OBJECTIVE To describe perceptions of the administrative procedures for seasonal bed closures and their consequences in the intensive care unit (ICU), and to critique this example of health care priority setting for legitimacy and fairness. DESIGN A qualitative study using case study methods and interviews with key participants. We evaluated fairness and legitimacy of the bed closure process u...

OBJECTIVES Longitudinal studies exploring the evolution of health information technology functions provide valuable information about how technology systems are integrated and exploited in situ. This study reports changes in the distribution of functions for a specific health information technology, the tele-ICU, over time. The studied tele-ICU provided care to six remote ICUs within a local ge...

The need for collaboration and data sharing among systems dedicated to individual functional areas and user groups has initiated major efforts towards the development of an integrated hospital information system. Major issues in the development of any integrated architecture that incorporates autonomous departmental systems include the development of commonly accepted interaction mechanisms, st...

“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit, ” send it to CRITICAL CARE NURSE, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 3622049; e-mail, [email protected]. The process of being “Beacon ...

BACKGROUND Since the onset of military operations in Iraq and Afghanistan, there has been a marked increased in multidrug resistant bacterial infections among combat casualties. We describe the rates of ventilator-associated pneumonia (VAP) before and after the implementation of aggressive infection control measures at the Air Force Theater Hospital in Iraq. METHODS All patients admitted to t...

INTRODUCTION UK policy recommendations advocate the use of intensive care unit (ICU) follow-up services to help detect and treat patients' physical and emotional problems after hospital discharge and as a means of service evaluation. This study explores patients' perceptions and experiences of these services. METHODS Thirty-four former ICU patients were recruited throughout the UK, using maxi...

OBJECTIVES To investigate the state of the mental well-being of patients from ethnic minority groups and possible related risk factors for the development of mental health problems among these patients during critical medical situations in hospital. DESIGN Qualitative ethnographic design. SETTING Oneintensive care unit (ICU) of a multiethnic urban hospital in Belgium. PARTICIPANTS 84 ICU ...

The accumulation of a number of acutely ill patients within a relatively small area, such as we see in the Intensive Care Unit (ICU), increases the potential for the development of infections, both endogenous and acquired. Infection has been a problem in ICUs for as long as these units have existed, especially in those undisciplined units where policies for antibiotic usage and infection contro...

OBJECTIVES To determine if a quality improvement intervention improves sleep and delirium/cognition. DESIGN Observational, pre-post design. SETTING A tertiary academic hospital in the United States. PATIENTS 300 medical ICU patients. INTERVENTIONS This medical ICU-wide project involved a "usual care" baseline stage, followed by a quality improvement stage incorporating multifaceted slee...

Background The Emergency Department length of stay for patients requiring mechanical ventilation paper in this issue is very illustrative of many variables that still confound the way we treat patients that may not require endotracheal intubation (ETI) but may benefit from non-invasive mechanical ventilation (NIV) [1]. Rose L et al. bring to light several important aspects the chief of which is...