Articles: checklist.
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Measuring the quality of care at the end of life and/or the quality of dying and death can be challenging. Some measurement tools seek to assess the quality of care immediately prior to death; others retrospectively assess, following death, the quality of end-of-life care. The comparative evaluation of the properties and application of the various instruments has been limited. ⋯ Four tools demonstrated some promise, but no single tool was consistent across all psychometric properties assessed. All tools identified would benefit from further psychometric testing.
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Eur J Cardiothorac Surg · Apr 2019
Reduced re-exploration and blood product transfusion after the introduction of the Papworth haemostasis checklist†.
Between 2% and 8% of patients return to the theatre for mediastinal bleeding following cardiac surgery. In the majority of patients, a surgical source of bleeding is identified. Both mediastinal bleeding and re-exploration are associated with increased morbidity and mortality and the use of blood products. The aim of this study was to develop a 'haemostasis checklist' with the intention of reducing mediastinal bleeding and re-exploration following cardiac surgery. ⋯ The haemostasis checklist represents a simple intervention which is quick and easy to use but has had a substantial impact on clinical outcomes. We have observed a significant reduction in the mediastinal blood loss, return-to-theatre rate and consumption of blood products, which is associated with a significant clinical and financial benefit.
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Drug courts, therapeutic justice programs for individuals charged with drug offenses, have sub-optimal completion rates. The Courtroom Behavior Checklist (CRBCL), an assessment that quantifies readiness for drug court and drug court behaviors, was developed to predict female offenders who may be at-risk for non-compliance and termination. Data derived from 264 mainly urban women recruited from a Municipal Drug Court System in St. ⋯ Other factors significantly associated with unfavorable drug court behaviors included greater lifetime arrests, lower education, and being less religious or spiritual. Our findings suggest that the CRBCL may have added utility in identifying women in drug court with recent substance use and risky sexual behaviors. However, further studies on other samples of offenders are needed to support these findings.
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Acta Anaesthesiol Scand · Mar 2019
Delirium assessment in neuro-critically ill patients: A validation study.
Delirium is underinvestigated in the neuro-critically ill, although the harmful effect of delirium is well established in patients in medical and surgical intensive care units (ICU).To detect delirium, a valid tool is needed. We hypothesized that delirium screening would be feasible in patients with acute brain injury and we aimed to validate and compare the Confusion Assessment Method for the ICU and the Intensive Care Delirium Screening Checklist against clinical International Classification of Diseases-10 criteria as reference. ⋯ Our findings suggest that the Intensive Care Delirium Screening Checklist may be a valid tool and the Confusion Assessment Method for the ICU is less suitable for delirium detection for patients in the Neuro-ICU. In the neuro-critically ill, delirium screening is challenged by limited feasibility.