Articles: hospitals.
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Critical care medicine · Jan 1998
Multicenter StudyConfidence in life-support decisions in the intensive care unit: a survey of healthcare workers. Canadian Critical Care Trials Group.
To examine the relationship between intensive care unit (ICU) healthcare workers' confidence and their decision to withdraw life support. ⋯ While confidence in decisions about withdrawal of life support increases with seniority and authority, consistency of decisions may not. When given standard information, healthcare workers can make contradictory decisions yet still be very confident about the level of care they would administer.
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The National Veterans Affairs Surgical Risk Study was designed to collect reliable, valid data on patient risk and outcomes for major surgery in the Veterans Health Administration and to report comparative risk-adjusted postoperative mortality rates for surgical services in Veterans Health Administration. ⋯ The Department of Veterans Affairs has successfully implemented a system for the prospective collection and comparative reporting of risk-adjusted postoperative mortality rates after major noncardiac operations. Risk adjustment had an appreciable impact on the rank ordering of the hospitals and provided a means for monitoring and potentially improving the quality of surgical care.
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The National Veterans Affairs Surgical Risk Study was designed to collect reliable, valid data on patient risk and outcomes for major surgery in the Veterans Health Administration and to report comparative risk-adjusted postoperative mortality and morbidity rates for surgical services in the Veterans Health Administration. ⋯ The Department of Veterans Affairs has successfully implemented a system for the prospective collection and comparative reporting of postoperative mortality and morbidity rates after major noncardiac operations. Risk adjustment had only a modest effect on the rank order of the hospitals.
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Sepsis syndrome is a leading cause of mortality in hospitalized patients. However, few studies have described the epidemiology of sepsis syndrome in a hospitalwide population. ⋯ Sepsis syndrome is common in academic hospitals, although the overall rates vary considerably with the patient population. A substantial fraction of cases occur outside ICUs. An understanding of the hospitalwide epidemiology of sepsis syndrome is vital for rational planning and treatment of hospitalized patients with sepsis syndrome, especially as new and expensive therapeutic agents become available.
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Multicenter Study
Incidence of falls in three different types of geriatric care. A Swedish prospective study.
The incidence and consequences of falls were investigated in three different types of Swedish geriatric care clinics: a geriatric rehabilitation clinic, a psychogeriatric clinic and a nursing home. Falls were prospectively registered by the nursing staff. ⋯ Most falls (62%) did not result in injury, while major injuries occurred in 5%. We conclude that accidental falls are a major problem in geriatric care in Sweden, but there is a considerable difference in incidence rates between different types of institutions.