scholarly journals Exploring and managing psychiatric symptoms in ICU healthcare professionals during the ongoing COVID-19 pandemic: a focused review and guideline

2021 ◽  
Vol 9 (41) ◽  
pp. 28-34
Author(s):  
Ashish Sarangi ◽  
Dalynn Kim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Professionals ◽  
Psychiatric Symptoms ◽  
Psychological Adaptation ◽  
Intensive Care Unit Setting ◽  
Healthcare Personnel ◽  
Secondary Effects ◽  
Healthcare Staff ◽  
The Impact

  Introduction: The COVID-19 pandemic has ravaged the healthcare system and stretched resources thin. The impact on healthcare staff working in the intensive care unit setting has been especially devastating.   Objective: To conduct a review of the impact of the pandemic on healthcare personnel in the intensive care unit setting in the hope of utilizing information gathered to inform various stakeholders.   Design: Focused literature and abstract review   Conclusion: This article seeks to highlight the association between critical care as it relates to trauma and COVID-19 and point stakeholders toward opportunities for anticipating and managing secondary effects in effort to promote psychological adaptation.

Assessment of Healthcare Professionals' Adherence to Hand Hygiene After Alcohol-Based Hand Rub Introduction at an Intensive Care Unit in São Paulo, Brazil

2007 ◽  
Vol 28 (3) ◽  
pp. 365-367 ◽  
Author(s):  
Solange L. Santana ◽  
Guilherme H. C. Furtado ◽  
Ana Paula Coutinho ◽  
Eduardo A. S. Medeiros
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Educational Program ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Night Shift ◽  
Nursing Assistants ◽  
Invasive Procedures ◽  
The Impact

We analyzed the impact of introducing an alcohol-based hand gel and an educational program on hand hygiene adherence among healthcare workers in an intensive care unit. Adherence to hand hygiene was significantly higher after the intervention for the night shift work period (P = .001), among nursing assistants (P = .001), among nurses (P = .007) on weekend days (P = .016), and for invasive procedures (P = .012).

scholarly journals Patient to healthcare personnel transmission of MRSA in the non–intensive care unit setting

2020 ◽  
Vol 41 (5) ◽  
pp. 601-603
Author(s):  
Gita Nadimpalli ◽  
Lyndsay M. O’Hara ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Patient Care ◽  
Transmission Rate ◽  
Intensive Care Unit Setting ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Methicillin Resistant ◽  
Contact Precautions

AbstractThe transmission rate of methicillin-resistant Staphylococcus aureus (MRSA) to gloves or gowns of healthcare personnel (HCP) caring for MRSA patients in a non–intensive care unit setting was 5.4%. Contamination rates were higher among HCP performing direct patient care and when patients had detectable MRSA on their body. These findings may inform risk-based contact precautions.

scholarly journals Evaluation of Basal Insulin Dose Reductions in Hospitalized Patients With Diabetes While Unable to Eat

2019 ◽  
Vol 55 (4) ◽  
pp. 246-252
Author(s):  
Sarah E. Petite ◽  
Joseph Huenecke ◽  
Natalie Tuttle
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Severe Hypoglycemia ◽  
Hospitalized Patients ◽  
Intensive Care Unit Setting ◽  
Hospital Length Of Stay ◽  
Insulin Regimen ◽  
The Impact

Background: The American Diabetes Association guidelines recommend a basal plus correction or basal insulin regimen for patients with type 2 diabetes mellitus (T2DM) receiving nothing by mouth (NPO; nil per os) in the non–intensive care unit setting. In the perioperative setting, 60% to 80% of long-acting insulin or half-dose morning insulin NPH is recommended. Objective: The goal of this study was to determine the impact of basal insulin dose reduction for hospitalized patients with insulin-dependent T2DM while NPO. Methods: This retrospective, single-center study evaluated patients admitted to the non–intensive care unit setting. Administration of >50% of home basal insulin was compared with administration of ≤50% of home basal insulin. The primary outcome was the difference in hypoglycemic events (blood glucose [BG] < 70 mg/dL). Secondary outcomes included comparing severe hypoglycemic events (BG < 40 mg/dL), hyperglycemic events (BG > 180 mg/dL), and hospital length of stay (LOS). Results: Two hundred fifty-eight patient encounters were included, of which 85 and 173 patients received ≤50% and >50% of their home basal insulin dose, respectively. There were no significant differences in hypoglycemia (21.2% vs 21.4%; P = .97), severe hypoglycemia (1.2% vs 2.9%; P = .67), and hospital LOS (3 [IQR 2.13-6.74] days vs 4.66 [IQR 2.94-8.17] days; P = .74). Hyperglycemia occurred at a higher rate in patients receiving ≤50% of their home basal insulin dose (97.6% vs 89%; P = .02). Conclusions: No differences were observed in hypoglycemic events between those patients receiving ≤50% and >50% of their home basal insulin.

