Intensive Care Unit Room Research Articles

Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates

ObjectiveTo determine the factors associated with second attempt success and the risk of adverse events following a failed first attempt at neonatal tracheal intubation.DesignRetrospective analysis of prospectively collected data on...

Clinician and Visitor Activity Patterns in an Intensive Care Unit Room: A Study to Examine How Ambient Monitoring Can Inform the Measurement of Delirium Severity and Escalation of Care.

The early detection of the acute deterioration of escalating illness severity is crucial for effective patient management and can significantly impact patient outcomes. Ambient sensing technology, such as computer vision, may provide real-time information that could impact early recognition and response. This study aimed to develop a computer vision model to quantify the number and type (clinician vs. visitor) of people in an intensive care unit (ICU) room, study the trajectory of their movement, and preliminarily explore its relationship with delirium as a marker of illness severity. To quantify the number of people present, we implemented a counting-by-detection supervised strategy using images from ICU rooms. This was accomplished through developing three methods: single-frame, multi-frame, and tracking-to-count. We then explored how the type of person and distribution in the room corresponded to the presence of delirium. Our designed pipeline was tested with a different set of detection models. We report model performance statistics and preliminary insights into the relationship between the number and type of persons in the ICU room and delirium. We evaluated our method and compared it with other approaches, including density estimation, counting by detection, regression methods, and their adaptability to ICU environments.

MODERN PARAMETERS OF LABORATORY EXPRESS DIAGNOSTICS IN INTENSIVE NEUROLOGY AND NEUROSURGICAL PRACTICE IN PATIENTS WITH CRANIOCEREBRAL INJURIES

The parameters listed in the article show the huge path that laboratory express diagnosis of emergency conditions in neurology has taken over the past 50 years. And this is not the limit - new unique technologies appear. The range of measured and calculated parameters continues to expand, which makes it possible to more fully and adequately assess the condition of a critically ill patient. Thus, a timely and qualitative study of the gaseous composition of blood is important for carrying out differential diagnosis, prescribing adequate treatment and monitoring the therapy effectiveness. The aim of the study was to highlight the current parameters of laboratory rapid diagnostics in intensive neurology and neurosurgical practice in patients with traumatic brain injury. There are two situations that necessitate the development of rapid methods for monitoring hemostasis in the neurological intensive care unit and neurosurgical operating room: the need to immediately determine the concentration or biological effect of anticoagulants. Some areas of surgical intervention are associated with increased blood loss due to coagulopathy, which requires timely replacement therapy. A long process of determining hemostatic parameters by routine methods in a general laboratory leads to a delay in diagnosis and, as a result, untimely treatment. Quite a few express methods designed to obtain specific information about the hemostasis process are currently available in the operating room. If these monitoring methods are used correctly, the research results are reliable, so some researchers use them to develop algorithms for determining the need for transfusion of blood components. However, the development of new monitoring methods requires close collaboration with scientists specialized in hemostasis, plus quality control must be established. It is necessary to prove the positive effect of rapid diagnostic methods on the result to ensure the possibility of their wide application in various operations.

Physical space of thirty pediatric intensive care units in the United States of America: a national survey.

The design of Pediatric Intensive Care Unit (PICU) rooms significantly impacts patient care and satisfaction. The aims were first, to describe the current physical space across PICUs in the USA, and second, to identify what proportion of PICUs are compliant with current guidelines. A descriptive cross-sectional survey was conducted, targeting division chiefs and medical directors of PICUs nationwide. The survey collected data on unit type, construction and renovation dates, room sizes, and available amenities. According to the Guidelines for Design and Construction of Hospitals, PICU rooms are recommended to be single rooms, at least 200 sq ft, have a window and a private bathroom. Data were anonymized and reported as median and interquartile ranges or frequencies and percentages. Thirty units responded. Among the respondents, 26 had general PICUs, 9 had cardiac ICUs, and 3 had intermediate care units, with some units containing multiple types of ICUs. The median annual admissions were 1,125, with a median occupancy rate of 78%. Twenty-three percent of units had at least one double room, and 3% had triple or quadruple rooms. The median room size was 265 sq ft (IQR 230; 304), the smallest room size was 220 sq ft (IQR 179; 275), and the largest single room size was 312 sq ft (IQR 273; 330). Thirty-seven percent of units had bathrooms in every room, while 80% had windows in every room. Additionally, 46% of units had dialysis capabilities in every room, and 7% had negative pressure capabilities in every room. The median building year was 2008 (IQR 2001;2014), with 36% of units having undergone at least one renovation. Larger rooms were associated with more recent build dates (p = 0.01). Only 30% of the PICUs met the guidelines for physical space. These compliant units were built at a median of 4 years ago (IQR 1; 8). This study highlights the variability in PICU room design and amenities across healthcare facilities. Many units still fall short of meeting the guidelines for room size, windows, and private bathrooms. Future research should investigate the relationship between room characteristics and patient outcomes to inform better design practices, with a goal of improving patient experiences and clinical outcomes.

