focus on improving training and teamwork among the intensive care team.
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Journal of critical care · Sep 2007
Multicenter Study Comparative StudyThe COASST study: cost-effectiveness of albumin in severe sepsis and septic shock.
The cost-effectiveness of albumin-based fluid support in patients with severe sepsis is not known. ⋯ The application of the SAFE Study results to CUB-Réa data shows that albumin infusion is cost-effective in severe sepsis.
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Journal of critical care · Sep 2007
Multicenter StudyA multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation.
Nursing-directed sedation protocols have been shown to reduce the duration of mechanical ventilation and shorten the length of intensive care unit (ICU) stay among critically ill adult patients. ⋯ In this survey of ICU nurses, we identified a perceived need for improvement in sedation and analgesia practices. Most respondents believed that the use of a nursing-directed sedation protocol in combination with a sedation scoring system would provide greater practice consistency among nurses and physicians and thus improve the care of critically ill patients.
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Journal of critical care · Jun 2007
Multicenter Study Comparative StudyImpact of the Leapfrog Group's intensive care unit physician staffing standard.
The aim of this study was to describe hospital efforts to meet the Leapfrog Group's intensive care unit (ICU) physician staffing (IPS) standard; compare adopters and committers with resisters relative to perceived benefits, barriers and motivating factors; and examine implementation strategies. ⋯ Most hospitals-including half of those who publicly resisted the standard-made attempts to change physician staffing in their ICUs, based on the criteria outlined by the Leapfrog Group. Major barriers that need addressing are implementation costs and convincing hospital organizations and medical staff regarding the benefits of adopting the standard.