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33
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August 2013 - November 2017
Publications
Publications (33)
Objectives
Telecritical care (TCC) refers to the delivery of critical care using telehealth technologies. Despite increasing utilization, significant practice variation exists and literature regarding efficacy remains sparse. The Telecritical Care Collaborative Network sought to provide expert, consensus-based best practice recommendations for the...
For decades, tele-critical care (TCC) programs have provided expert population surveillance with standardized clinical interventions for critically ill patients. The COVID-19 pandemic created massive strains on critical care resources. For this report, standard questions were used to solicit COVID-19 pandemic workflow and service modifications from...
The Joint Commission (TJC), the nation's largest healthcare accreditor, was founded in the 1950s. Its Standards for Medication Management (MM) of titratable medications focused on prescriptive ordering practices versus reliance on nurse clinical decision making. The use of measurable endpoints to guide nurse decision making regarding medication tit...
Background:
Institutions struggle with successful use of sepsis alerts within electronic health records.
Objective:
Test the association of sepsis screening measurement criteria in discrimination of mortality and detection of sepsis in a large dataset.
Design:
Retrospective, cohort study using a large United States (U.S.) intensive care databa...
Objectives:
Electronic health records enable automated data capture for risk models but may introduce bias. We present the Philips Critical Care Outcome Prediction Model (CCOPM) focused on addressing model features sensitive to data drift to improve benchmarking ICUs on mortality performance.
Design:
Retrospective, multicenter study of ICU patie...
Introduction: SARS-CoV-2 (COVID-19) has increased the burden on ICUs leading to a rise in patient admissions, severity of illness, length of stay (LOS), and mortality.
Objectives: The objectives are to investigate the effects of COVID-19 on patient demographics, clinical outcomes, and treatments for a large dataset spanning 11 US health systems wi...
Telehealth in intensive care units (TeleICU) is the provision of critical care using audio-visual communication and health information systems across varying clinical and geographically dispersed settings. The optimal structure of a TeleICU team is one that leverages expert clinical knowledge to address the needs of critical care patients, regardle...
Background
For decades, medication titration has been within nurses’ scope and practice. In 2017 The Joint Commission (TJC) revised elements for orders for the titration of continuous intravenous medications.
Objectives
To explore the practice and perceptions of nurses regarding TJC standards for titration of continuous intravenous medications.
M...
Background
Critical care nurses titrate continuous infusions of medications to achieve clinical end points. In 2017, The Joint Commission (TJC) placed restrictions on titration practice, decreasing nurses’ autonomous decision-making.
Objectives
To describe the practice and perceptions of nurses regarding the 2017 TJC accreditation/regulatory stand...
Consumers of healthcare services are demanding more convenient and accessible options to care. Technologic advancements can support this demand, but knowledge related to telehealth is lacking. This article will describe the current state of telehealth and examine the role that NPs can play in furthering adoption of it.
Telehealth is an acknowledged strategy to meet patient healthcare needs. In critical care settings, Tele-ICU's are expanding to deliver clinical services across a diverse spectrum of critically ill patients. The expansion of telehealth provides increased opportunities for advanced practice providers including advanced practice nurses and physician...
Telehealth in intensive care units (TeleICU) is the provision of critical care using audio-visual communication and health information systems across varying clinical and geographically dispersed settings. The optimal structure of a TeleICU team is one that leverages expert clinical knowledge to address the needs of critical care patients, regardle...
Background: Statin use is associated with a decreased rate of severe sepsis. The objective of this paper is to quantify the level of organ dysfunction of patients with and without statin use prior to hospitalization.
Methods: MIMIC-III was searched for adult sepsis patients. Immunosuppressed patients were excluded. Organ dysfunction was defined as...
Purpose
Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR).
Methods
We cond...
The purpose of this article is to describe the usability and human factors engineering standards used in development of a sepsis alert known as the sepsis prompt. Sensory processing, cognitive processing, signal detection, criterion response, and user satisfaction were evaluated with controlled user testing and critical incident response techniques...
Background:
Intensive care unit (ICU) telemedicine improves access to high quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following tele-ICU implementation and after the addition of logistic center function has not been published.
Methods:...
Background: Information on the impact of tele-intensive care on nursing and priority areas of nursing care is limited. Objectives: To conduct a national benchmarking survey of nurses working in intensive care telemedicine facilities in the United States. Methods: In a 2-phased study, an online survey was used to assess nurses' perceptions of intens...
Objectives:
To review the growth and current penetration of ICU telemedicine programs, association with outcomes, studies of their impact on medical education, associations with medicolegal risks, identify program revenue sources and costs, regulatory aspects, and the ICU telemedicine research agenda.
Data sources:
Review of the published medica...
The Institute of Medicine's proposed 6 aims to improve health care are timely, safe, effective, efficient, equitable, and patient-centered care. Unfortunately, it also asserts that improvements in these 6 dimensions cannot be achieved within the existing framework of care systems. These systems are based on unrealistic expectations on human cogniti...
This article evaluates the feasibility of a tele-intensive care unit (ICU) nurse-driven early identification and treatment process for severe sepsis patients in improving compliance to evidence-based practice.
Florence Nightingale identified that by using science, logic, and compassion to manipulate the patient care environment nurses could create...
ID 1862
Title Increased documentation of ICD-9-CM Codes 995.92 and 785.52 with template-oriented monitoring
and screening by a Tele-ICU
Authors
Teresa A. Rincon BSN, CCRN-E, RN (Sutter Health Sac-Sierra, Sacramento, CA)
Adam J. Seiver MD, MBA, PhD, FCCM (Hospital Division, Respironics, Inc., Burlingame, CA)
William Farrell PhD (Sutter Health, Sacra...
PURPOSE: Sepsis is responsible for 215,000 deaths per year and the Surviving Sepsis Campaign was initiated to standardize care and improve outcomes in this patient population. We previously reported on reduced sepsis mortality (CCM 2006, Vol. 34, A2 & A108) in our ICU patients and we hypothesized that the improvement in outcomes correlated with the...
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