Articles: intensive-care-units.
-
Intensive care medicine · Jan 2000
Study of paediatric intensive care units in Spain. Spanish Society of Paediatric Intensive Care.
To describe the organisation of paediatric intensive care units in Spain and the medical assistance provided during 1996. ⋯ In Spain, paediatric intensive care is principally performed by specialised paediatricians. Although the general results for 1996 are similar to those of other European countries, efficiency studies are necessary to plan and re-organise the paediatric intensive care units in Spain.
-
J Clin Monit Comput · Jan 2000
Computerisation and decision making in neonatal intensive care: a cognitive engineering investigation.
This paper reports results from a cognitive engineering study that looked at the role of computerised monitoring in neonatal intensive care. A range of methodologies was used: interviews with neonatal staff, ward observations, and experimental techniques. ⋯ Factors that seemed to affect staff use of the computer were the lack (or shortage) of training on the system, the specific clinical conditions involved, and the availability of alternative sources of information. These findings have relevant repercussions for the design of computerised decision support in intensive care and suggest ways in which computerised monitoring can be enhanced, namely: by systematic staff training, by making available online certain types of clinical information, by adapting the user interface, and by developing intelligent algorithms.
-
Klinische Pädiatrie · Jan 2000
Case Reports[Surveillance of nosocomial infections: prospective study in a pediatric intensive care unit. Background, patients and methods].
BACKGROUND, PATIENTS AND METHODS: From November 1997 through May 1998, the incidence of nosocomial infections was studied prospectively in a 10-bed multidisciplinary pediatric intensive care unit in Germany. A standardized surveillance [SEKI] system based on the National Nosocomial Infection Surveillance [NNIS] System of the Centers for Disease Control and Prevention [CDC] was used. The CDC definitions for nosocomial infections were adapted to the current practice of pediatric intensive care in Germany. Infection rates were calculated as infections per 100 patients, per 1000 patient-days, and per 1000 device-days (central venous catheters, urinary-catheters, and mechanical ventilation). ⋯ Surveillance data are indispensable for internal and external quality control, and prospective surveillance of nosocomial infections should become an essential component of hospital infection control programs in pediatric intensive care in Germany. The standardized calculation of (device utilization ratios and) device-specific infection rates yields results which can be compared with national and international surveillance data. SEKI meets the criteria of a practice oriented, prospective and standardized surveillance system. Considerable efforts for collecting and interpreting the required data should be balanced against the benefit of prevention of nosocomial infections in this population of critically ill persons.
-
The patients' mortality with multiple organ failure (MOF) is very high and patients who consume the most resources are those with uncertain prognosis. In order to use the limited resources adequately, it is necessary to know the cost-benefit relationship of their treatment and in this study cost, mortality, quality of life (QOL) of survivors who developed MOF has been investigated. ⋯ A high proportion of resources were used by MOF patients, but patients who died and who remained with worst QOL consumed the highest part. Although the mortality after one year was high (72%), 80% of the survivors achieved an acceptable QOL and for this reason, treatment of these patients should not be limited if survival and QOL predictions are not 100% correct.
-
Enfermería intensiva · Jan 2000
[Patients' sleep in intensive care units and sleep-modifying factors].
Patients admitted to intensive care units sleep poorly, generally because of the environmental conditions of these units. Sleep deprivation in critical patients has severe consequences and can contribute to deterioration of their condition. The quality of sleep of the patients in our unit was evaluated to identify factors that they considered disruptive of sleep. ⋯ The most disruptive environmental factor was the sound of alarms, pain bothered patients more than fear or anxiety, and endotracheal intubation and mechanical ventilation were the techniques that most interfered with sleep. The quality of sleep of patients in the unit was apparently uninfluenced by pre-admission sleep problems, the severity of the process, or the type of analgesia-sedation administered. The largest percentage of patients who slept poorly had been admitted to one of the wings of the unit, which should be studied specifically.