Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018)

Kashyap, Rahul; Vashistha, Kirtivardhan; Saini, Chetan; Dutt, Taru; Raman, Dileep; Bansal, Vikas; Singh, Harpreet; Bhandari, Geeta; Ramakrishnan, Nagarajan; Seth, Harshit; Sharma, Divya; Seshadri, Premkumar; Daga, Mradul Kumar; Gurjar, Mohan; Javeri, Yash; Surani, Salim; Varon, Joseph; Team, Inin Investigators

doi:10.5492/wjccm.v9.i2.31

Cited by 10 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, they did not evaluate association with mortality. 14 , 15 A study based on the Project IMPACT database of 1,01,832 patients in 123 ICUs in the United States had also found that even after adjusting for disease severity, patients managed by critical care specialists showed higher mortality. 16 They speculated that some routine critical care practices and procedures may not be beneficial or that the presence of confounders not included in the model may account for worse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intensive Care in India in 2018–2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study

Divatia¹,

Mehta²,

Govil³

et al. 2022

Indian Journal of Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

A bstract Background We aimed to study organizational aspects, case mix, and practices in Indian intensive care units (ICUs) from 2018 to 2019, following the Indian Intensive Care Case Mix and Practice Patterns Study (INDICAPS) of 2010–2011. Methods An observational, 4-day point prevalence study was performed between 2018 and 2019. ICU, patient characteristics, and interventions were recorded for 24 hours, and ICU outcomes till 30 days after the study day. Adherence to selected compliance measures was determined. Data were analyzed for 4,669 adult patients from 132 ICUs. Results On the study day, mean age, acute physiology and chronic health evaluation (APACHE II), and sequential organ failure assessment (SOFA) scores were 56.9 ± 17.41 years, 16.7 ± 9.8, and 4.4 ± 3.6, respectively. Moreover, 24% and 22.2% of patients received mechanical ventilation (MV) and vasopressors or inotropes (VIs), respectively. On the study days, 1,195 patients (25.6%) were infected and 1,368 patients (29.3%) had sepsis during their ICU stay. ICU mortality was 1,092 out of 4,669 (23.4%), including 737 deaths and 355 terminal discharges (TDs) from ICU. Compliance for process measures related to MV ranged between 62.7 and 85.3%, 11.2 and 47.4% for monitoring delirium, sedation, and analgesia, and 7.7 and 25.3% for inappropriate transfusion of blood products. Only 34.8% of ICUs routinely used capnography. Large hospitals with ≥500 beds, closed ICUs, the APACHE II and SOFA scores, medical admissions, the presence of cancer or cirrhosis of the liver, the presence of infection on the study day, and the need for MV or VIs were independent predictors of mortality. Conclusions Hospital size and closed ICUs are independently associated with worse outcomes. The proportion of TDs remains high. There is a scope for improvements in processes of care. Registered at clinicaltrials.gov (NCT03631927). How to cite this article Divatia JV, Mehta Y, Govil D, Zirpe K, Amin PR, Ramakrishnan N, et al . Intensive Care in India in 2018–2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study. Indian J Crit Care Med 2021;25(10):1093–1107.

show abstract

Section: Discussionmentioning

confidence: 99%

Intensive Care in India in 2018–2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study

Divatia¹,

Mehta²,

Govil³

et al. 2022

Indian Journal of Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Using in-person, instant messaging, e-mail, and video conference exchanges, we assembled a core team comprising professionals from across the medical hierarchy, including doctors, nurses, emergency medical technicians, and medical students ( Figure 1 ) . For a global-scale study, it was imperative that the core team members be well versed with human subject research regulations; team building and outreach; data collection, data entry, cleaning, and manipulation; epidemiology and data analysis; and statistics [ 12 , 13 ]. The ViSHWaS study used and expanded upon the core competencies in human subject research expertise; team building; and data storage, cleaning, and manipulation that were already present within the Global Remote Research Scholars Program (an existing remote research team) [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Guiding principles for the conduct of the Violence Study of Healthcare Workers and System (ViSHWaS): Insights from a global survey

