Abstract
This Six Sigma project was initiated to evaluate and improve the transfer of care of patients from the OR to the ICU. Medical errors are responsible for billions of dollars in increased healthcare spending. Miscommunication among healthcare providers is a major contributor to these errors, with handoffs a particularly vulnerable period in the care process. At our institution, surgical patients with scheduled admissions to the ICU are first recovered in the postanesthesia care unit (PACU). With this process, multiple, unstructured, and individual handoffs occur in parallel between providers, which may lead to communication errors, differential information sharing, content variability, care delays, and inefficiency.
Highlights
To assess cerebral hemodynamics in an experimental sepsis model
Since the Surviving Sepsis Campaign (SSC) in 2002, the Health Service Ombudsman for England published recommendations for improving recognition and treatment of sepsis [2], the Royal College of Physicians issued a toolkit for the management of sepsis in the acute medical unit [3], and NHS England released a patient safety alert to support prompt recognition and treatment of sepsis [4]
We sought to estimate the number of unalerted sepsis episodes to assess the efficacy of our screening tool and improve early recognition
Summary
We evaluated platelet activation markers as potential predictive markers of sepsis and of mortality among four commonly encountered populations of patients admitted to ICUs. Methods Ninety-nine non-infected ICU patients were prospectively screened at day 1 (T1) and day 3 (T2) of admission after elective cardiac surgery, trauma, acute neurologic dysfunction or prolonged ventilation (>48 hours). The present study was performed with the aim of assessing whether nursing and physician staff were able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS) Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching hospital over a 3-month period in 2010.
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