Intensive care unit design and mortality in trauma patients

Pettit, Nicholas; Wood, Teresa L.; Lieber, M. M.; OʼMara, Michael Shay

doi:10.1016/j.jss.2014.04.007

Cited by 18 publications

(8 citation statements)

References 19 publications

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“…Injury severity score (ISS) is based on the abbreviated injury scale (AIS),and is the most prevalence trauma score in clinical [15] .ISS is initially as a tool of comparison injury severity for multiple trauma patients.Over time,much of research demonstrated that the ISS is not only a tool for comparison of injury severity,but also a strongly correlation with mortality in multiple trauma patients [16] .Generally,patients with multiple trauma that de ned ISS ≥ 16 points associated with a mortality risk of 10%,which called as severe multiple trauma [17] .Additionally,A retrospective study showed injury severity score (ISS) was not only the one of independent risk factors of mortality,but also was the only one independent risk factor of complications and ICU length of stay [18] .ISS has been associated with mortality but the association between ISS and MODS is yet known.In our study,MODS group had a signi cantly higher ISS compared to non-MODS group(31.16±6.57 vs 23.72±7.20,P 0.001),and multivariate logistic regress analysis showed ISS could be as a predictor for MODS following multiple trauma.…”

Section: Discussionmentioning

confidence: 99%

A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients

Miao

Wei

Zhou

2020

Preprint

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BackgroundMultiple organ dysfunction syndrome (MODS) is the one of common complications,and the leading cause of late mortality in multiple trauma patients.The present study aims to develop and validate a nomogram based on clinical characteristics in order to identify the patients with multiple trauma who were at risk of developing MODS.MethodsAn retrospective cohort study was performed with data from January 2011 to December 2019,totally 770 patients with multiple trauma were enrolled in our study.They were randomly categorized into training set (n=514) and validation set (n=256).The univariate and multivariate logistic regression analyses were used to screen the predictors for multiple trauma patients who were at risk of developing MODS from training set data.Then we established a nomogram based on these above predictors.The discriminative capacity was assessed by receiver operating characteristic (ROC) curve area under the curve (AUC), and the predictive precision was depicted by calibration plot.The Hosmer-Lemeshow test was used to evaluate the the model’s goodness of fit.ResultsOur study showed that age,ISS,hemorrhagic shock,heart rate,blood glucose,D-dimer and APTT were independent risk factors for MODS in patients with multiple trauma by multivariate logistic regression analysis.A nomogram was established on basis of these above risk factors.The area under the curve (AUC) was 0.868 (95% confidence interval [CI]:0.829-0.908) in the training set and 0.884 (95% confidence interval [CI]:0.833-0.935) in the validation set.The Hosmer-Lemeshow test has a p value of 0.227 in training set and 0.554 in validation set respectively,which confirm the model’s goodness of fit.Calibration plot showed that the predicted and actual incidence of MODS probability were fitted well on both internal and external validations.ConclusionsThe present nomogram had a well predictive precision and discrimination capacity,which can facilitate improved screening and early identification of multiple trauma patients who were at high risk of developing MODS.

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Section: Discussionmentioning

confidence: 99%

A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients

Miao

Wei

Zhou

2020

Preprint

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“…Environmental conditions and resources present at birth may influence the behaviors of the childbearing woman and the attending health care personnel. Investigations of environmental conditions that may influence patients’ and providers’ behaviors have been conducted in settings such as operating rooms, intensive care units, and long-term care facilities (Catrambone, Johnson, Mion, & Minnick, 2009; Maxwell, Mion, & Minnick, 2013; Needleman & Minnick, 2009; O’Hara, 2014; Pettit, Wood, Lieber, & O’Mara, 2014; Rashid, 2014). Among the conditions identified in these studies are lighting, noise, interruptions, and space.…”

Section: Environment and Resources At Births In The United Statesmentioning

confidence: 99%

Providers’ Reports of Environmental Conditions and Resources at Births in the United States

et al. 2018

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Environmental conditions and resources that may influence provider's behaviors have been investigated in birth environments focusing on location rather than conditions and available resources. Using a descriptive, cross sectional design, we surveyed a random sample of certified nurse-midwives (CNMs), obstetricians, family practice physicians, and certified professional midwives (CPMs) to describe conditions, resources, and workforce present during U.S. births. In all, 1,243 midwives and physicians reported most environmental resources were present at almost 100% of births they attended. Conditions varied: room noise acceptability restriction of phone calls/texts from any source and lighting kept to a minimum. Trainees were present at most births regardless of setting and provider type. The impact of room noise, phone calls/texting, and lighting on outcomes should be determined. The roles and impact of personnel, including trainees, should be described. The extent to which clusters of resources are associated with outcomes might provide new directions for interventions that improve care.

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“…More importantly, it is unclear whether visibility of patient units plays a role in staff’s response to call buttons. Previous studies have demonstrated the impacts of visibility on the effectiveness of patients’ visual surveillance [ 32 ], patient safety [ 33 , 34 ], nurses’ awareness of patients’ conditions [ 35 , 36 ], and nurses’ peer awareness and teamwork [ 35 , 37 ]. For instance, Cai and Zimring [ 36 ] found that the overall number of rooms that a nurse is aware of patient status is positively correlated to the visibility of the nurses’ assigned workstation (r = 0.715, p = 0.004).…”

Section: Introductionmentioning

confidence: 99%

Impact of Inpatient Unit Design Features on Overall Patient Experience and Perceived Room-Level Call Button Response

Cai

Fullam

MacAllister³

et al. 2021

IJERPH

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This study explores the relationship between inpatient unit design and patient experience and how spatial features and visibility impact patients’ perception of staff responsiveness. The first part of this study is a retrospective pre–post and cross-sectional study evaluating the impacts of unit design on patient experience at the unit level. This study compares patient experiences based on Press Ganey and HCAHPS surveys in two orthopedic units (existing unit in Atrium building and new unit in Tower) with differing design features at Rush University Medical Center. The chi-square test results show that when moving from the old orthopedic unit to the new unit, almost all patient survey items related to patient experience showed statistically significant improvements. The second part of this study is a room level on the new unit. The ANOVA and Pearson correlation tests revealed that the visibility measure of metric step depth had significant impacts on patients’ perception of staff’s “promptness in responding to call button” and “help with toileting”. This study confirms that inpatient unit design plays a direct role in improvement for patient experience and should be considered as an important area of focus for future development.

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Intensive care unit design and mortality in trauma patients

Cited by 18 publications

References 19 publications

A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients

A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients

Providers’ Reports of Environmental Conditions and Resources at Births in the United States

Impact of Inpatient Unit Design Features on Overall Patient Experience and Perceived Room-Level Call Button Response

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