Articles: intensive-care-units.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.
The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. ⋯ The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.
-
Intensive care medicine · Nov 1995
The impact of HIV testing on blood utilization in the intensive care unit in patients with gastrointestinal bleeding.
To determine whether the AIDS epidemic has influenced physician use of blood products in intensive care unit management of gastrointestinal hemorrhage. ⋯ These data indicate that physicians are transfusing patients at lower hemoglobin levels than they did before the beginning of HIV testing. However, there has been no decrease in the total median amount of blood products transfused since that time. This change in practice may be due to increased concern about HIV transmission through blood products and suggests the need for greater awareness of existing transfusion guidelines.
-
Japanese heart journal · Nov 1995
Case ReportsCorrected transposition of the great arteries: dynamic three-dimensional echocardiography and volumetry. A new diagnostic tool in intensive care management.
Today, an increasing incidence of severe complications of cardiac malformations in adult patients must be expected since the life expectancy of such individuals is prolonged due to improved management. A 32-year-old woman with corrected transposition of the great arteries (CTGA) was admitted to the intensive care unit because of cardiac decompensation. ⋯ In CTGA uncommon complications may cause pulmonary edema. Using dynamic three-dimensional echocardiography to reveal function, volume parameters and the morphology of both ventricles and to exclude additional complications may be considered an adequate diagnostic tool for responding to this challenge.
-
Randomized Controlled Trial Comparative Study Clinical Trial
The cost-effectiveness of a special care unit to care for the chronically critically ill.
To assess the relative value of healthcare programs, technologic innovations, and clinical decisions, policymakers are searching for ways to evaluate cost-effectiveness. What constitutes cost-effectiveness and how should it be measured? The authors discuss ways in which the cost-effectiveness of clinical programs can be measured and describes various methods of assessing both costs and effectiveness. Comparison of the cost-effectiveness of a nurse managed special care unit with that of traditional intensive care units illustrates some of these methods.