Abstract:
OBJECTIVES:To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES:Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. STUDY SELECTION:English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included. DATA EXTRACTION:Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist. DATA SYNTHESIS:Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention. CONCLUSIONS:This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Lydon S,Power M,McSharry J,Byrne M,Madden C,Squires JE,O'Connor Pdoi
10.1097/CCM.0000000000002691subject
Has Abstractpub_date
2017-11-01 00:00:00pages
e1165-e1172issue
11eissn
0090-3493issn
1530-0293journal_volume
45pub_type
杂志文章,评审abstract::This study was performed to determine if particulate material within the pulmonary vascular bed could be sampled by aspirating blood from a wedged pulmonary artery catheter. 99mTechnetium-labeled albumin microspheres (20 micrometers) were injected and embolized into the precapillary pulmonary vasculature of 6 critical...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198304000-00001
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:To determine the relative distribution of fluid within the extracellular fluid volume (ECFV) and the effect on oxygen delivery after infusing either normal saline or 5% albumin in cardiac surgical patients. DESIGN:Prospective, randomized, unblinded, interventional study. SETTING:Cardiac surgical intensive c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200112000-00011
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Cytomegalovirus reactivation may complicate critical illness in latent carriers of the virus, even in patients who were previously immunocompetent. Patients with acute respiratory distress syndrome are considered to be prone for reactivation. Prophylactic antiviral therapy in immunocompetent cytomegalovirus s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000712
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To determine whether aerosolized antibiotics can be delivered efficiently to the lower respiratory tract in mechanically ventilated patients and to define possible clinical responses to these agents. DESIGN:Prospective serial study with cases as their own control. SETTING:A 10-bed respiratory care unit for...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199801000-00013
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Carbon monoxide (CO), an endogenous byproduct of heme metabolism, is produced at high levels in injured tissue via induction of heme-oxygenase-1 activity, where it contributes to the modulation of proinflammatory processes. Alone, CO has potent anti-inflammatory effects in models of acute and chronic inflamma...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000166349.76514.40
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the use of multifrequency bioelectrical impedance analysis to predict creatinine/urea clearance based on 24 hours urine collection. A practical formula was developed, and its performance was compared with that of established formulas such as Cockcroft-Gault, Modification of Diet in Renal Disease,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004033
更新日期:2019-12-01 00:00:00
abstract::Hemodynamic effects of iso-oncotic 3% dextran-60, 6% dextran-70, and Ringer's acetate were compared in 28 male pigs (25 to 30 kg) subjected to experimental trauma and hemorrhage. The animals were kept anesthetized with 75% N2O/25% O2, 0.8% halothane. Hemodynamic and respiratory conditions were allowed to stabilize for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198804000-00008
更新日期:1988-04-01 00:00:00
abstract::Arterial oxygen saturation, determined noninvasively by pulse oximetry in 32 pediatric patients with cyanotic congenital heart disease (CHD), was compared with oxygen saturation measured by a cooximeter in simultaneously obtained arterial blood samples. The patients were studied in the cardiac catheterization laborato...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198711000-00015
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To determine alterations in intestinal epithelial permeability to solutes in burn injured rats with and without Enterococcus faecalis infection and the role of neutrophils in the intestinal permeability changes. DESIGN:Prospective sham-controlled animal study. SETTING:University research laboratory. SUBJEC...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000145579.66001.05
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVES:To compare the effects of two lung-protective ventilation strategies on pulmonary vascular mechanics in early acute respiratory distress syndrome. DESIGN:Experimental study. SETTING:University animal research laboratory. SUBJECTS:Twelve pigs (30.8 ± 2.5 kg). INTERVENTIONS:Acute respiratory distress syndr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002701
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:During pressure support ventilation, ventilator inspiration ends when inspiratory flow drops to a given percentage of the peak inspiratory flow cycling-off criteria. This study evaluated the effect of two different cycling-off criteria on breathing pattern, respiratory effort, and gas exchange in patients wit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000287594.80110.34
更新日期:2007-11-01 00:00:00
abstract::Cardiac arrest is most commonly encountered as the end result of severe derangements in metabolic homeostasis. These derangements may include toxic, ischemic, or electrophysiological causes of circulatory and/or respiratory arrests. Occasionally, mechanical obstruction or impediment to circulation may cause cardiac ar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198203000-00013
更新日期:1982-03-01 00:00:00
abstract:OBJECTIVE:Preliminary experimental data suggest that selective β1-blockers may improve ex vivo cardiac function in animal sepsis. Currently, the effects of esmolol on in vivo cardiac function and on vascular function are unknown. The present study was designed to examine the effects of the β1-selective blocker esmolol ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001078
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. DATA SOURCES:Systematic literature searc...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000000148
更新日期:2014-05-01 00:00:00
