Enhancing the quality of care in the ICU:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa. [u.a.]
Elsevier
2013
|
| Schriftenreihe: | Critical care clinics
29,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | X, 128 S. Ill., graph. Darst. |
| ISBN: | 9781455770755 |
Internformat
MARC
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| 245 | 1 | 0 | |a Enhancing the quality of care in the ICU |c ed.: Robert C. Hyzy |
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| 300 | |a X, 128 S. |b Ill., graph. Darst. | ||
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Datensatz im Suchindex
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| adam_text | Enhancing the Quality of Care in the ICU
Contents
Preface: Enhancing the Quality of Care in the Intensive Care Unit
ix
Robert
С
Hyzy
Achieving Zero Central Line-associated Bloodstream Infection Rates in Your
Intensive Care Unit
1
Rommel
Sagana
and Robert
С
Hyzy
Centra! line-associated bloodstream infection (CLABSI) is one of the most
common health care-associated infections in the United States. The costs
associated with CLABSIs include an estimated
28,000
deaths in the inten¬
sive care unit and up to
$2.3
billion annually. Best practice guidelines,
checklists, and establishing a culture of safety in hospitals are all initiatives
designed to reduce the rate of CLABSI to zero.
Preventing Clostridium Difficile Infection in the Intensive Care Unit
11
Marya D. Zilberberg and Andrew
R
Shorr
Clostridium difficile is a formidable problem in the twenty-first century.
Because of injudicious use of antibiotics, the emergence of the hyperviru-
lent epidemic strain of this organism has been difficult to contain. The
NAP1/BI/027 strain causes more-severe disease than other widely preva¬
lent strains and affects patients who were not traditionally thought to be at
risk for Clostridium difficile infection. Critically ill patients remain at high
risk for this pathogen, and preventive measures, such as meticulous con¬
tact precautions, hand hygiene, environmental disinfection, and, most
importantly, antibiotic stewardship, are the cornerstones of mitigation in
the intensive care unit.
Preventing Catheter-Associated Urinary Tract Infections in the Intensive Care Unit
19
Carol Chenoweth and Sanjay Saint
Urinary tract infection remains one of the most common heatthcare-asso-
ciated infections in the intensive care unit and predominantly occurs in
patients with indwelling urinary catheters. Duration of
catheterizatkxi
is
the most important risk factor for developing catheter-associated urinary
tract infection
(CAUTI).
General strategies for preventing
CAUTI
include
measures such as adherence to hand hygiene. Targeted strategies for pre¬
venting
CAUTI
include limiting the use and duration of urinary catheters,
using aseptic technique for catheter insertion, and adhering to proper
catheter care. Anti-infective catheters may be considered in some set¬
tings. Successful implementation of these measures has decreased
urinary catheter use and
CAUTI.
Ventilator-associated Complications. Including Infection-related Complications:
The Way Forward
33
Marin H. Kollef
Acute respiratory failure represents the most common condition requiring
admission to an adult intensive care unit Ventilator-associated pneumonia
vi
Contents
(VAP)
has been used as a marker of quality for patients with respiratory fail¬
ure. Hospital-based process-improvement initiatives to prevent VAP have
been successfully used. The use of ventilator-associated complications
(VACs) has been proposed as an objective marker to assess the quality
of care for this patient population. The use of evidence-based bundles
targeting the reduction of VACs, as well as the conduct of prospective
studies showing that VACs are preventable complications, are reasonable
first-steps in addressing this important clinical problem.
Preventing Delirium in the Intensive Care Unit
51
Nathan E. Brummel and Timothy D.
Girard
Delirium in the intensive care unit (ICU) is exceedingly common, and risk
factors for delirium among the critically ill are nearly ubiquitous. Address¬
ing modifiable risk factors including sedation management, deliriogenic
medications, immobility, and sleep disruption can help to prevent and
reduce the duration of this deadly syndrome. The ABCDE approach to crit¬
ical care is a bundled approach that clinicians can implement for many
patients treated in their ICUs to prevent the adverse outcomes associated
with delirium and critical illness.
