From task assignment to patient allocation: a change evaluation

The way in which nursing work in a ward is planned and allocated amongst the staff available has a considerable influence on the continuity of patient care, nurse-patient relationships, nurses' satisfaction with their role and the learning experiences of students. An attempt was made to explore these factors when it was decided to change the organization of a medical ward from task assignment to patient allocation. The change-over was accomplished successfully using a form of action research and the evaluation indicated general satisfaction with the new system.     

Nosocomial pneumonia in the ICU patient

Although mechanically ventilated patients represent only a small proportion of the hospital population at risk for pneumonia, they are generally seriously ill with disproportionately high rates of pneumonia and fatality. Hand carriage of nosocomial pathogens is a well-known mode of transmission and can be substantially reduced by proper handwashing. Knowledge of the potential hazards of all respiratory therapy equipment and tubing condensate is essential in preventing transmission of nosocomial pathogens that are often implicated in hospital-acquired pneumonia in ventilated patients. Administration of prophylactic antibiotics may reduce the risk of pneumonia, but more studies are needed in this area. Over the past decade there has been significant progress in the prevention of nosocomial pneumonia, but more research is needed to firmly establish the efficacy of these concepts in specific subsets of hospitalized patients.     

Care of the family of the ICU patient

A nurse working in intensive care may easily forget the first impact this environment makes and therefore may unintentionally overlook a family's needs. It is hoped that this article will help nurses recognize the importance of easing stress within the family as well as provide the tools to meet the needs of each family whose loved one enters an intensive care unit.     

Keys to the successful implementation of an ICU patient data management system

Implementation of an ICU data management system requires consideration of many factors, including site preparation for equipment, system backup, ICU & medical staff training and evaluation. This paper describes the strategy for implementing a patient data management system at Cedars-Sinai Medical Center and details our steps for planning, training, configuration and problem resolution.L.S. Avila is currently employed with EMTEK Health Care Systems, Inc.     

Preventable mortality evaluation in the ICU

ABSTRACT: Mortality is the most widely measured outcome parameter. Improvement of this outcome parameter in critical care is nowadays expected not to come from new technologies or treatment, but from delivering the right care at the right moment in a safe way. The measurement of mortality as an outcome parameter confronts us with a problem in providing follow-up to the results. Especially when proven structure and process interventions are applied already, the cause of a suboptimal performance cannot be deduced easily. One possibility is to evaluate the causes of death and to judge preventability. In this article we explore the opportunities and difficulties of a tool to evaluate preventable mortality in the ICU.     

2种个性化音乐疗法对改善ICU患者焦虑状况的对比研究

目的 通过2种不同音乐疗法对改善重症监护室(ICU)患者焦虑状况的比较,探索最佳个性化音乐的设置,提高音乐治疗的效率.方法 将入住ICU超过1周的患者60例,按入院先后顺序随机分为实验组和对照组各30例,2组除常规护理外,实验组每日播放不同的音乐曲目,且不定时播放;对照组每日播放固定的音乐曲目,并定时播放.2组干预前后,分别采用焦虑自评量表(SAS)测评患者焦虑情绪并进行比较.结果 实验组干预后SAS的评分下降明显,与干预前评分比较差异有统计学意义(P＜0.01),对照组干预后SAS的评分也降低,但与干预前比较差异无统计学意义(P＞0.05);干预结束后,实验组的SAS评分低于对照组,其差异有统计学意义(P＜0.01).结论 非固定曲目不定时播放的音乐疗法,对减轻ICU患者焦虑的效果优于固定曲目定时播放.