Amal,

Banga,

Bhatt

et al. 2024

J Glob Health

Self Cite

View full text Add to dashboard Cite

Background Although many studies worldwide have reported on violence against health care workers, there is a lack of homogeneous data for understanding the current state of the issue. Conducting a global survey required a robust team organisation structure, unique dissemination strategies, and continual networking to maintain and propagate the pool of survey collaborators and responders. Here we aimed to describe the strategies that helped us carry out a global survey-based study, the lessons learned, and provide a practical roadmap for future large-scale cross-sectional studies. Methods We conducted this cross-sectional survey-based study from 6 June to 9 August 2022, basing it on the ‘Hub and Spoke’ model, with a single core team and subgroups in different regions managed by country leads. The key steps included team organisation, strategy formulation for survey dissemination and data collection, social media launch, and conducting a post-survey analysis amongst the collaborators. The core team convened weekly via video conference to discuss the modus operandi. The language barrier was managed through audio translation or by shifting to ‘an interviewer-administered’ questionnaire. Results The core team included 11 members from seven countries, followed by 28 country leads from 110 countries. We also gathered 80 regional collaborators who provided feedback and spread the message. The Violence Study of Healthcare Workers and Systems (ViSHWaS) returned 5500 responses globally. Guiding principles garnered through this collaborative project include focusing on effective team organisation, ensuring external validation of survey tool, personalised communication, global networking, timely communication for maintaining momentum, and addressing regional limitations. The post-survey analysis showed that WhatsApp messaging was the most common modality used for survey dissemination, followed by in-person meetings and text messaging. We noted that the successful techniques were direct communication with respondents, regular progress updates, responsiveness to regional and country lead needs, and timely troubleshooting. The most common barriers for the respondents were limitations in language proficiency, technical fallouts, lack of compliance with, and difficulty understanding the questionnaire. Conclusions In this global survey-based study of more than 5500 responses from over 110 countries, we noted valuable lessons in team management, survey dissemination, and addressing barriers to collaborative research.

show abstract

“…To seek maximum responses from as many countries as possible, a ‘hub and spoke model’ of team building was adopted 20. The senior investigator had prior experience in conducting global survey-based studies 21–24. The hub of this survey was the core team.…”

Section: Methodsmentioning

confidence: 99%

“…20 The senior investigator had prior experience in conducting global survey-based studies. [21][22][23][24] The hub of this survey was the core team. which consisted of 11 members from five countries.…”

Section: Survey Dissemination Strategymentioning

confidence: 99%

ViSHWaS: Violence Study of Healthcare Workers and Systems—a global survey

Banga,

Mautong,

Alamoudi

et al. 2023

BMJ Glob Health

Self Cite

View full text Add to dashboard Cite

ObjectiveTo provide insights into the nature, risk factors, impact and existing measures for reporting and preventing violence in the healthcare system. The under-reporting of violence against healthcare workers (HCWs) globally highlights the need for increased public awareness and education.MethodsThe Violence Study of Healthcare Workers and Systems study used a survey questionnaire created using Research Electronic Data Capture (REDCap) forms and distributed from 6 June to 9 August 2022. Logistic regression analysis evaluated violence predictors, including gender, age, years of experience, institution type, respondent profession and night shift frequency. A χ2test was performed to determine the association between gender and different violence forms.ResultsA total of 5405 responses from 79 countries were analysed. India, the USA and Venezuela were the top three contributors. Female respondents comprised 53%. The majority (45%) fell within the 26–35 age group. Medical students (21%), consultants (20%), residents/fellows (15%) and nurses (10%) constituted highest responders. Nearly 55% HCWs reported firsthand violence experience, and 16% reported violence against their colleagues. Perpetrators were identified as patients or family members in over 50% of cases, while supervisor-incited violence accounted for 16%. Around 80% stated that violence incidence either remained constant or increased during the COVID-19 pandemic. Among HCWs who experienced violence, 55% felt less motivated or more dissatisfied with their jobs afterward, and 25% expressed willingness to quit. Univariate analysis revealed that HCWs aged 26–65 years, nurses, physicians, ancillary staff, those working in public settings, with >1 year of experience, and frequent night shift workers were at significantly higher risk of experiencing violence. These results remained significant in multivariate analysis, except for the 55–65 age group, which lost statistical significance.ConclusionThis global cross-sectional study highlights that a majority of HCWs have experienced violence, and the incidence either increased or remained the same during the COVID-19 pandemic. This has resulted in decreased job satisfaction.

show abstract

Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018)

Cited by 10 publications

References 14 publications

Intensive Care in India in 2018–2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study

Intensive Care in India in 2018–2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study

Guiding principles for the conduct of the Violence Study of Healthcare Workers and System (ViSHWaS): Insights from a global survey

ViSHWaS: Violence Study of Healthcare Workers and Systems—a global survey

Contact Info

Product

Resources

About