A44. ICU CURRICULUM AND SYSTEMS最新文献

A Just-in-Time Curriculum to Teach Critical Incident Debriefing 一个及时的课程来教授关键事件汇报

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1535

J. Wykowski, S. Merel, P. Kritek, K. G. Hicks

引用次数: 1

Resident Burnout, Moral Distress, and Resilience in the Medical Intensive Care Unit in an Academic Tertiary Care Center 住院医师职业倦怠、道德困扰和韧性在学术三级护理中心的医疗重症监护室

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1536

H. Patel, J. Banks, A. Davis, J. Cadigan, B. Forcier, C. Orantes, K. Dover, K. Patel

引用次数: 0

ICU Structures and Protocols in Ecuador: A Peri-Pandemic Nationwide Assessment 厄瓜多尔ICU的结构和规程:大流行前后的全国评估

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1541

P. Morejón, B. Seth, J. Vivanco-Suarez, W. Checkley, M. Grunauer, Ecuador Covid-19 Consortium

{"title":"ICU Structures and Protocols in Ecuador: A Peri-Pandemic Nationwide Assessment","authors":"P. Morejón, B. Seth, J. Vivanco-Suarez, W. Checkley, M. Grunauer, Ecuador Covid-19 Consortium","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1541","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1541","url":null,"abstract":"Rationale: Ecuador was among the top fifth of countries affected by the COVID-19 pandemic worldwide. Intensive care units (ICUs), and health system resilience form key elements of the health system to prepare for meeting needs of its population, both during surge needs, and for postpandemic planning. There is limited evaluation of the existing ICU infrastructure, processes and protocols within ICUs. Our study sought to perform an assessment of the ICU practices across Ecuador. Methods: During December, 2020, we conducted an observational, cross-sectional study using questionnaires developed in Spanish, that were deployed in 42 Ecuadorian medical facilities, using trained physicians. The questionnaires were developed by experts, covering domains including hospital characteristics, utilization, and structural factors, such as human resources, and staffing practices. ICUs were categorized by the degree of global resource availability. The primary outcomes were availability and access to equipment, personnel, protocols, and therapies relevant to the practice of critical care. Secondary outcomes were mortality, admissions in the emergency department and ICU annually. Results: Thirty-six hospitals (85.7%) agreed to participate and were enrolled in the study. Annual average ICU mortality in 2019 was 20% (IQR: 14-30), which in 2020 increased to 40.5% (IQR 28.9-49.8), in the facilities evaluated. Annual average ICU admissions were 311 (154-404), with an average annual bed capacity of 120 (82-221.5). Sepsis, deep venous thromboprophylaxis, and glucose monitoring protocols were most commonly reported (96%), while protocols for massive transfusion (48%), targeted temperature management (41%), and palliative care (30%) were less common. In a multivariable linear regression adjusting for ICU level, annual ICU mortality was significantly lower in hospitals that reported higher use of respiratory protocols (- 3.4%, 95% CI-5.4 to -1.3;p=0.003) and sepsis protocols (-8.4%, 95% CI -14.1 to -2.7);p= 0.006). Conclusions: To our knowledge, this is the first study describing the ICU structure, process and components of different facilities across Ecuador. These may help guide decision-making policymakers, and health service communities to understand Ecuador's health system resilience, and key avenues for improvement and planning.","PeriodicalId":264442,"journal":{"name":"A44. ICU CURRICULUM AND SYSTEMS","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113955853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ICU Physicians Turning to Social Media to Mitigate Burnout - A Quantitative Study ICU医生转向社交媒体减轻倦怠-一项定量研究

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1538

S. Fatima, O. Haider, M. Khan, I. Ratnani

引用次数: 0

The Cost of Re-Consultation: Outcomes of Patients Who Require Repeat Intensive Care Unit Consults 再次咨询的成本:需要重复重症监护病房咨询的患者的结果