Performance of an Autonomous Sanitary Sterilisation Ultraviolet Machine (ASSUM) on terminal disinfection of surgical theaters and rooms of an intensive-intermediate care unit

Ultraviolet- C (UV-C) light is effective for reducing environmental bioburden in hospitals, and the use of robots to deliver it may be advantageous. To evaluate the feasibility and clinical efficacy of an autonomous programmable UV-C robot in surgical and intensive care unit (ICU) rooms of a tertiary hospital. During ten consecutive months, the device was used in six theatres where cardiac, colorectal and orthopaedic surgeries were performed, and in the rooms previously occupied by patients subjected to contact precautions of a 14-bed ICU. Surgical site infection (SSI) rates of procedures performed in the UV-cleaned theatres were compared with those of the previous year. Incidence in clinical samples of ICU-acquired multiple-drug resistant (MDR) microorganisms was compared with that of the same period of the previous year. An UV-C exposure study done by semi-quantitative dosimeters and a survey of the bioburden on surfaces were carried out. SSI rates in the pre- and post-intervention periods were 8.67% (80/922) and 7.5% (61/813), respectively (p=0.37). Incidence of target microorganisms in clinical samples remained unchanged (38.4 vs. 39.4 per 10,000 patient-days, p=0.94). All the dosimeters exposed to ≤1 meter received ≥500 mJ/cm2. The bacterial load on surfaces decreased after the intervention, particularly in ICU rooms (from 4.57±7.4 CFU to 0.27±0.8 CFU, p<0.0001). Deployment of an UV-C robot in surgical and ICU rooms is feasible, ensures adequate delivery of germicidal UV-C light and reduces the environmental bacterial burden. Rates of surgical site infections or acquisition of MDR in clinical samples of critically-ill patients remained unchanged.

Driving Pressure-guided Ventilation in the Intensive Care Unit and Operating Room

Mechanical ventilation is the cornerstone of management for critically ill patients and those undergoing general anesthesia. Currently, lung protective ventilation strategies primarily include low tidal volume, positive end-expiratory pressure, and limited pressure, combined with certain recruitment maneuvers. Recently, driving pressure has been proposed as a key parameter to optimize mechanical ventilation. This study reviewed the relevant literature and suggests that driving pressure may be correlated with improved survival in patients with acute respiratory distress syndrome, enhanced intraoperative pulmonary mechanics, reduced postoperative atelectasis, and better gas exchange and oxygenation, even in normal lungs. However, the correlation between driving pressure and postoperative pulmonary complications has also been described as controversial. These findings could serve as a reference for future clinical practice.

Frequently Touched Sites in the Intensive Care Unit Environment Returning 100 Colony-Forming Units per Surface Area Sampled Are Associated With Increased Risk of Major Bacterial Pathogen Detection.

