American Journal of Critical Care最新文献

Calling Attention to the Practice of Acute and Critical Care Nursing. 呼吁关注急危重症护理实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025397

Michele C Balas, Kirsten E Hepburn, Martha A Q Curley

引用次数: 0

Maximizing Data Capture for Race and Ethnicity of Children Admitted to Critical Care Units. 最大限度地获取入住重症监护病房的儿童的种族和民族数据。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025971

Patricia A Hickey, Jean A Connor, Cheryl Toole, Valerie L Ward

{"title":"Maximizing Data Capture for Race and Ethnicity of Children Admitted to Critical Care Units.","authors":"Patricia A Hickey, Jean A Connor, Cheryl Toole, Valerie L Ward","doi":"10.4037/ajcc2025971","DOIUrl":"https://doi.org/10.4037/ajcc2025971","url":null,"abstract":"Background: Access to complete patient sociodemographic data in a hospital's electronic health record is important for identifying and understanding health inequities and designing interventions to close health care gaps. Through participation in a national safety collaborative, this team identified many patients in intensive care units (ICUs) for whom sociodemographic data (race and ethnicity) were incomplete or missing.Objectives: To describe the processes the team used to understand how sociodemographic data were being ascertained for children admitted to hospital ICUs; demonstrate how interprofessional care teams can collaborate to create solutions for vulnerable patients; and provide steps that can be used at other hospitals to decrease missing sociodemographic data and deliver equitable care.Methods: A plan-do-study-act framework guided this initiative to improve collection of data on the race and ethnicity of ICU patients. Via 4 plan-do-study-act cycles, care vulnerabilities and implemented tests of change were evaluated to achieve the goal of capturing sociodemographic data within 72 hours of patient admission.Results: A new process was developed for patient experience representatives to collect, enter, and track sociodemographic data accurately. Through education and use of a script, documentation rates reached 80% to 100%.Conclusions: Overcoming barriers in the electronic health record and creating new processes supported the collection of sociodemographic data for children admitted to ICUs. Engaging and acknowledging the value of interprofessional teams was important in this successful groundwork to help deliver equitable care.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"167-173"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

AACN's Healthy Work Environment Standards: Why They Matter. AACN的健康工作环境标准：为什么它们很重要。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025277

Meredith Padilla

引用次数: 0

Longitudinal Evaluation of Implementation of AACN's Healthy Work Environment Framework in an Intensive Care Unit. 在重症监护室实施AACN健康工作环境框架的纵向评价。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025172

Philip Parker, Heather Pena, Jason Stokes, Jessica Seabrooks, Amanda Ornell, Annie Jaeger, Adam Millard, Robert Stern, Benjamin Edwards, Kelly Kester, Bradi Granger

{"title":"Longitudinal Evaluation of Implementation of AACN's Healthy Work Environment Framework in an Intensive Care Unit.","authors":"Philip Parker, Heather Pena, Jason Stokes, Jessica Seabrooks, Amanda Ornell, Annie Jaeger, Adam Millard, Robert Stern, Benjamin Edwards, Kelly Kester, Bradi Granger","doi":"10.4037/ajcc2025172","DOIUrl":"https://doi.org/10.4037/ajcc2025172","url":null,"abstract":"Background: Bedside nurse turnover in the United States is 22.5%, representing a national challenge that has been attributed to poor work environments. Poor work environments result in decreased nurse satisfaction and retention as well as poor patient outcomes. Healthy work environments have the opposite effects.Objectives: To evaluate the impact of implementation of the American Association of Critical-Care Nurses (AACN) healthy work environment framework in an intensive care unit on work environment scores, turnover, and tenure during a 6-year period.Methods: A prospective, longitudinal design was used to evaluate implementation of the healthy work environment framework in an intensive care unit in a large academic medical facility. Interventions for each of the 6 healthy work environment standards were carried out. The AACN Healthy Work Environment Assessment Tool was used to measure each standard in 2017, 2019, 2021, and 2023.Results: No statistically significant differences were found between cohorts. The score for each healthy work environment standard and the overall score increased significantly from 2017 to 2023. Nurse turnover increased during the COVID-19 pandemic but restabilized within 2 years.Conclusions: Findings from this study suggest that targeted interventions addressing the healthy work environment standards are associated with improved staff satisfaction and reduced turnover. Furthermore, the findings highlight the value of the healthy work environment framework in improving nurse retention.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"183-192"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral Microbiome Changes During Hospitalization in Older Adults Not Receiving Mechanical Ventilation. 未接受机械通气的老年人住院期间口腔微生物组的变化。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025470

