Abstract:
:The Institute of Medicine's (IOMs) report, "To Err is Human," recently addressed patient safety in the United States, alerting the nation to the need for improved systems of health care. Seven main findings were addressed in this report, we focus on 3: (1) patient safety is a nationwide problem, (2) health care workers are not to blame, and (3) safety and harm are products of care systems. This article discusses systems in intensive care units (ICUs) and how these systems affect patient safety. We use a case example to outline the complex chain of medical and administrative system failures that can result in an adverse event. Then we discuss evidence linking ICU organizational characteristics with patient safety, focusing on how safer systems in ICUs can directly improve patient care.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Pronovost P,Wu AW,Dorman T,Morlock Ldoi
10.1053/jcrc.2002.34363subject
Has Abstractpub_date
2002-06-01 00:00:00pages
78-85issue
2eissn
0883-9441issn
1557-8615pii
S0883944102500289journal_volume
17pub_type
杂志文章abstract:PURPOSE:Patient data management systems (PDMS) are widely used in intensive care units (ICUs) to improve care traceability. Verbal orders are still used for prescriptions requiring immediate execution but should be subsequently recorded in the system. We assessed the rapid sequence induction (RSI) traceability for endo...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.08.021
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:Optimal dosing of antibiotics is important for efficacy and avoidance of resistance. Fluoroquinolones are frequently used to treat severe infections in critically ill patients. We studied ciprofloxacin pharmacokinetics after administration of 400 mg twice a day (bid) intravenously (IV). MATERIAL AND METHODS:Se...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2007.11.011
更新日期:2008-09-01 00:00:00
abstract::The events of the 2009 influenza pandemic sparked discussion regarding the need to optimize delivery of care to those most severely ill. We propose in this conceptual study that a tiered regionalization care system be instituted for patients with severe acute respiratory distress syndrome. Such system would be a compo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.09.016
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:To assess the feasibility of a trial evaluating whether hyperoncotic albumin, in addition to diuretics, improves diuresis and facilitates liberation from mechanical ventilation in critically ill adults. MATERIALS AND METHODS:We randomized 46 hemodynamically stable patients with hypoalbuminemia, prescribed diur...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2018.07.020
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Closed endotracheal suctioning (CES) may impact ventilator-associated pneumonia (VAP) risk by reducing environmental contamination. In developing countries where resource limitations constrain the provision of optimal bed space for critically ill patients, CES assumes greater importance. MATERIALS AND METHODS:...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2010.10.002
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to evaluate the benefits of adjuvant treatment with crude rhubarb in patients with systemic inflammation reaction syndrome/sepsis by conducting a meta-analysis. METHODS:We conducted a systematic literature search of medical electronic databases (up to October 2013). Only random...
journal_title:Journal of critical care
pub_type: 杂志文章,meta分析
doi:10.1016/j.jcrc.2014.11.008
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Given the complexity of biological systems, understanding their dynamic behaviors, such as the Acute Inflammatory Response (AIR), requires a formal synthetic process. Dynamic Mathematical Modeling (DMM) represents a suite of methods intended for inclusion within the required synthetic framework. The DMM, h...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.12.001
更新日期:2007-03-01 00:00:00
abstract:PURPOSE:The specific norepinephrine dose at which epinephrine should be added in septic shock is unclear. This study sought to determine the norepinephrine-equivalent dose at epinephrine initiation that correlated with hemodynamic stability. METHODS:Septic shock patients receiving both norepinephrine and epinephrine w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.05.024
更新日期:2019-10-01 00:00:00
abstract::National clinical quality registries (CQRs) are effective tools for improving the outcomes of patients admitted to the intensive care unit (ICU), and are increasingly important as healthcare needs evolve. A high-quality ICU CQR is built from a foundation of common requirements and challenges. First, performance indica...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2020.08.012
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:The purpose of this article is to elucidate the effect of L-canavanine, a selective inhibitor of inducible NO synthase (iNOS), on hemodynamics, blood gas parameters, and plasma concentrations of lactate and endothelin-1 (ET-1) during endotoxic shock. MATERIALS AND METHODS:Eleven mongrel dogs under pentobarbita...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.21792
更新日期:2001-03-01 00:00:00
abstract::Noninvasive positive pressure ventilation has been demonstrated to be of benefit in preventing endotracheal intubation and reducing mortality in specific patients in the setting of acute exacerbations of chronic obstructive pulmonary disease. The successful application of noninvasive positive pressure ventilation depe...