A threshold for surface hygiene has not been defined for the healthcare arena. We aimed to identify the magnitude of bacterial contamination offrequently touched sites in the intensive care unit (ICU) environment that could be used to guide quality improvement initiatives. Nineteen patients in a mixed ICU environment (providing care for medical and surgical patients) were followed from admission for 72 hoursin 2010. Baseline cultures of frequently touched environmental sites were obtained at time zero following active decontamination and at 12, 24, 48, and 72 hours without further disinfection. We tested for an association of environmental reservoirs returning ≥ 100 colony-forming units (CFU) per surface area sampledwith major bacterial pathogen detection. There were 446 ICU room, day, and reservoir combinations sampled from 19 patients. There were pathogens detected in 40% (79/199) of samples with ≥ 100 CFU vs. 14% (35/247) of samples returning < 100 CFU. The relative risk was 2.80 (95% CI: 1.97-3.98, P <0.0001). The odds ratio adjusted for time in hours was 3.11 (95% CI: 1.84-5.34, P < 0.0001). Frequently touched ICU environmental sites returning ≥ 100 CFU are associated with major bacterial pathogen detection. This threshold for surface hygiene can be used to ensure compliance with ICU environmental cleaning protocols and toguide quality improvement initiatives.

Clearing the Air, Breathe Easy: Intensive Care Unit Remodeling Unveils Insights into Aspergillosis Prevention

Background: Invasive aspergillosis (IA) poses a substantial threat to morbidity and mortality, particularly among immunocompromised individuals. In 2023, a New York City Intensive Care Unit (ICU) experienced an aspergillus outbreak following a structural water leak, resulting in two patients diagnosed with Invasive Aspergillus niger in their bronchial cultures. Immediate interventions, including patient relocation and ICU reconstruction were implemented to mitigate further impacts. This study aims to assess the impact of timely relocation of patients and renovation of the ICU, on the incidence of invasive aspergillosis. Method: A quasi-experimental study design of ICU patients over a nine month period included surveillance by the Infection Prevention department from March 1 to December 1, 2023. Surveillance included review of microbiology reports, environmental cultures, and patient chart reviews. The Pre-intervention spanned March 1 to May 1, and the post-intervention from May 4 to December 1. Indoor mold assessments of pre- and post-intervention involved testing wall surfaces for moisture, air sample collection for fungal spores, and surface swabs for direct fungal analysis. The intervention included relocating all seventeen patients from the impacted ICU and comprehensive reconstruction. Reconstruction involved the removal and replacement of all sheetrock within the unit extending four feet from the floor with moisture-resistant sheetrock. Additionally, moisture resistant single sheet welded vinyl flooring and cove-bases were installed. All heating, ventilation, and air-conditioning (HVAC) systems were inspected and cleaned. Construction activities strictly adhered to Infection Control Risk Assessment (ICRA) guidelines, with emphasis on maintaining negative pressure, to ensure a safe environment. Result: Environmental swab samples from 50% of ICU rooms indicated growth of Aspergillus/Penicillium, Chaetomium, and Stachybotrys/Memnoniella type spores during the pre-intervention phase. Environmental microbiology results strongly suggest the indoor environment as the fungal spore source, with the presence of fruiting structures indicating surface mold growth. Indoor air samples, when compared to outdoor samples collected during pre-intervention, showed rare (2-6 raw count) growth of Aspergillus in 55% of the sampled rooms and subequently no growth post-intervention. Prospective surveillance revealed no further aspergillus growth in the ICU population and environment. Conclusion: Our findings highlight a potential correlation between environmental modifications and reduced IA incidence. Swift mitigation and structural interventions are crucial in averting potentially fatal outcomes, marking a significant advancement of prevention strategies for inner-city hospital settings. Although promising, study limitations include the inability to speciate environmental aspergillus for comparison to patient bronchial cultures and the absence of baseline bronchial cultures for affected patients on admission.

Low-field MRI for use in neurological diseases.

To review recent clinical uses of low-field magnetic resonance imaging (MRI) to guide incorporation into neurological practice. Use of low-field MRI has been demonstrated in applications including tumours, vascular pathologies, multiple sclerosis, brain injury, and paediatrics. Safety, workflow, and image quality have also been evaluated. Low-field MRI has the potential to increase access to critical brain imaging for patients who otherwise may not obtain imaging in a timely manner. This includes areas such as the intensive care unit and emergency room, where patients could be imaged at the point of care rather than be transported to the MRI scanner. Such systems are often more affordable than conventional systems, allowing them to be more easily deployed in resource constrained settings. A variety of systems are available on the market or in a research setting and are currently being used to determine clinical uses for these devices. The utility of such devices must be fully evaluated in clinical scenarios before adoption into standard practice can be achieved. This review summarizes recent clinical uses of low-field MR as well as safety, workflows, and image quality to aid practitioners in assessing this new technology.

