The Medical Intensive Care Unit

It was the worst thing in my life. One sip of the wrong drink and my best friend, Brady, was in the Intensive Care Unit, with a small change of survival. How was I supposed to know that his ex-boyfriend was going to poison the water supply? No one is supposed to know about that, until it already happened.

Critical Care Medicine Physicians (Intensivists) diagnose and treat a wide variety of clinical problems representing the extremes of human illness (American College of Physicians, 2017). This coordinated care is provided to critically ill and injured patients. This care is also needed for post-operative care of cardiac, vascular, and neurosurgical patients. By the year 2020 there is a predicted shortage of 1500 Critical Care Physicians (Croasdale, 2006). The Intensivist to patient ratio is complex but is recommended to be around 1-to-15 (Ward et al, 2013). ICU care is expensive to provide. In the Unites States there are approximately 20 ICU Beds per 100,000 population (Murthy & Wunsch, 2012). The service must provide an appropriate number of

According to the American Hospital Association (AHA), Critical Access Hospitals (CAHs) are rural hospitals that receive reimbursements from programs like Medicare and Medicaid. Critical Access Hospitals are part of a national effort to provide equal access to affordable health care to all citizens.

The American Board of Medical Specialties [ABMS] recognizes palliative care as a medical subspecialty classified under internal medicine (ABMS, 2015). Currently, there are only 5,000 board-certified palliative care specialists in the US (Quill & Abernethy, 2013). The demand for palliative care physicians outweighs the supply. This opens the door for other medical disciplines, such as intensive care unit (ICU) doctors or anesthesia personnel to step-in and assume some care of this unique patient population. Only 75-85% of hospitals with greater than 300 beds provide palliative care services and palliative care is available in only 20% of smaller hospitals (fewer than 50 beds)(Morrision, Augustin, Souvanna, & Meier, 2011; Goldsmith, Dietrich, Du, & Morrison, 2008).

Historical data and participant observation were the two primary methods of research. It is observed that in addition to the patient acuity levels nurses perceive insufficient staffing related to the non-nursing work they are expected to perform such as delivering food trays, housekeeping responsibilities, and performing ancillary services. Many different views of the nurse to patient ratio are explored, and it was sufficiently established that the redundancy of the data was reached. It was not established whether or not informed consent was obtained.

In addition to not fully understanding or recognizing the need for increased ICU intensivists and critical care nurses may be unfamiliar and uncomfortable with the technology. Because the hospital or health system pays all of the operating and staffing expenses of the eICU, cash layouts for an eICU system may be deemed an unnecessary and expensive venture, at least in the short-run. Despite these concerns, as many as 100 hospitals nationwide have implemented eICU programs, while others are considering expanding these programs to other high-risk areas of the hospital, such as step-down

After watching the video of the patient care team at Christiana Care's Wilmington Hospital intensive care unit demonstrates the patient and family centered care practice of interdisciplinary rounds at the bedside, I (recreated), used ,the assessment tool for group dynamics to evaluate the group functioning (Christiana Care, 2012, Video). Overall the rating of the group function was rated acceptable however there three areas that received low scale rating (2.0) according to the key provided, (in some areas), those areas were Communications, Leadership and Situation (Team Dynamics Assessment Tool, 2012 and Christiana Care, 2012, Video).

An Electronic Intensive Care Unit (eICU) is a form of telemedicine, that uses technology to provide care to patients in multiple hospitals.

