Seminars in anesthesia最新文献_第10页

Technology strategies to improve ICU practice 提高ICU执业水平的技术策略

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.005

Michael J. Breslow MD (FCCM) , David J. Stone MD

{"title":"Technology strategies to improve ICU practice","authors":"Michael J. Breslow MD (FCCM) , David J. Stone MD","doi":"10.1053/j.sane.2004.11.005","DOIUrl":"10.1053/j.sane.2004.11.005","url":null,"abstract":"<div><p>Information technology tools have transformed most industries, increasing safety, productivity and efficiency. Healthcare, however, continues to rely on hand-written documents, verbal communication and individual performances. Recent data highlighting high error rates, avoidable deaths and poor compliance with demonstrated best practices highlight the need for dramatic changes in how we care for sick patients. Technology tools offer great potential to enhance the quality and safety of patient care and increase provider effectiveness. Specific areas where technology tools can add value include: 1) improving data presentation, 2) enhancing communication amongst care providers, 3) providing point-of-care decision support, 4) identifying problems and flagging gaps in care, 5) auditing performance and 6) leveraging personnel. While there is widespread recognition of the need for technology tools in healthcare, true clinical transformation will require improved products, standardization of clinical processes and changes in provider behavior. This manuscript reviews the rationale for information technology tools in critical care and examines issues related to their adoption and acceptance.</p></div>","PeriodicalId":82686,"journal":{"name":"Seminars in anesthesia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sane.2004.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130493708","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: 8

Evidence based medicine in the Intensive Care Unit: Improving care for the septic patient 重症监护病房的循证医学:改善对脓毒症患者的护理

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.009

Robert K. Michaels MD, MPH, Todd Dorman MD (FCCM)

引用次数: 1

Exclusive anesthesia contracts: History, theory, nuts and bolts 独家麻醉合同:历史，理论，螺母和螺栓

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.006

Mark F. Weiss JD

引用次数: 0

Topics in Sem Anesth 半身麻醉专题

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/S0277-0326(05)00006-1

引用次数: 0

Acid-base balance revisited: Stewart and strong ions 酸碱平衡重新审视:斯图尔特和强离子

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.008

David A. Story BMedSci (Hons), MBBS (Hons), MD (FANZCA) , John A. Kellum MD (FACP, FCCM)

引用次数: 13

Approach to sedation in the ICU ICU的镇静方法

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.004

William T. Peruzzi MD, SM (FCCM), Kiki Hurt MD

引用次数: 6

Evaluating the impact of the Leapfrog Group’s standard for Intensive Care Unit physician staffing 评估Leapfrog集团对重症监护病房医师配置标准的影响

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.001

Peter J. Pronovost MD, PhD , David A. Thompson DNSc, MS, RN , Christine G. Holzmueller , Todd Dorman MD , Barbara A. Rudolph PhD, MSSW

{"title":"Evaluating the impact of the Leapfrog Group’s standard for Intensive Care Unit physician staffing","authors":"Peter J. Pronovost MD, PhD , David A. Thompson DNSc, MS, RN , Christine G. Holzmueller , Todd Dorman MD , Barbara A. Rudolph PhD, MSSW","doi":"10.1053/j.sane.2004.11.001","DOIUrl":"10.1053/j.sane.2004.11.001","url":null,"abstract":"<div><p>There is growing concern over the quality and escalating costs of health care in the US. This paper reviews the Leapfrog Group’s ICU Physician Staffing (IPS) standard, summarizes evidence supporting the standard, reviews the cost of implementing the standard, and discusses the impact of the standard on critical care in the US. The IPS standard requires that all patients in adult or pediatric general medical and/or surgical ICUs be managed or co-managed by physicians certified in critical care medicine. A systematic review of the literature demonstrated high intensity physician staffing (e.g. intensivists manage all patients) was associated with a 30% reduction in hospital mortality and a 40% reduction in ICU mortality. Interviews with authors from 19 studies demonstrated that the IPS requirement for pager response and weekday and weekend hours were supported by the evidence. Cost savings estimates with IPS ranged from $510,000 to $3.3 million (greater savings in larger ICUs). The impact of the IPS is unknown, although most hospitals in the original 6 regional rollouts made efforts to implement IPS. Given the results from this study, if IPS were implemented nationally, up to 134,000 lives could be saved annually with most hospitals incurring a net savings.</p></div>","PeriodicalId":82686,"journal":{"name":"Seminars in anesthesia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sane.2004.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114308249","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: 4

Minimally invasive hemodynamic monitoring and goal-directed therapy 微创血流动力学监测和目标导向治疗

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.007

Michael R. Pinsky MD, Dr hc

引用次数: 4

Strategies for renal preservation and resuscitation: The responsibility of critical care medicine is the preservation of renal function 肾脏保存和复苏的策略:重症监护医学的责任是保存肾功能

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.003

Susan Garwood MB, ChB

引用次数: 0

Pain management in the trauma setting 创伤环境中的疼痛管理

Seminars in anesthesia Pub Date : 2005-03-01 DOI: 10.1053/j.sane.2004.11.002

Mirjana Lovrincevic MD, Fayez Kotob MD, Julianne Santarosa BS

{"title":"Pain management in the trauma setting","authors":"Mirjana Lovrincevic MD, Fayez Kotob MD, Julianne Santarosa BS","doi":"10.1053/j.sane.2004.11.002","DOIUrl":"10.1053/j.sane.2004.11.002","url":null,"abstract":"<div><p><span><span><span>One critical aspect of trauma management is dealing with pain. It is, nowadays, well understood that appropriate treatment of pain in injured patients would improve care results. Injured patients are often experiencing considerable pain while being clinically unstable. Such instability makes these patients susceptible to analgesic interventions. Morbidity and mortality are high among trauma patients due to various effects on their vital systems. Trauma complications, such as </span>hypovolemia, </span>coagulopathies, and head or spine injuries, are frequently encountered and would limit several pain relief approaches. In the recent decades, there have been significant advances in </span>posttraumatic pain<span><span> management. This added to the increased awareness of the consequences of undertreating posttraumatic pain, has produced adaptation of therapeutic concepts, such as multimodal and multidisciplinary approaches to pain in injured patients. The following text serves as a concise discussion of the management of pain in the trauma setting. We outlined posttraumatic pain concept, pathophysiology, clinical presentation, </span>clinical approach and treatment. Towards the end of the text, we devoted special headlines to discuss some specific scenarios that might require a particular management.</span></p></div>","PeriodicalId":82686,"journal":{"name":"Seminars in anesthesia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sane.2004.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114346500","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: 5