QUALITATIVE EVALUATION OF ANTIBIOTIC USE IN THE NICU ROOM (NEONATE INTENSIVE CARE UNIT) IN HOSPITAL X CITY OF PADANG YEAR 2022

Neonates are very vulnerable to infection due to exposure to microorganisms during labor and sometime after birth. Some neonates need special care in the Neonatal Intensive Care Unit (NICU) room because of infection cases that require antibiotic therapy. This study aims to evaluate the use of antibiotics qualitatively. This study is an analytic descriptive study with cross sectional design, using retrospective data. Evaluation of antibiotic use qualitatively with the Gyssens method. While the relationship between the rationality of antibiotic use with the description of demographic and clinical characteristics of patients was analyzed by chi square. The source of data was the medical records of patients admitted to the NICU room of Hospital X in Padang City who were admitted from January 1, 2022 to December 31, 2022. Descriptive analysis was performed to determine the description of demographic and clinical characteristics of patients and evaluation of antibiotic use. From this study, the results of qualitative evaluation obtained category 0 (rational) 180 (71.14%), category IIa as many as 14 (5.53%), category IIb as many as 9 (3.56%), category IIIa as many as 21 (8.30%) and category IIIb as many as 28 (11.07%).The relationship between the accuracy of antibiotic use with the description of demographic characteristics and NICU discharge conditions obtained the results there is a difference in the level of accuracy of antibiotic use with the birth process (p=0.000) and there is a difference in the level of accuracy of antibiotic use with NICU discharge conditions (p=0.000).

Best practices for flexible endoscope high-level disinfection-an integrative review

Background: Flexible endoscopes have a complicated design which includes several small lumen channels intended to facilitate the flow of fluids, tissue, and tools through the length of the device. This complex design leads to reprocessing challenges for high-level disinfection (HLD) to ensure endoscopes are free from contaminants that could lead to hospital-acquired infections. The aim of this project was to identify optimal strategies and obstacles for each stage of flexible endoscope HLD through an integrative review with the goal of achieving reprocessing excellence. Methods: A literature search was conducted using PubMed/Medline and CINAHL databases. A total of 32 articles and six guidelines were included in the review. Results: Ten elements with best-practice recommendations of flexible endoscope HLD have been identified. The HLD elements that received the most literature support include quality assurance/process monitoring and manual cleaning/decontamination. Several barriers to the adequate performance of HLD elements were also identified. Conclusion: This integrative review applied varying levels of rigour to identify and synthesize best practices for the following HLD elements: point-of-use treatment, transport, leak testing, manual cleaning/decontamination, visual inspection, manual or automated HLD, rinsing/drying, storage/hang time, record keeping, and quality assurance/process monitoring.

How to Defeat Multidrug-Resistant Bacteria in Intensive Care Units. A Lesson from the COVID-19 Pandemic. Prevention, Reservoirs, and Implications for Clinical Practice.

