American Journal of Critical Care最新文献_第5页

Patient- and Family-Centered Outcomes After Intensive Care Unit Admission. 入住重症监护室后以患者和家属为中心的结果。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025684

Misty N Schreiner, Perry M Gee, Ramona O Hopkins, Jorie M Butler, Danielle Groat, Stephanie C Stokes, Sarah Beesley, Samuel M Brown, Eliotte L Hirshberg

{"title":"Patient- and Family-Centered Outcomes After Intensive Care Unit Admission.","authors":"Misty N Schreiner, Perry M Gee, Ramona O Hopkins, Jorie M Butler, Danielle Groat, Stephanie C Stokes, Sarah Beesley, Samuel M Brown, Eliotte L Hirshberg","doi":"10.4037/ajcc2025684","DOIUrl":"https://doi.org/10.4037/ajcc2025684","url":null,"abstract":"Background: Family satisfaction with intensive care is a measure of patient experience and patient-centered care. Among the factors that might influence family satisfaction are the timing of patient admittance to the intensive care unit (ICU), the ICU environment, and individual health care providers.Objective: To evaluate family satisfaction with the ICU and to explore associations between satisfaction and specific characteristics of the ICU stay.Methods: Participants were adult family members of ICU patients. One family member per patient was enrolled. Regression was used to test the association between time or day of admittance and scores on the Family Satisfaction With Care in the Intensive Care Unit survey. Additionally, we explored exposure to admitting physicians and registered nurses. Free-text survey comments were grouped by using qualitative content analysis.Results: Surveys were completed by 401 family members. There was no association between survey scores and providers, nor between scores and the time or day of the ICU admission. Three major themes emerged as important to patient and family satisfaction: (1) communication and information, (2) personalization or the patient as expert, and (3) staff and environment.Conclusions: Family satisfaction with an ICU admission was not influenced by the timing of the admission. Overall satisfaction with the ICU was high. The qualitative analysis points to the importance of collecting qualitative data in addition to using standard survey tools to capture the richness of patient experience. Ongoing efforts to engage with families remain critical to the practice of family- and patient-centered care in the ICU.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 1","pages":"12-20"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909197","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

A 12-Lead Electrocardiography Patch for Continuous Arrhythmia Monitoring: A Case Example. 用于持续心律失常监测的12导联心电图贴片：一例。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025802

Dillon J Dzikowicz, Sukardi Suba, Salah Al-Zaiti

引用次数: 0

Clinical Pearls. 临床珍珠。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025738

Rhonda Board

引用次数: 0

From Moral Distress to Moral Integrity: Qualitative Evaluation of a New Moral Conflict Assessment Tool. 从道德困境到道德正直：新道德冲突评估工具的定性评估。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025500

Soudabeh Jolaei, Patricia Rodney, Rosalie Starzomski, Peter Dodek

{"title":"From Moral Distress to Moral Integrity: Qualitative Evaluation of a New Moral Conflict Assessment Tool.","authors":"Soudabeh Jolaei, Patricia Rodney, Rosalie Starzomski, Peter Dodek","doi":"10.4037/ajcc2025500","DOIUrl":"https://doi.org/10.4037/ajcc2025500","url":null,"abstract":"Background: Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested.Objective: To evaluate the utility of the MCA.Methods: All intensive care unit professionals in 3 hospitals were invited to attend a presentation about the MCA and to participate in semistructured interviews that followed the steps of the MCA. Transcriptions of interviews were interpreted by using qualitative content analysis.Results: Analysis of individual interviews of 7 participants and 1 focus group of 3 participants revealed that the MCA was a catalyst for expressing feelings and characterizing moral distress, but optimal use required a facilitator. Participants noted that prevention and amelioration of moral distress were determined by organizational culture issues such as consistent understanding of what can be accomplished in the intensive care unit, resolution of power imbalances among staff, and psychological safety to mention moral issues. Structural determinants included disparate work and education schedules between nurses and physicians. Leader determinants included listening to staff and ensuring accountability to address causes and consequences of moral distress. Education and communication were proposed most often as solutions for moral distress.Conclusions: The evaluation revealed positive and negative features of the MCA. Prevention and amelioration of moral distress require attention to cultural, structural, and leadership issues through education and communication.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 1","pages":"52-59"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909096","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

Noninvasive Ventilation and Mortality During COVID-19: What Could Have Been Wrong? COVID-19期间的无创通气和死亡率：可能出了什么问题？

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025543

Stefano Bambi, Pasquale Iozzo, Yari Bardacci, Carolina Forciniti, Alberto Lucchini

引用次数: 0

Skilled Communication and the Pursuit of Perfect Cardiopulmonary Resuscitation. 娴熟的沟通和追求完美的心肺复苏。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025920

Cindy Cain

引用次数: 0

The Intensive Care Unit: Tomorrow and Beyond. 重症监护室：明天和未来。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-11-01 DOI: 10.4037/ajcc2024936