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1545

M. Freedman, K. Hess, K. Miller, M. Kashiouris

引用次数: 0

Opinions on Scare Resource Allocation Policy Exemptions and Adjustments Among Laypeople and Healthcare Workers by License Type 外行和医护人员按执照类型的惊吓资源配置政策豁免和调整意见

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1528

J. Channick, L. Wisk, R. Buhr

{"title":"Opinions on Scare Resource Allocation Policy Exemptions and Adjustments Among Laypeople and Healthcare Workers by License Type","authors":"J. Channick, L. Wisk, R. Buhr","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1528","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1528","url":null,"abstract":"Introduction: COVID-19 magnified the importance of health systems' readiness for scarce resource allocation during times of potential crisis-related shortages. Understanding how ethical values of laypeople differ from that of healthcare workers (HCW) is crucial to ensure a widely accepted policy. We intended to better understand how the values of laypeople, licensed independent practitioners (LIP), and non-LIP HCW align and differ regarding scarce resource allocation, particularly on exemptions and adjustments to ICU triage decisions, which could otherwise undermine public trust if not appropriately understood. Methods: Data were collected from a web-based national survey aimed at understanding the effects of the COVID-19 pandemic. We analyzed 1934 adult respondents, including 1353 lay-people, 200 LIPs and 381 non-LIP HCW. Respondents' values were assessed by 9- point Likert scale, (1= should be less likely to receive, 5 = should not influence, 9 = should be much more likely to receive ICU care), comparing responses using Kruskal-Wallis tests. Results: All groups equally prioritized ICU care for pregnant persons in first trimester. Agreement on prioritization was stronger for 3rd trimester pregnancy, where LIP rated agreement higher than other HCW (P=0.020). Laypeople favored a principle of reciprocity, prioritizing front-line health workers more than either LIP or other HCW (8 vs 7 vs 6, respectively, P<0.001). Laypersons rated their trust that health systems would apply SRA policy in a fair and consistent way slightly lower compared to either LIP or other HCW, but this was not significant (6 vs 7 vs 7, P=0.5). All groups felt similarly anxious and worried when thinking about policies like this (median score 7 where 9 = “I feel very anxious when thinking about this”, P=0.9). Discussion/Conclusions: In creating policies for scarce resource allocation, it is important to consider the nuanced values of all groups affected by these policies. In particular, while concern may exist that systems using non-healthrelated factors in treatment decisions may be less agreeable, we found similar levels of agreement when prioritizing on two key groups: pregnancy and at-risk health worker status. While our survey showed all groups lean towards trusting the healthcare system to fairly allocate resources, the range of responses and the consistent anxiety surrounding these policies emphasizes the importance of trying to understand and accommodate the priorities of affected groups as able. (Table Presented).","PeriodicalId":264442,"journal":{"name":"A44. ICU CURRICULUM AND SYSTEMS","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128694171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preliminary Assessment of a Formalized Airway Curriculum in Adult Pulmonary and Critical Care Fellowship Program 成人肺部和重症监护奖学金项目中气道课程的初步评估

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1532

J. Mbae, M. Reddy, M. Kaul, I. Imayama, T. F. Ferrer Marrero

引用次数: 0

Inter-Hospital ICU Transfers to a Tertiary Care Center: A Qualitative Analysis 医院间ICU转至三级护理中心:一项定性分析

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1539

B. Noureddine, J. Aliotta, N. Ward

引用次数: 0

Disconnect Between Provider Expectations and Delivered Therapy: Implications for Patients with Artificial Airways 提供者期望与交付治疗之间的脱节:对人工气道患者的影响

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1534

S. Hyder, S. R. Russell

引用次数: 0

Outcomes Associated with Intensive Care Unit Discharge During Times of High Unit Occupancy 高单位占用期间重症监护病房出院的相关结果

A44. ICU CURRICULUM AND SYSTEMS Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1540

H. Soh, R. Fiter, N. Goel, V. Astha, Y. Li, E. Benn, K. Mathews

引用次数: 0