Background: Intensive care unit (ICU) patients are at high risk of infection due to multiple invasive procedures, malnutrition, or immunosuppression. The rapid increase in infections with multidrug-resistant organisms (MDRO) during the COVID-19 pandemic caused a dilemma, as the rules of the sanitary regime in ICU rooms were strictly adhered to in the prevailing epidemiological situation. The combat to reduce the number of infections and pathogen transmission became a priority for ICU staff. This study aimed to assess whether eliminating environmental reservoirs and implementing improved procedures for patient care and decontamination and washing equipment in the ICU reduced the incidence of infections caused by MDR strains. Material and methods: The study retrospectively analyzed data in the ICU during the COVID-19 pandemic. The samples were collected based on microbiological culture and medical records in the newly opened ICU (10 stations) and hospital wards where COVID-19 patients were hospitalized. Environmental inoculations were performed during the COVID-19 pandemic every 4-6 weeks unless an increase in the incidence of infections caused by MDR strains was observed. Through microbiological analysis, environmental reservoirs of MDR pathogens were identified. The observation time was divided into two periods, before and after the revised procedures. The relationship between isolated strains of Klebsiella pneumoniae NDM from patients and potential reservoirs within the ICU using ERIC-PCR and dice methods was analyzed. Results: An increased frequency of infections and colonization caused by MDRO was observed compared to the preceding years. A total of 23,167 microbiological tests and 6,985 screening tests for CPE and MRSA bacilli were collected. The pathogen spread was analyzed, and the findings indicated procedural errors. Assuming that the transmission of infections through the staff hands was significantly limited by the restrictive use of personal protective equipment, the search for a reservoir of microorganisms in the environment began. MDR strains were grown from the inoculations collected from the hand-wash basins in the wards and from inside the air conditioner on the ceiling outside the patient rooms. New types of decontamination mats were used in high-risk areas with a disinfectant based on Glucoprotamine. Active chlorine-containing substances were widely used to clean and disinfect surfaces. Conclusions: Infections with MDR strains pose a challenge for health care. Identification of bacterial reservoirs and comprehensive nursing care significantly reduce the number of nosocomial infections.

Effectiveness of SplashGuard Caregiver prototype in reducing the risk of aerosol transmission in intensive care unit rooms of SARS-CoV-2 patients: a prospective and simulation study

The contagiousness of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is known to be linked to the emission of bioaerosols. Thus, aerosol-generating procedures (AGPs) could increase the risk of infection among healthcare workers (HCWs). To investigate the impact of an aerosol protection box, the SplashGuard Caregiver (SGGC) with suction system, by direct analysis of the presence of viral particles after an AGP, and by using the computational fluid dynamics (CFD) simulation method. This prospective observational study investigated HCWs caring for patients with SARS-CoV-2 admitted to an intensive care unit (ICU). Rooms were categorized as: SGCG present and SGCG absent. Virus detection was performed through direct analysis, and using a CFD model to simulate the movement dynamics of airborne particles produced by a patient's respiratory activities. Of the 67 analyses performed, three samples tested positive on quantitative polymerase chain reaction: one of 33 analyses in the SCCG group (3%) and two of 34 analyses in the non-SGCG group (5.9%). CFD simulations showed that: (1) reduction of the gaps of an SGCG could decrease the number of emitted particles remaining airborne within the room by up to 70%; and (2) positioning HCWs facing the opposite direction to the main air flow would reduce their exposure. This study documented the presence of SARS-CoV-2 among HCWs in a negative pressure ICU room of an infected patient with or without the use of an SGCG. The simulation will help to improve the design of the SGCG and the positioning of HCWs in the room.

The Relationship of Knowledge about Patient Care with Family Anxiety Levels in Intensive Care Unit of Antonius Pontianak Hospital

In the intensive care unit of Santo Antonius Hospital Pontianak with p value = 0.00 Family members will experience anxiety when facing one of the family members who is admitted to the ICU. Anxiety in the family can interfere with the patient's treatment process, because anxiety can cause stress in the family that can affect treatment support. Method: This study is a quantitative research that uses a correlative descriptive design with a cross sectional design. Sampling sampling technique with Total Sampling of 41 people. Croncbach's Alpha validity test result of 0.901 and proven reliable with &gt; result of 0.6 Result: Most of the respondents (56.1%) had good knowledge about treatment in the ICU of St. Antonius Hospital Pontianak. Almost half of the respondents (36.6%) experienced mild anxiety because their families were treated at St. Anthony's Hospital. The results of statistical tests using Chi Square and the level of significance (α) 0.05 were obtained There is a relationship between knowledge about patient care and the level of family anxiety in the intensive care unit room of St. Antonius Hospital Pontianak with a p value = 0.001. Conclusion: There is a relationship between knowledge about patient care and the level of family anxiety.