journal_title:Journal of critical care
pub_type: 指南,杂志文章,实务指引
doi:10.1016/j.jcrc.2004.04.006
更新日期:2004-06-01 00:00:00
abstract:PURPOSE:We hypothesized that the predictability of stroke volume variation (SVV) on fluid responsiveness would be reduced in patients with coronary disease who have wide pulse pressure (PP). METHODS:Sixty-six patients undergoing coronary surgery were divided into 2 groups according to the PP measured 1 day before surg...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.09.011
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:To compare the application of three standardized definitions of acute kidney injury (AKI), using corrected serum creatinine values, in children immediately after liver transplantation. METHODS:Retrospective search of a tertiary pediatric hospital database yielded 77 patients (age < 18 years) who underwent live...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.010
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To explore whether psoas cross sectional area (CSA) and density (Hounsfield Units, HU) are associated with nutritional adequacy and clinical outcomes in surgical intensive care unit patients. MATERIALS AND METHODS:Subjects with at least one CT scan within 72h of ICU admission were included. Demographic, nutrit...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.12.027
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:A nationwide increase in the rate and severity of Clostridium difficile-associated disease may reflect infection with a virulent strain characterized by polymerase chain reaction as ribotype 027 (NAP1/B1). HYPOTHESIS:The high prevalence of ribotype 027 at our institution would allow investigation of the ris...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2009.04.002
更新日期:2010-06-01 00:00:00
abstract:PURPOSE:The objective of this study was to evaluate the impact of regionalization on sepsis survival, to describe the role of inter-hospital transfer in rural sepsis care, and to measure the cost of inter-hospital transfer in a predominantly rural state. MATERIALS AND METHODS:Observational case-control study using sta...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.07.016
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:Hyponatremia is frequently observed in intensive care unit (ICU) patients, but there is still lack information on the physiological mechanisms of development. MATERIALS AND METHODS:In this retrospective analysis we performed tonicity balances in 54 patients with ICU acquired hyponatremia. We calculated fluid a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.05.017
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:The purpose of this study is to determine the effect of postoperative fluid balance (FB) on subsequent outcomes in acute care surgery (ACS) patients admitted to the surgical intensive care unit (ICU). MATERIAL AND METHODS:Acute care surgery patients admitted to the surgical ICU from 06/2012 to 01/2013 were fol...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.06.023
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Transesophageal probe insertion in the ventilated patients often is difficult. Different complex techniques were suggested for easier placement of the transesophageal probe. In this work, we describe a simple technique of TEE probe insertion in ventilated patients. METHODS AND RESULTS:In the period 2015-2018, ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.020
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:We investigated whether a critical rise of intracranial pressure (ICP) leading to a loss of cerebral perfusion pressure (CPP) could serve as a surrogate marker of brain death (BD). MATERIALS AND METHODS:We retrospectively analyzed ICP and CPP of patients in whom BD was diagnosed (n = 32, 16-79 years). Intracra...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.03.009
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:Patients with severe penetrating head injury often have a coagulopathy that is difficult to correct. In this report, we describe 3 such patients who were treated with activated factor VII (FVIIa) to stop ongoing hemorrhage that was refractory to conventional treatment. SUBJECTS AND METHODS:We treated 3 patient...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.02.004
更新日期:2005-06-01 00:00:00
abstract:PURPOSE:The aim of the study was to investigate possible associations between different heart rate variability (HRV) indices and various biomarkers of inflammation in 45 septic patients. MATERIALS AND METHODS:We daily assessed HRV in the time domain (SD of RR intervals [SDNN]), frequency domain (low [LF], high frequen...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.11.010
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patien...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.03.011
更新日期:2006-12-01 00:00:00
abstract:PURPOSE:The goal of this study was to determine the impact of surgical rib fixation (SRF) in a treatment protocol for severe blunt chest trauma. MATERIALS AND METHODS:Patients with flail chest admitted between September 2009 and June 2010 to our level I trauma center who failed traditional management and underwent SRF...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.08.003
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:To determine the neurologic outcome of patients with intracranial hypertension treated with barbiturate-induced coma. MATERIALS AND METHODS:The records of 49 patients who were admitted to a 31-bed medicosurgical intensive care unit over a 5-year period in whom a barbiturate coma was induced to control intracra...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2002.33032
更新日期:2002-03-01 00:00:00
abstract:PURPOSE:Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what inform...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.12.003
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:The purpose of this article was to determine the outcome, clinical and prognostic features, and microbiology of a large group of patients with community-acquired pneumonia (CAP) presenting in septic shock. MATERIALS AND METHODS:The placebo limb of the Norasept II database was examined. Data were collected on p...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2000.16460
更新日期:2000-09-01 00:00:00
abstract:PURPOSE:The response to inhaled nitric oxide (iNO) is inconsistent in patients with acute respiratory distress syndrome (ARDS). We sought to determine whether the response to iNO, defined as 20% Pao(2)/Fio(2) increase from baseline, depends on the level of cardiac natriuretic peptides. MATERIALS AND METHODS:This is a ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.10.014
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. METHODS:The incidence of IAI and the number of infections caused by organisms during the 6 mo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.12.013
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:Early rehabilitation programs in a medical intensive care unit can improve patient outcomes, but clinicians face barriers in implementing and sustaining such programs. We sought to describe a multidisciplinary team perspective regarding how to implement and sustain a successful early rehabilitation program. ME...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.019
更新日期:2015-08-01 00:00:00