Kimberly Paige Rathbun, Mary Lou Sole, Shibu Yooseph, Rui Xie, Annette M Bourgault, Steven Talbert

{"title":"Oral Microbiome Changes During Hospitalization in Older Adults Not Receiving Mechanical Ventilation.","authors":"Kimberly Paige Rathbun, Mary Lou Sole, Shibu Yooseph, Rui Xie, Annette M Bourgault, Steven Talbert","doi":"10.4037/ajcc2025470","DOIUrl":"https://doi.org/10.4037/ajcc2025470","url":null,"abstract":"Background: Oral bacteria can be pathogenic and may change during hospitalization, potentially increasing risk for complications for older adults, including residents of skilled nursing facilities (SNFs).Objectives: To compare the oral microbiome at hospital admission by prehospital residence (SNF vs home) in older adults not receiving mechanical ventilation and to assess changes in their oral microbiome during hospitalization.Methods: This prospective, observational study included 46 hospitalized adults (≥65 years old) not receiving mechanical ventilation, enrolled within 72 hours of hospitalization (15 admitted from SNF, 31 from home). Oral health was assessed with the Oral Health Assessment Tool at baseline and days 3, 5, and 7. Genomic DNA was extracted from unstimulated oral saliva specimens for microbiome profiling using 16S ribosomal RNA sequencing. Taxonomic composition, relative abundance, α-diversity (Shannon Index), and β-diversity (Bray-Curtis dissimilarity) of bacterial communities were determined.Results: Most patients were female (70%) and White (74%) or Hispanic (11%). Mean age was 78.7 years. More patients admitted from SNFs than from home had cognitive impairment (P < .001), delirium (P = .01), frailty (P < .001), and comorbidities (P = .04). Patients from SNFs had more oral bacteria associated with oral disease, lower α-diversity (P < .001), and higher β-diversity (P = .01). In the 28 study completers, α-diversity altered over time (P < .001). A significant interaction was found between groups after adjusting for covariates (P < .001).Conclusions: Hospitalized older adults admitted from SNFs experience oral microbial and oral health disparities.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"208-217"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethics Is Essential. 道德是必要的。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025767

Cindy L Munro, Lakshman Swamy

引用次数: 0

Beginning to Think About Ethical Issues in Critical Care. 开始思考重症监护中的伦理问题。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025435

Catherine Green

引用次数: 0

Inflammatory Cardiac Disease in a Young Adult With Syncope. 青壮年晕厥并发炎症性心脏病

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025551

Sudhir K Mummidi, Mary G Carey, Sukardi Suba, Dillon J Dzikowicz

引用次数: 0

Reducing Readmission for Sepsis by Improving Risk Prediction Algorithms. 通过改进风险预测算法减少败血症的再入院。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025455

Valerie J Renard, Parisa Farahani, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, Amy L B Frazier, David Edelman, Truls Østbye, Lana Wahid

{"title":"Reducing Readmission for Sepsis by Improving Risk Prediction Algorithms.","authors":"Valerie J Renard, Parisa Farahani, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, Amy L B Frazier, David Edelman, Truls Østbye, Lana Wahid","doi":"10.4037/ajcc2025455","DOIUrl":"https://doi.org/10.4037/ajcc2025455","url":null,"abstract":"Unplanned readmissions after sepsis, rates of which range from 17.5% to 32%, pose substantial challenges for health care systems. Associated costs for sepsis surpass those for other critical conditions. Existing readmission risk models rely primarily on clinical indicators, which limits their predictive accuracy for patients with sepsis. This review explores how integrating social determinants of health into readmission models can enhance model precision and applicability for predicting 30-day readmission among sepsis survivors. Although socioeconomic status, neighborhood deprivation, and access to health care are known to influence postdischarge outcomes, these social determinants of health are underused in current risk algorithms. Evidence shows that incorporating social determinants of health into predictive models significantly improves model performance. Furthermore, failure to account for health disparities driven by social determinants of health in high-risk populations can exacerbate existing inequities in health care outcomes. The integration of social determinants of health into sepsis readmission risk models offers a promising avenue for improving prediction accuracy, reducing readmissions, and optimizing care for vulnerable populations. Future research should focus on refining these models and exploring postdischarge monitoring strategies to further mitigate the burden of sepsis readmissions.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"230-235"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fostering a Spirit of Inquiry: Inspiring Nurses to Advance Practice Based on Best Evidence. 培养探究精神：激励护士基于最佳证据推进实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025618

Mary Beth Flynn Makic

引用次数: 0