ANALISA JARAK AMAN PAPARAN RADIASI BAGI PETUGAS RUMAH SAKIT ICU CENTRAL DI RSUD ARIFIN ACHMAD PROVINSI RIAU

The Intensive Care Unit (ICU) is a room in a hospital with specialized staff and equipment. The patient in the ICU is unstable, so he needs the help of intensive equipment. The ICU patients' limitations require that X-ray examinations be carried out using an X-ray mobile. When an X-ray examination occurs, hospital staff, such as doctors, nurses, and staff, must maintain a certain distance from the radiation source (mobile X-ray aircraft). This study aimed to determine which distances and areas are safe from radiation exposure for hospital medical staff in the Central ICU room at Arifin Achmad Hospital, Riau Province. This research is quantitative with experimental methods. Retrieval of data in research by measuring exposure to radiation doses from 4 different points. The study was conducted from March to July 2023. The data obtained will be analyzed by comparing the results of measurements with NBD based on BAPETEN Regulation No. 15 of 2015 to explore safe areas for hospital staff in the ICU room. Measures at 4-point places show that all-point measurements are safe. Point 1 is the distance from the radiation source to the main door at 11m with a scatter radiation value of 0.9 mSv/y. Point 2 is the distance from the radiation source to the shielding at a distance of 12 m with a scatter radiation value of 0 mSv/y. The most recommended point for the safest medical staff at point 2 (behind the shielding) is the ICU staff room. Keywords: intensive care unit (ICU), safety distance, radiation exposure, X-ray mobile.

Factors Influencing Parents' Perception of Their Infants' Transition From a 6-Bed Pod to Single Family Room in a Mixed-Room Neonatal Intensive Care Unit.

Factors Influencing Parents' Perception of Their Infants' Transition From a 6-Bed Pod to Single Family Room in a Mixed-Room Neonatal Intensive Care Unit.

GAMBARAN PENGALAMAN PERAWAT TENTANG BANTUAN HIDUP DASAR (BHD) DI RUANG INTENSIVECARE UNIT (ICU) RUMAHSAKIT SANTA ELISABETH MEDAN TAHUN 2023

Work experience is the length of time employees work at work from the time they are accepted into the workplace until now. Basic life support (BHD) is an effort made to maintain life when the victim experiences respiratory arrest and cardiac arrest. The purpose of the study is to determine the Nurse's Experience on Basic Life Support (BHD) in the Intensive Care Unit (ICU) Room of Santa Elisabeth Hospital Medan 2023. This study used qualitative methods where the data collection is carried out with interviews as many as 4 questions so as to be able to dig deeper into nurses' experiences about basic life support. The sampling technique uses purposive sampling as many as 5 participants. The data analysis technique used is thematic analysis.The results of the study are obtained: The nurse's experience of basic life support is to maintain breathing so that respiratory arrest and cardiac arrest do not occur, Basic life support is an interesting experience because in BHD requires high energy / concentration and adds insight for nurses to do BHD, Basic life support can increase cohesiveness and teamwork and doctors on duty in doing BHD, Basic life support is understanding and skills because nurses have done BHD training, basic life support can be provided to patients who experience respiratory arrest and cardiac arrest. The results In this study, the experience of nurses on basic life support is supported by updated BHD knowledge and training to add to the experience that nurses have followed.

Cluster of Carbapenemase-Producing Carbapenem-Resistant Pseudomonas aeruginosa Among Patients in an Adult Intensive Care Unit - Idaho, 2021-2022.