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Hospital Type ◽  
Vaccination Rates ◽  
Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

Differential impact of on-site or telepharmacy in the intensive care unit: a controlled before–after study

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Sandra Cristina Hernandes ◽  
Talita Teles Teixeira Pereira ◽  
Shana Oliveira ◽  
Denis de Melo Soares ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Phase 1 ◽  
Phase 2 ◽  
Differential Impact ◽  
Scarce Resources ◽  
Clinical Pharmacists ◽  
Versus Phase ◽  
Quasi Experimental ◽  
The Impact

Abstract Background Clinical pharmacists have an important role in the intensive care unit (ICU) team but are scarce resources. Our aim was to evaluate the impact of on-site pharmacists on medical prescriptions in the ICU. Methods This is a retrospective, quasi-experimental, controlled before-after study in two ICUs. Interventions by pharmacists were evaluated in phase 1 (February to November 2016) and phase 2 (February to May 2017) in ICU A (intervention) and ICU B (control). In phase 1, both ICUs had a telepharmacy service in which medical prescriptions were evaluated and interventions were made remotely. In phase 2, an on-site pharmacist was implemented in ICU A, but not in ICU B. We compared the number of interventions that were accepted in phase 1 versus phase 2. Results During the study period, 8797/9603 (91.6%) prescriptions were evaluated, and 935 (10.6%) needed intervention. In phase 2, there was an increase in the proportion of interventions that were accepted by the physician in comparison to phase 1 (93.9% versus 76.8%, P &lt; 0.001) in ICU A, but there was no change in ICU B (75.2% versus 73.9%, P = 0.845). Conclusion An on-site pharmacist in the ICU was associated with an increase in the proportion of interventions that were accepted by physicians.

The presence of liver cirrhosis is a strong negative predictor of survival for patients admitted to the intensive care unit – Cirrhosis in intensive care patients

2021 ◽  
Author(s):  
Jörg Bojunga ◽  
Mireen Friedrich-Rust ◽  
Alica Kubesch ◽  
Kai Henrik Peiffer ◽  
Hannes Abramowski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Liver Cirrhosis ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Intensive Care Treatment ◽  
Matched Cohort ◽  
Care Treatment ◽  
Cirrhotic Patients ◽  
The Impact ◽  
Cirrhotic Group

Abstract Background and Aims Liver cirrhosis is a systemic disease that substantially impacts the body’s physiology, especially in advanced stages. Accordingly, the outcome of patients with cirrhosis requiring intensive care treatment is poor. We aimed to analyze the impact of cirrhosis on mortality of intensive care unit (ICU) patients compared to other frequent chronic diseases and conditions. Methods In this retrospective study, patients admitted over three years to the ICU of the Department of Medicine of the University Hospital Frankfurt were included. Patients were matched for age, gender, pre-existing conditions, simplified acute physiology score (SAPS II), and therapeutic intervention scoring system (TISS). Results A total of 567 patients admitted to the ICU were included in the study; 99 (17.5 %) patients had liver cirrhosis. A total of 129 patients were included in the matched cohort for the sensitivity analysis. In-hospital mortality was higher in cirrhotic patients than non-cirrhotic patients (p < 0.0001) in the entire and matched cohort. Liver cirrhosis remained one of the strongest independent predictors of in-hospital mortality (entire cohort p = 0.001; matched cohort p = 0.03) along with dialysis and need for transfusion in the multivariate logistic regression analysis. Furthermore, in the cirrhotic group, the need for kidney replacement therapy (p < 0.001) and blood transfusion (p < 0.001) was significantly higher than in the non-cirrhotic group.  Conclusions In the presented study, liver cirrhosis was one of the strongest predictors of in-hospital mortality in patients needing intensive care treatment along with dialysis and the need for ventilation. Therefore, concerted efforts are needed to improve cirrhotic patients’ outcomes, prevent disease progression, and avoid complications with the need for ICU treatment in the early stages of the disease.

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