Lakshman Swamy, Cindy L Munro

引用次数: 0

Factors Associated With Parent-Perceived Miscommunication in the Pediatric Intensive Care Unit. 儿科重症监护室中家长认为沟通不畅的相关因素。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-11-01 DOI: 10.4037/ajcc2024596

Jesse R Wool, Jesse Chittams, Salimah Meghani, Wynne Morrison, Janet Deatrick, Connie M Ulrich

{"title":"Factors Associated With Parent-Perceived Miscommunication in the Pediatric Intensive Care Unit.","authors":"Jesse R Wool, Jesse Chittams, Salimah Meghani, Wynne Morrison, Janet Deatrick, Connie M Ulrich","doi":"10.4037/ajcc2024596","DOIUrl":"https://doi.org/10.4037/ajcc2024596","url":null,"abstract":"Background: Parents of children in pediatric intensive care units have varied communication experiences with health care professionals. Little is known about factors associated with parents' perceptions of miscommunication.Objective: To examine children's clinical and parents' demographic and psychosocial factors associated with perceptions of miscommunication in the pediatric intensive care unit.Methods: This study was a cross-sectional survey of parents of children admitted to the pediatric intensive care unit between January 1, 2018, and February 29, 2020, with a stay of greater than 24 hours.Results: Most of the 200 parent respondents were female (83.4%), White (71.4%), and non-Hispanic (87.9%); median age was 39 years (mean [SD], 40.2 [8.75] years); 17.6% were Black or African American. Among 210 children, mean (SD) age was 6.1 (6.02) years, mean (SD) stay was 4.5 (6.2) days, 38.6% were admitted because of respiratory illness, and the admission was the first for 51.0%. Of the parents, 16.5% reported miscommunication in the pediatric intensive care unit. In multivariable linear regressions, parents' stress (β = 0.286), parents' views of clinician communication (β = -0.400), parents' trust in physicians (β = -0.147), and length of stay (β = 0.122) accounted for 45% of the explained variance in parent-perceived miscommunication (R2 = 0.448, F = 41.19, P < .001).Conclusions: Parental stress and trust in physician scores were associated with perceived miscommunication. Further research is needed to understand the causes and consequences of miscommunication in order to support hospitalized children and their parents.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 6","pages":"402-409"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556921","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

Variation in Mentions of Race and Ethnicity in Notes in Intensive Care Units Across a Health Care System. 医疗保健系统重症监护室笔记中提及种族和民族的差异。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-11-01 DOI: 10.4037/ajcc2024422

Julien Cobert, Edie Espejo, John Boscardin, Hunter Mills, Deepshikha Ashana, Karthik Raghunathan, Timothy A Heintz, Allyson Cook Chapman, Alex K Smith, Sei Lee

{"title":"Variation in Mentions of Race and Ethnicity in Notes in Intensive Care Units Across a Health Care System.","authors":"Julien Cobert, Edie Espejo, John Boscardin, Hunter Mills, Deepshikha Ashana, Karthik Raghunathan, Timothy A Heintz, Allyson Cook Chapman, Alex K Smith, Sei Lee","doi":"10.4037/ajcc2024422","DOIUrl":"https://doi.org/10.4037/ajcc2024422","url":null,"abstract":"Background: Social constructs like race can affect how patients are perceived and impact care. This study investigated whether mentions of race in notes for critically ill patients differed according to patients' race.Methods: This retrospective cohort study included intensive care unit notes for adults (≥18 years old) admitted to any of 6 intensive care units at University of California, San Francisco, from 2012 through 2020. Notes were linked to National Provider Identifier records to obtain note writer characteristics. Logistic regression analysis with robust SEs clustered on note writers was adjusted for patient-, note- and clinician-level characteristics. Any race or ethnicity mention was the outcome of interest.Results: Among 5573 patients with 292 457 notes by 9742 unique note writers, 3225 patients (57.9%) self-reported their race as White, 997 (17.9%) as Asian, 860 (15.4%) as Latinx, and 491 (8.8%) as Black. Note writers documented race/ethnicity for 20.8% of Black, 10.9% of Latinx, 9.1% of White, and 4.4% of Asian patients. Black patients were more likely than White patients to have race mentioned in notes (adjusted odds ratio, 2.05 [95% CI, 1.49-2.82]).Conclusions: Black patients were more than twice as likely as White patients to have race mentioned in notes. Note language containing information on social constructs has consequences for clinicians and patients reading notes and for algorithms trained on clinical notes.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 6","pages":"462-466"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556930","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

Chest Discomfort After Percutaneous Coronary Intervention. 经皮冠状动脉介入术后胸部不适。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-11-01 DOI: 10.4037/ajcc2024482

Sukardi Suba, Dillon J Dzikowicz, Mary G Carey

引用次数: 0