Treatment of carbapenemase-producing carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) infections is challenging because of antibiotic resistance. CP-CRPA infections are highly transmissible in health care settings because they can spread from person to person and from environmental sources such as sink drains and toilets. During September 2021-January 2022, an Idaho hospital (hospital A) isolated CP-CRPA from sputum of two patients who stayed in the same intensive care unit (ICU) room (room X), 4 months apart. Both isolates had active-on-imipenem metallo-beta-lactamase (IMP) carbapenemase gene type 84 (blaIMP-84) and were characterized as multilocus sequence type 235 (ST235). A health care-associated infections team from the Idaho Division of Public Health visited hospital A during March 21-22, 2022, to discuss the cluster investigation with hospital A staff members and to collect environmental samples. CP-CRPA ST235 with blaIMP-84 was isolated from swab samples of one sink in room X, suggesting it was the likely environmental source of transmission. Recommended prevention and control measures included application of drain biofilm disinfectant, screening of future patients who stay in room X (e.g., the next 10 occupants) upon reopening, and continuing submission of carbapenem-resistant P. aeruginosa (CRPA) isolates to public health laboratories. Repeat environmental sampling did not detect any CRPA. As of December 2022, no additional CP-CRPA isolates had been reported by hospital A. Collaboration between health care facilities and public health agencies, including testing of CRPA isolates for carbapenemase genes and implementation of sink hygiene interventions, was critical in the identification of and response to this CP-CRPA cluster in a health care setting.

THE RELATIONSHIP BETWEEN THE APACHE II SCORE AND THE NUMBER OF DAYS OF HOSPITALIZATION IN THE INTENSIVE CARE UNIT (ICU) AT HARAPAN INSAN HOSPITAL, SENDAWAR WEST KUTAI

The APACHE II score is a method for determining disease severity and assessing patient mortality in ICU. The result of measuring the patient's condition was obtained in the first 24 hours of admission to the ICU. Scoring is used to estimate prognostic risk factors for patients who can leave the ICU room in recovering or dying conditions. The length of hospitalization for patients in the Intensive Care Unit (ICU) is on average more than 5 days. The purpose of this study was to determine the relationship between the APACHE II score and the range of days in the Intensive Care Unit (ICU) at RSUD Harapan Insan Sendawar West Kutai. The design of this study was cross-sectional. The sampling technique in this study used accidental sampling, and the research samplers were 30 respondents. The test instrument used the APACHE II Observation sheet. The results of the statistical analysis of the bivariate test using Chi-Square obtained a p-value of 0.757, which is greater than the alpha value, it means that there is no relationship between the APACHE II score and the range of days of hospitalization in the Intensive Care Unit (ICU) at Harapan Insan Hospital, Sendawar, West Kutai. The Odds Ratio (OR) value was obtained at 0.786, which means that patients who have an APACHE II score were in a low category, and they have an opportunity of 0.786 times to have a range of days of hospitalization in the category of short hospital days. There is no relationship between the APACHE II score and the range of days of hospitalization in the Intensive Care Unit (ICU) at Harapan Insan Hospital, Sendawar, West Kutai. The suggestions for hospital management to add beds in the ICU and the results of the research are expected to be guidelines for patient care in the ICU by using the APACHE II score and improving services in the ICU

Gene similarity examination Pseudomonas aeruginosa in Intensive Care Unit (ICU) at Prof. Dr. dr. I.G.N.G Ngoerah hospital using the ERIC-PCR method: case reports

Background: Pseudomonas aeruginosa is an opportunistic pathogen that has the potential to cause severe degrees of healthcare-associated infections, especially in immunocompromised patients who have AIDS, cancer, burns, and respiratory tract infections. Antibiotic resistance genes by genetic elements are increased so that it becomes a worldwide concern and also causes the evolution of resistant strains (MDR) ERIC-PCR technique is a PCR-based method in which the location and number of different ERIC sequences in bacteria are used as genetic markers of bacterial diversity. Case Presentation: We presented three patients with Pseudomonas aeruginosa infection treated in the ICU (Intensive Care Unit) room of Prof. dr. I. G. N. G Ngoerah Hospital. While being treated in the ICU, the three patients' beds were located side by side in one room. Three patients, in this case, reports were treated in the same room where the beds were side by side and experienced a worsening of their condition. After examination, it was found that the bacteria that caused the infection was Pseudomonas aeruginosa. However, after conducting molecular analysis using the ERIC-PCR method, there was no gene similarity between the three isolates examined. This might have happened because the patient had been treated in a different room before being admitted to the ICU. Conclusion: We presented a discrepancy between Pseudomonas aeruginosa infection in three patients treated in the same ICU room. However, the ERIC-PCR results found no gene similarity between the three isolates examined.