1: Activation of Poly(adp-Ribose) Polymerase-1 Contributes to Nad+ Depletion and Impaired Nad+ Dependent Mitochondrial Respiration Following Status Epilepticus

Lai, Yi‐Chen; Searle, Rebecca; Craigen, William J.; Anderson, Anne J.

doi:10.1097/01.ccm.0000408627.24229.88

Cited by 16 publications

(35 citation statements)

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“…Instead, drawing on a prior study—by one of the coauthors [20] —and on recently reported research literature that showed the evidence for disproportionate time allocation, we evaluated whether structured tools had any effect on moderating the effects of disproportionate time allocation.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Cohen et al [18] examined video-recordings of 23 end-of-week handoff sessions in a 21-bed intensive care unit (ICU) and found that patients discussed earlier received about 50% more time than the patients discussed later in the same session, regardless of their severity or complexity of illness. Similarly, Kannampallil et al, [20] reported an average decrease of 54 seconds for every additional patient discussion during morning rounds in a Cardiothoracic ICU. As a part of a larger clinical trial, Sung et al [21] analyzed 759 patient discussions from 2 clinical teams and found similar decrease in the time spent for patients discussed later during the rounds, after adjusting for illness severity.…”

Section: Introductionmentioning

confidence: 97%

“…Recent research has illustrated that verbal discussions during rounds were vulnerable to unequal time allocation––a phenomenon that has been described as a “portfolio problem” or “end of round time compression” [18-20]. For example, Cohen et al [18] examined video-recordings of 23 end-of-week handoff sessions in a 21-bed intensive care unit (ICU) and found that patients discussed earlier received about 50% more time than the patients discussed later in the same session, regardless of their severity or complexity of illness.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

Abraham¹,

Kannampallil²,

Patel³

et al. 2016

JMIR Hum Factors

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BackgroundRecent research has shown evidence of disproportionate time allocation for patient communication during multidisciplinary rounds (MDRs). Studies have shown that patients discussed later during rounds receive lesser time.ObjectiveThe aim of our study was to investigate whether disproportionate time allocation effects persist with the use of structured rounding tools.MethodsUsing audio recordings of rounds (N=82 patients), we compared time allocation and communication breakdowns between a problem-based Subjective, Objective, Assessment, and Plan (SOAP) and a system-based Handoff Intervention Tool (HAND-IT) rounding tools.ResultsWe found no significant linear dependence of the order of patient presentation on the time spent or on communication breakdowns for both structured tools. However, for the problem-based tool, there was a significant linear relationship between the time spent on discussing a patient and the number of communication breakdowns (P<.05)––with an average of 1.04 additional breakdowns with every 120 seconds in discussion.ConclusionsThe use of structured rounding tools potentially mitigates disproportionate time allocation and communication breakdowns during rounds, with the more structured HAND-IT, almost completely eliminating such effects. These results have potential implications for planning, prioritization, and training for time management during MDRs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

Abraham¹,

Kannampallil²,

Patel³

et al. 2016

JMIR Hum Factors

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“…Patients achieve target balance within 500 ml on fewer than half of therapy days, and manual charting of ultrafiltration volumes contains inaccuracies on 60% of therapy days [35]. Accurate and meticulous volume and fluid management is crucial in AKI, as hypervolemia is associated with increased mortality [36,37].…”

Section: Leveraging Data Capture In Dialysis To Improve Patient Carementioning

confidence: 99%

Integrating Real Time Data to Improve Outcomes in Acute Kidney Injury

Hirsch

Mohan²

2015

Nephron

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Critically ill patients with acute kidney injury requiring renal replacement therapy have a poor prognosis. Despite well-known factors, which contribute to outcomes, including dose delivery, patients frequently miss the target dose and volume removal. One major barrier to effective care of these patients is the traditional dissociation of dialysis device data from other clinical information systems, notably the electronic health record (EHR). This lack of integration and the resulting manual documentation leads to errors and biases in documentation and missed opportunities to intervene in a timely fashion. This review summarizes the technological advancements facilitating direct connection of dialysis devices to EHRs. This connection facilitates automated data capture of many variables - including delivered dose, ultrafiltration rate and pressure measurements - which in turn can be leveraged for data mining, quality improvement and real-time targeted therapy adjustments. These interventions hold the promise to significantly improve outcomes for this patient population.

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“…For patients, this can regard delayed potentially beneficial therapeutic decisions, the maintenance of aggressive therapy and the resultant lower quality of treatment. Almoosa et al [20] have shown that lack of clear decisions concerning the continuation or withdrawal of treatment, as well as waiting for admission, prolonged unjustified ICU stays and the prevented hospitalisation of other patients. The negative impact of conflicts on the ICU team manifests as lack of coherence, lower efficiency and quality of work, and irrational behaviour.…”

mentioning

confidence: 99%

Konflikty na oddziale anestezjologii i intensywnej terapii

Wujtewicz¹,

Wujtewicz²,

Owczuk³

2015

Anaesthesiol Intensive Ther

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Conflicts in intensive care units (ICUs) are common and concern all professional groups, patients and their families. Both intra-and inter-team conflicts occur. The most common conflicts occur between nurses and physicians, followed by those within nursing teams and between ICU personnel and family members. The main causes of conflicts are considered to be unsatisfactory quality of the information provided, inappropriate ways of communication and improper approach towards treatment of patients. ICU conflicts can have serious consequences not only for families but also for patients, physicians, nurses and wider society. Lack of communication among ICU teams is likely to impair cooperation and ICU team-family contacts. From the point of view of patients and their families, communication skills, as one of the factors affecting the satisfaction of families with treatment, are essential to ensure high quality of ICU treatment. While conflicts are generally unfavourable, they can also have positive implications for the parties involved, depending on their prevalence and management, as well as the community they concern.

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1: Activation of Poly(adp-Ribose) Polymerase-1 Contributes to Nad+ Depletion and Impaired Nad+ Dependent Mitochondrial Respiration Following Status Epilepticus

Abstract: of open aneurysm repair (OAR). The fact that survival from treatment has not changed, however, has little to do with declining incidence and mortality from AAA in the popula 4,5 Screening programs need periodic reassessment. It is time to reassess this one.

Cited by 16 publications

References 0 publications

Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

Integrating Real Time Data to Improve Outcomes in Acute Kidney Injury

Konflikty na oddziale anestezjologii i intensywnej terapii

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