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. METHODS:Semistructured interviews were conducted with 20 staff and faculty who were involved in the early rehabilitation program at the Johns Hopkins Hospital Medical Intensive Care Unit. Transcripts were evaluated using the Consolidated Framework of Implementation Research Theory. RESULTS:Four major constructs emerged as important, as follows: (1) necessary components, (2) implementation strategies, (3) perceived barriers, and (4) positive outcomes. All participants reported that staff buy-in was necessary, whereas having a multidisciplinary team with good communication among team members was reported as helpful by 90% of participants. The most common barrier reported was increased staff workload (80%). All participants (100%) noted improved patient outcomes as an important benefit, and 95% reported improved job satisfaction. CONCLUSIONS:This qualitative study of a successful early rehabilitation program highlights the importance of assessing and engaging a multidisciplinary team before implementation and the positive outcomes of early rehabilitation on staff by improving job satisfaction and changing the culture of a hospital unit.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Eakin MN,Ugbah L,Arnautovic T,Parker AM,Needham DMdoi
10.1016/j.jcrc.2015.03.019subject
Has Abstractpub_date
2015-08-01 00:00:00pages
698-704issue
4eissn
0883-9441issn
1557-8615pii
S0883-9441(15)00119-7journal_volume
30pub_type
杂志文章abstract:PURPOSE:This paper describes the methodology of a clinical trial of prone positioning in pediatric patients with acute lung injury (ALI). Nonrandomized studies suggest that prone positioning improves oxygenation in patients with ALI/acute respiratory distress syndrome without the risk of serious iatrogenic injury. It i...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jcrc.2005.12.004
更新日期:2006-03-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
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journal_title:Journal of critical care
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.09.012
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS:We assessed 6929 consecutive patients...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.07.001
更新日期:2011-04-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.08.008
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.05.004
更新日期:2005-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 临床试验,杂志文章
doi:10.1053/jcrc.2003.50003
更新日期:2003-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
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journal_title:Journal of critical care
pub_type: 杂志文章
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.12.008
更新日期:2013-08-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.03.001
更新日期:2013-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.001
更新日期:2015-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.08.012
更新日期:2014-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.026
更新日期:2018-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/0883-9441(94)90013-2
更新日期:1994-09-01 00:00:00
abstract::The capacity for consciousness and self-awareness is uniquely synonymous with human life and personhood, and its absence is necessary and sufficient to identify that death has occurred. The presence of these functions is uniquely synonymous with human life. Ongoing organ function, response to infection, growth, wound ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.04.013
更新日期:2014-08-01 00:00:00
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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
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.024
更新日期:2014-12-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2012.05.001
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.030
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.06.021
更新日期:2019-10-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.006
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS:Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2017.04.041
更新日期:2017-10-01 00:00:00
abstract::Cell-free circulating DNA (cf-DNA) can be detected by various of laboratory techniques. We described a branched DNA-based Alu assay for measuring cf-DNA in septic patients. Compared to healthy controls and systemic inflammatory response syndrome (SIRS) patients, serum cf-DNA levels were significantly higher in septic ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.10.013
更新日期:2016-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 信件
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更新日期:2018-10-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2009.12.014
更新日期:2010-09-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.025
更新日期:2015-10-01 00:00:00
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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:PURPOSE:To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS:An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.022
更新日期:2018-06-01 00:00:00