abstract::The pericardium serves many important functions, but it is not essential for life. Pericardial heart disease comprises only pericarditis and its complications, tamponade and constriction, and congenital lesions. However, the pericardium is affected by virtually every category of disease. The critical care physician is...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000271159.84639.2B
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:The electronic health record is a primary source of information for all professional groups participating in ICU rounds. We previously demonstrated that, individually, all professional groups involved in rounds have significant blind spots in recognition of patient safety issues in the electronic health reco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003302
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To evaluate partial occlusion in patients with pulmonary hypertension with regard to a) the degree to which it leads to overestimation of pulmonary artery occlusion pressure (Ppao) and b) identification of factors that could enhance its recognition. DESIGN:Observational descriptive study. SETTING:Medical in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00015
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To determine the reliability of volitional and nonvolitional limb muscle strength assessment in critically ill patients and to provide guidelines for the implementation of limb muscle strength assessment this population. DATA SOURCES:The following computerized bibliographic databases were searched with MeSH...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000030
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002762
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To assess the number of adult critical care beds in Asian countries and regions in relation to population size. DESIGN:Cross-sectional observational study. SETTING:Twenty-three Asian countries and regions, covering 92.1% of the continent's population. PARTICIPANTS:Ten low-income and lower-middle-income eco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004222
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Our first objective was to determine a blood lactate threshold predictive of survival in human immunodeficiency virus patients experiencing lactic acidosis related to nucleoside analogs, and second, to test l-carnitine for the treatment of patients exceeding that threshold. DESIGN:a) Retrospective study usin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.CCM.0000053649.69377.08
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:Reviews of patient safety efforts suggest that technical/administrative change must be augmented by global factors such as organizational culture and climate. The objective was to outline a comprehensive model for healthcare climate and test one of its elements, the nursing subclimate, in terms of several pa...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000262404.10203.C9
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:Vital organ hypoperfusion significantly contributes to the dismal survival rates observed with manual cardiopulmonary resuscitation after cardiac arrest. The impedance threshold device is a valve which reduces air entry into lungs during chest recoil between chest compressions, producing a potentially benefi...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e318170ba80
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:Optimistic expectations about prognosis by surrogate decision-makers in ICUs are common, but there are few data about the causes and clinical consequences. Our objective was to determine the causes of optimistic expectations about prognosis among surrogates and whether it is associated with more use of life ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003807
更新日期:2019-09-01 00:00:00
abstract::The effect of halothane on electrodes covered with polypropylene and FEP teflon membranes, used for monitoring transcutaneous oxygen tension, was compared in vitro and in patients anesthetized with halothane. In vitro experiments with halothane showed a false increase in PO2 measured by the electrode covered with poly...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198308000-00006
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:To examine the value of laser bronchoscopy in patients with inoperable carcinoma of the lung who required ventilatory assistance for acute respiratory failure. DESIGN:Retrospective review of the medical records of all patients undergoing laser bronchoscopy. SETTING:The Lahey Clinic Medical Center, a tertiar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00016
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:To determine the abnormalities present in endotracheal tubes removed from mechanically ventilated patients for "massive airleak." "Massive airleak" was defined as a leak that the attending physician felt was indicative of endotracheal tube defect such that extubation (and reintubation, if needed) would be ind...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:Peripheral perfusion in critically ill patients frequently is assessed by use of clinical signs. Recently, the pulse oximetry signal has been suggested to reflect changes in peripheral perfusion. A peripheral perfusion index based on analysis of the pulse oximetry signal has been implemented in monitoring sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200206000-00006
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether changing heat and moisture exchangers (HMEs) every 96 hrs rather than 24 hrs would affect their efficacy to preserve the heat and moisture of inspiratory gases. The impact of a prolonged use of the HME on its microbial colonization was also assessed. DESIGN:Pros...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200003000-00019
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of norepinephrine on static (right atrial pressure, pulmonary artery occlusion pressure ) and dynamic (pulse pressure variation and arterial systolic pressure variation) preload indicators in experimental hemorrhagic shock. DESIGN:Prospective controlled experimental study. SETTING:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000182801.48137.13
更新日期:2005-10-01 00:00:00