Operation In Intensive Care Unit Research Articles

Efficacy of Hand rubbing with alcohol based solution versus standard hand washing with soap and water in a Tertiary care Hospital in The North Iran

Nosocomial infections have a growing trend and are a serious threat to the health system. The aim of this work was to compare the effectiveness of hand rubbing with alcohol-based solution and standard hand washing with soap and water on transient flora of hands in intensive care unit (ICU) staff. This cross-sectional study was done at Razi Hospital, Rasht, Iran between March to August 2016. Nurses who were willing to participate were included. In each group (alcohol group, typical soap group), 50 health cares were considered randomly (a total of 100 health cares in two groups). Since 4 samples were taken from each care (two samples before work and two samples after work, both of which were taken before and after washing), a total of 400 samples were analyzed for microbial status. A total of 15 nurses (all were female) with 100 samples were included. The most rate of colony count before hands washing and operation was 45.8±39.99 CFU/ml, and the least rate after hand washing with alcohol after the operation was 15.07±31.87CFU/ml. There was a significant relationship between colony count and the measured time. There was also a significant relationship between alcohol and soap groups,as the reduction in the alcohol group was 20.58±54.4 and in soap group was 2.66 ± 48.17 (p=0.001).Our study showed that alcohol significantly decreased colony counts of staffs’ hands after operation in intensive care unit, whereas no significant differences were seen with soap solution.

The effect of the Greek financial crisis on the operation of public intensive care units

SUMMARYThe National Healthcare System in Greece has taken a serious blow by the financial crisis the country has been experiencing for the past 9 years. The operation of the Intensive Care Units (ICUs) in public hospitals could not remain unaffected, since the largest part of their funding comes from the state’s budget.Objective: To investigate the effect of the financial crisis on the operation of public ICUs in Greek hospitals.Method: Narrative literature review including Greek and English language articles in medical databases such as PUBMED, CINAHL, and in websites of Greek newspapers and other media.Results: During the crisis years, a clear shift of healthcare users from the private sector to public hospitals, together with a significant reduction of functional beds in the ICUs of public hospitals have created significant ICU bed shortages and rendered Greek ICUs clearly incapable of meeting nationwide needs. The doctors and nurses employed in public ICUs are not sufficient, and, subsequently, a decline in the quality of the healthcare provided to the critically ill has been noted.Conclusions: The situation in Greek public ICUs is critical. Without sufficient state funding, staff and ICU-bed shortages increase the likelihood that the care provided within Greek ICUs will deviate from international standards.

중환자부 시설기준 수립을 위한 가이드라인 조사·분석연구 - 미국, 영국, 호주 사례를 중심으로

Purpose: At the moment, There is a facility standard for intensive care units on the Korea medical services Act. However, the contents of regulation are so limited and difficult to apply. Therefore, it is necessary to draw up the guideline to complement the regulation for efficient operation of intensive care units. This study aims to suggest basic data for guideline of intensive care units. Methods: 2 Methods have been used in this paper. 1) Comparative analysis between the national regulation of Korea with the design standard of the United States America, the United Kingdom and Australia. 2) A literature survey about operation method for intensive care unit, focused on materials published in intensive care medicine society of each country. Results: In comparison with guideline of abroad cases, additional supplement are required, with regard to item such as operation environment, size, nursing manpower ratio, bed space area, space program of intensive care units for healing environment. Implications: This study is a basic research for guideline of intensive care unit, and need to be followed by further study using various perspectives and methods.

Effect of early active nursing on muscle strength in patients after major operation in intensive care unit

Objective To analyze the influence of early active nursing on muscle strength in patients after major operation in intensive care unit(ICU). Methods Of 96 ICU patients after major operation were enrolled in the study, 49 patients were assigned to routine ICU nursing (control group, excluding 1 case), and 47 patients were assigned to early active nursing (intervention group, excluding 2 cases) by random number table method. The health condition, muscle strength between 2 groups were compared. Results Acute and chronic physiology score after intervention was (10.62±2.04) points in intervention group, and (12.54±2.28) points in control group, and there was significant difference,t=4.269 5,P<0.01. The score of muscle strength was (56.93±4.32) points in intervention group, and (49.42±5.48) points in control group, and there was significant difference,t=7.307 1,P<0.01. The incidence of ICU-acquired muscle weakness in intervention group (6.67%, 3/45) was significantly lower than that of control group (43.75%,21/48),χ2= 16.681 5,P<0.01. Conclusions Early active nursing is of great importance to improve muscle strength and decrease the incidence of ICU-acquired muscle weakness. Key words: Nursing care; Intensive care units; Muscle strength; Early intervention

Blood transfusion practice in a referral cardiovascular center in tehran, iran: a critical point of view.

Background:Unnecessary perioperative transfusions are likely to be related to increased morbidity and additional costs in cardiac surgery.Objectives:The aim of this study was to evaluate the blood transfusion practice during and after adult cardiac surgery in a referral university hospital in Iran.Patients and Methods:In a descriptive study, we collected data from 153 adult patients underwent cardiac surgery at Rajaie Cardiovascular Medical and Research Center, Tehran, Iran from January to March 2013. The variables were patients’ demographic, operative and post-operative data and the numbers of transfused packed red blood cell (PC) units and fresh frozen plasma (FFP) during and after cardiac surgery. Then we evaluated patients’ and physicians’ related causes of relatively increased transfusion rate in our patients and compared them with literature.Results:Of 153 patients, 96.8% received PC and 54.9% transfused FFP during or after surgery. Most of the transfusions were done after operation in intensive care unit (ICU). Also, 20% and 17% of the patients underwent transfusion of more than 6 units of PC and FFP, respectively. The mean left ventricular ejection fraction of the patients was 42.5 ± 10.9%. A significant number of patients had anemia (especially women) or received anticoagulants or antiplatelet agents preoperatively. Thirteen percent of the patients underwent emergency operations and 12.3% had re-exploration.Conclusions:The results of this study demonstrate that the cardiac surgery patients receive a relatively greater number of PC or FFP units during and after the operation in our center. This finding may be explained to some extent by the fact that the sicker and more co-morbid patients referred to our center and such patients are more anemic and undergoing more emergent and complex procedures. Moreover, Transfusion strategy or protocol should be updated, especially after the operation in ICU.

Acute respiratory distress syndrome: a historical perspective.

Though well described even in ancient writings, the acute respiratory distress syndrome (ARDS) gained major medical attention with the availability of mechanical ventilation and establishment of intensive care units. In the 50 years since this beginning there have been remarkable advances in the understanding of the etiology, physiology, histology, and epidemiology of this often lethal complication of common human maladies. Until recently, improvements in outcome have mainly followed improvements in intensive care unit operation and their associated life support systems, and have not come through discoveries made in the course of prospective randomized trials. In spite of the remarkable increase in research focused on ARDS, there remain a large number of unanswered clinical questions that are potentially extremely important with regard to short-term morbidity as well as long-term outcome. The ARDS Clinical Trials Network study of tidal volume has proven that randomized trials in ARDS with positive results are possible even when using difficult primary outcome measures such as mortality or ventilator-free days. Therefore, the rich combination of new trial strategies, potential treatments, experienced investigators, and increasingly standardized routine care set the stage for rapid advances to be made in the short- and long-term outcomes of this devastating syndrome.