Intensive care coordination services were provided through a CFT (client family team) meeting. WYP gathered information during the meeting. The client is improving in his independents living skills (waking up for school, going to school, doing his laundry, and other chores). The client is doing well with maintaining a positive relationship with his foster family by engaging in activities. The client needs to work on his communication skills (client is not honest, attempt to manipulate the situation, and wait until the last minute to ask for help). WYP will follow up with assisting the client to decrease manipulation and work on better communication. WYP updated the team that the client is doing well with following the directives. The foster

You mentioned medical errors in your post. As a nurse working in the ICU a few years back, I have seen my share of medical errors as it happened. Sad to say, most of them were highly preventable. According to Garrouste (2012), medical errors and adverse events are very common in ICUs, and among them the most prevalent involve medications (Garrouste-Orgeas, et al., 2012) . It is interesting to note that diagnostic errors are also a frequent cause of medical errors in the U.S.( Singh, et al., 2008). The authors cite some examples of diagnostic errors (Singh, et al., 2008): failure to use an indicated diagnostic test, misinterpretation of test results, and failure to act on abnormal results. The authors also added that although diagnostic errors

Interventions provided during this service: Intensive care coordination services were provided through a CFT (client family team) meeting. WYP gathered information during the meeting. The client is making to all his appointment (going to school, going to therapy, going to court), except one (court on Friday). Client did not feel like going to court, due to the incentive/reward was not to his preferences. Client is doing better with following adults' directives (client is listening to his teacher and foster parents). Client has shown improvement in not arguing to an adult. Client is not displaying any challenging behaviors in his classes. WYP praised the client for improving in following directives. WYP updated the team about the goals WYP

The Patient units constitutes 36% of total floor plan. In patient units, the patient room occupies the most space in which a portion of space is allocated for families. This family zone is not calculated under Public & Family. Diagnostic & Treatment area is used to treat outpatient and diagnose both outpatient and inpatient.

The first study is a nationally administered ICU survey regarding end of life care for the critically ill. The study was conducted by Nelson et al. (2006) with the objective of analyzing the views of ICU directors in order to understand the barriers to palliative care in the ICU and possible strategies that could improve end of life care. To best measure and record the views of respondents, close ended questions with a Likert scale rating system of responses were used. These questions encompassed barriers to care related to patient/family factors, clinician factors, and institutional/ICU factors. Additionally, questions were given to assess interventions that could improve end of life care rated from not helpful to very helpful on a 1-3 scale. Prior to survey administration; the researchers verified its quality with pretesting, a clinical sensibility assessment for instrument evaluation, interrater reliability testing to evaluate test-retest reliability, and pilot testing (Nelson et al, 2006). Based on these measures, the survey instrument was modified and items with a weighted Cohen’s k < 0.7 were eliminated from the survey. The survey was then mailed for self-administration to the nurse and physician directors of a random, stratified sample of 600 ICU’s nationally, representing 10% of ICUs in the United States. From this sample of 1205 ICU directors who were mailed surveys at 600 different ICUs, responses were returned from 590 ICU directors (406 nurse directors and 184

The research project will be conducted from four adult intensive care units (ICUs) at a level I trauma county hospital in Santa Clara County. The sample in this research will be registered nurses from four ICUs in the hospital. The researcher will be using a purposive sampling strategy to select the appropriate sample by recruiting ICU nurses who are qualified to provide the data needed for this study. Purposive sampling is sometimes called “judgmental sampling,” and it is based on the researcher's judgment to select the proper sample for the study (Murphy et al., 2018). The sample will consist of 8 to 10 registered nurses who are willing to share their experiences of a patient death in the ICU settings and are in the best position to provide

This study was performed in order to see the different types of care that children were receiving in the pediatric intensive care unit. This study focused on three types of care given by nurses: medically orientated nursing care, parent oriented nursing care, and smooth operating nursing care. Children sometimes do not have the ability to put into words what they are feeling and parents always think they know what is best for their children, but it is a nurse’s job to listen and advocate for their patient, especially when the patient is a small child. Janet Mattsson, Maria Forsner, Maaret Castre´n, and Maria Arman conducted this study to demonstrate how health care still needs to improve in relation to creating a trustworthy relationship with children, advocating for them and allowing them to choose what happens to them. I am very interested in this article because pediatrics is one of the areas I’m really interested in because I love children, and I believe in creating relationships with patients, especially children because they are so innocent, honest and kind hearted.