Sedation and Mobility: Changing the Paradigm
67
John P. Kress
A large fraction of intensive care unit (ICU) patients with respiratory failure
who survive their critical illness leave the hospital with substantial neuro-
muscular weakness. In light of this reality, a shift in the approach to critical
care management has begun. This viewpoint has broadened the perspec¬
tive of ICU care providers beyond the narrow goal of leaving the ICU alive
to a broader notion focused on minimizing the complications that accom¬
pany the inherent noxious nature of ICU care. Mobilization of mechanically
ventilated patients is feasible, safe, and carries the potential for tremen¬
dous benefit for our patients.
Improving Intensive Care Unit Quality Using Collaborative Networks
77
Sam R. Watson and Damon C. Scales
Collaborative networks of intensive care units can help promote a quality-
improvement agenda across an entire system or region. Proposed advan¬
tages include targeting a greater number of patients, sharing of resources,
and common measurement systems for audit and feedback or benchmark¬
ing. This review focuses on elements that are essential for the success and
sustainability of these collaborative networks, using as examples networks
in Michigan and Ontario. More research is needed to understand the mech¬
anisms through which collaborative networks lead to improved care deliv¬
ery and to demonstrate their cost-effectiveness in comparison with other
approaches to system-level quality improvement.
Does Value-Based Purchasing Enhance Quality of Care and Patient Outcomes in
the ICU?
91
James M. O Brien Jr, Anupam Kumar, and Mark L.
Metersky
As health care expenditures increase, payers, including the Centers for
Medicare and Medicaid Services, are moving away from reimbursement
Contents
based
on types and volume of services to an emphasis on quality of pro¬
vided care, an approach called value-based purchasing (VBP). Because it
is tied to reimbursement, VBP creates economic motivation to measure
and improve care. VBP is proceeding without high-level evidence support¬
ing its effectiveness in improving health care quality. Rising health care
costs, however, make VBP an attractive approach for curtailing costs
and emphasizing improved quality, and VBP is likely to become a more
prevalent mechanism of reimbursement for providers and facilities.
Enhancing the Quality of Care in the Intensive Care Unit: A Systems Engineering
Approach
113
Steven P. Tropello, Alan D. Ravitz, Mark
Romig,
Peter J. Pronovost, and
Adam Sapirstein
This article presents an overview of systems engineering and describes
common core principles found in systems engineering methodologies.
The Patient Care Program Acute Care Initiative collaboration between
the Armstrong Institute of the Johns Hopkins School of Medicine and
the Gordon and Betty Moore Foundation, which will use systems engineer¬
ing to reduce patient harm in the intensive care unit, is introduced. Specific
examples of applying a systems engineering approach to the Patient Care
Program Acute Care Initiative are presented.
Index
125
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| spelling | Enhancing the quality of care in the ICU ed.: Robert C. Hyzy Philadelphia, Pa. [u.a.] Elsevier 2013 X, 128 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care clinics 29,1 Clinics review articles Intensivstation (DE-588)4161965-1 gnd rswk-swf Qualitätssteigerung (DE-588)4176587-4 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Intensivstation (DE-588)4161965-1 s Qualitätssteigerung (DE-588)4176587-4 s DE-604 Hyzy, Robert C. Sonstige (DE-588)1030226261 oth Critical care clinics 29,1 (DE-604)BV000019838 29,1 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025686050&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Enhancing the quality of care in the ICU |
| title_auth | Enhancing the quality of care in the ICU |
| title_exact_search | Enhancing the quality of care in the ICU |
| title_full | Enhancing the quality of care in the ICU ed.: Robert C. Hyzy |
| title_fullStr | Enhancing the quality of care in the ICU ed.: Robert C. Hyzy |
| title_full_unstemmed | Enhancing the quality of care in the ICU ed.: Robert C. Hyzy |
| title_short | Enhancing the quality of care in the ICU |
| title_sort | enhancing the quality of care in the icu |
| topic | Intensivstation (DE-588)4161965-1 gnd Qualitätssteigerung (DE-588)4176587-4 gnd |
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