Telemedicine in the intensive care unit environment—A survey of the attitudes and perspectives of critical care clinicians

Purpose

This study was conducted to assess the preimplementation knowledge and perceptions of intensive care unit (ICU) clinicians regarding the ability of telemedicine in the ICU environment (Tele-ICU) to address challenges resulting from the shortages of experienced critical care human resources and the drive to improve quality of care.

Methods

An online survey was administered to clinicians from a Canadian multisite critical care department. Qualitative and quantitative analyses were undertaken to identify key positive and negative themes.

Results

The overall self-rated knowledge about Tele-ICU was low, with significant uncertainty particularly related to the novelty of the technology, lack of widespread existing implementations, and insufficient education. A significant degree of skepticism was expressed regarding the ability of Tele-ICU to address the challenges of staff shortages and quality of care.

Conclusions

Significant uncertainty and skepticism were expressed by critical care clinicians regarding the ability of Tele-ICU to address the challenges of human resource limitation and the delivery of quality care. This suggests the need for further research and education of system impact beyond patient outcomes related to this new technology.     

Nurse Practitioner Use of Point-of-Care Ultrasound in Critical Care

The use of point-of-care ultrasound (POCUS) is considered the standard of care in the management of patients in the intensive care unit (ICU). No current evidence demonstrates the ability of ICU NPs to accurately utilize POCUS. The purpose of this project was to determine ICU NPs’ ability to accurately acquire and interpret POCUS images. NPs working in a surgical ICU obtained POCUS images of the inferior vena cava and documented their interpretation of the volume status of the patient based on the image. ICU NPs demonstrated 86% acquisition accuracy and 80.5% interpretation accuracy of POCUS images.     

The Critical Care Research Network: a partnership in community-based research and research transfer

The objectives of this study were to present a short history of the Critical Care Research Network (CCR‐Net), describe its approach to health services research and to summarize completed and current research projects. In doing this, we explored the question is this research network accomplishing its goals? We reviewed the medical literature to identify studies on similar types of Networks and also the evidence supporting the methodology used by CCR‐Net to conduct research using MEDLINE, HEALTHSTAR, CINAHL and the keywords network and health care or healthcare, benchmarking and health care or healthcare, and research transfer or research utilization. We also reviewed the bibliographies of retrieved articles and our personal files. In addition, we summarized the results of studies conducted by CCR‐Net and outlined those currently in progress. A review of the literature identified studies on two similar networks that appeared to be succeeding. In addition, the literature was also supportive of the general process used by CCR‐Net, although the level of evidence varied. Finally, the studies conducted to date within CCR‐Net follow the suggested methodology. At the time of this preliminary communication CCR‐Net appears to have adopted a valid approach to health services research within the area of Critical Care Medicine. Further direct evidence is required and appropriate studies are planned.     

NICU危重患者家属需求与护士对家属需求的认知差异调查

目的：调查神经外科重症监护病房（Neurosurgical Intensive CareUnit,NICU）护士对家属需求的认知与NICU危重患者家属实际需求之间的差异。方法：使用中文改良版危重患者家属需求量表(Modified critical care family needs inventory,M-CCFNI)对复旦大学附属华山医院神经外科监护室（NICU）2021年1～9月收治的危重患者家属323人以及在职护士62人进行调查分析。结果：(1)NICU危重患者家属需求平均分为（128.52±15.62）分,各条目均分为（3.43±0.44）分,呈高需求状态;护士认知的患者需求平均分为（118.05±15.46）分,各条目均分为（3.15±0.41）分,评分差异具有统计学意义（P<0.01）。(2)NICU危重患者家属需求5个维度的得分排序中NICU护士与患者家属一致认为最重要的需求是“病情保证”,但双方在“亲近患者的需求” 和“医护人员的支持”两个维度存在着明显差异（P<0.01）。(3)M-CCFNI量表共有37条需求,NICU危重患者家属认为最重要10条需求中,护士与其吻合的有7条,但家属认为极为重要的“希望每天和医生进行交流(IS)”,“医护人员能如实回答我的问题(AS)”,“每天都能得到有关患者病情的相关消息(PS)”3条需求,护士的认知远低于患者家属的需求。(4) NICU危重患者家属与护士在得分后10条的需求中,危重患者家属将自身心理、精神方面的需求列为其最不重要的需求项目;而NICU护士则低估了危重患者家属想要了解患者病情的信息以及探视的需求。结论：神经外科重症患者家属需求呈高需求状态,远高于护士的对家属需求的认知,且护士对家属需求侧重点的认识存在着偏差。