What evidence is published on timing and appropriateness of education for patients in the intensive care unit?

Results below are from a search of PubMed and CINAHL for these concepts:

  • patient education
  • intensive care
  • English language limit
  • time/timing

PubMed:  “Patient Education as Topic”[MAJR] AND “intensive care”[mesh] AND english[lang]

CINAHL:  (MH “Intensive Care Units”) AND (MM “Patient Education+”) AND ( (time OR timing) )   This search focuses on papers that discuss some aspect of timing as it relates to patient education.  Removing the (time OR timing) part of the search will retrieve some additional papers discussing aspects, such as education for transition from ICU to general unit.

The PubMed search results are more general.  The references below discuss general aspects of patient education in the ICU.  Other references in the search results discuss patient education in specific situations, such as with patients on ventilators:

Häggström M, Asplund K, Kristiansen L.  How can nurses facilitate patient’s transitions from intensive care?: a grounded theory of nursing.  Intensive Crit Care Nurs. 2012 Aug;28(4):224-33

Scott A.  Managing anxiety in ICU patients: the role of pre-operative information provision.   Nursing in Critical Care (NURS CRIT CARE), 2004 Mar-Apr; 9 (2): 72-9.

Clark BJ, Moss M. Secondary prevention in the intensive care unit: does intensive care unit admission represent a “teachable moment?”. Crit Care Med. 2011 Jun;39(6):1500-6.

What is the effectiveness of falls prevention programs?

Bottom line:  In hospitals, multifaceted interventions may be associated with reduced incidence of falls, but evidence in this Cochrane review was inconclusive.  In care facilities, vitamin D supplementation is effective; exercise may be effective but studies have conflicting results; and multifaceted prevention programs may be beneficial but results are inconclusive.  In subacute hospitals, exercise is associated with a reduction in falls.

Details: Cochrane Database Syst Rev. 2012 Dec 12;12:CD005465. doi: 10.1002/14651858.CD005465.pub3. Interventions for preventing falls in older people in care facilities and hospitals. Cameron ID, et al.

Systematic review of 60 randomized controlled trials, N=60,345 (17 in hospitals  29,972 participants.)  Beginning on page 107, the review presents analysis of evidence in the following intervention categories:  vitamin D, exercise, medication review by pharmacist, environmental interventions, social interventions, other single interventions, multiple interventions, and multifactorial intervention programs.  Analysis of data pertaining to hospitals begins at Analysis 12.1 (p. 132.)

Updated 3/1/13

What evidence supports the use of mild hypothermia after cardiac arrest?

A  search of PubMed retrieved these references using the search strategy:((“Heart Arrest”[Mesh])) AND (“Hypothermia, Induced”[Mesh]) AND (systematic[sb] AND hasabstract[text] AND “last 5 years”[PDat] AND English[lang])   TO SEE MORE

Arrich J, Holzer M, Havel C, Müllner M, Herkner H.
Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation
Cochrane Database Syst Rev. 2012 Sep 12;9:CD004128. doi: 10.1002/14651858.CD004128.pub3.

Delhaye C, Mahmoudi M, Waksman R. Hypothermia therapy: neurological and
cardiac benefits. J Am Coll Cardiol. 2012 Jan 17;59(3):197-210. doi: 10.1016/j.jacc.2011.06.077. Review. PubMed PMID: 22240124.

Cullen D, Augenstine D, Kaper L, Tinkham S, Utz D.
Therapeutic hypothermia initiated in the pre-hospital setting: a meta-analysis.
Adv Emerg Nurs J. 2011 Oct-Dec;33(4):314-21. doi: 10.1097/TME.0b013e3182343cb6.

 

Where can I access the current practice bulletins from the American Congress of Obstetrics and Gynecology?

Bottom line:  These practice bulletins are published in Obstetrics and Gynecology.  Use this link to display PubMed references for the practice bulletins.

ACOG Practice Bulletins in PubMed

For best results, open the link in your VDT Internet Explorer browser.

To access the full-text options, use the Find It @ Emory button in the full PubMed record for one of the bulletins.

Is there evidence on the use of sequential compression (intermittent pneumatic compression) devices for treatment of active deep vein thrombosis?

Bottom line:  No evidence identified to support or refute use of sequential compression devices in hospitalized patients with active DVT.

Evidence summary resources (DynaMed, Joanna Briggs) do not mention these devices in relation to treating active deep vein thrombosis (DVT).

A PubMed search for these concepts:    “Venous Thrombosis/therapy”[Mesh] AND “intermittent pneumatic compression devices”[MeSH Terms] AND (“humans”[MeSH Terms] AND English[lang])

Only identified one small (n=24) pilot study in patients with venous thrombosis in the proximal leg who received catheter-directed thrombolytic medication (CDT).  Patients were randomized to either intermittent pneumatic compression device in addtition to CDT or CDT alone.
See:  Ogawa T, et al. J Vasc Surg. 2005 Nov;42(5):940-4. Intermittent pneumatic compression of the foot and calf improves the outcome of catheter-directed thrombolysis using low-dose urokinase in patients with acute proximal venous thrombosis of the leg.

More research would be needed to confirm findings, generalize findings to broader population, etc.

What is the evidence on effect of hyperglycemia on post-surgical complications?

A search of Joanna Briggs Institute EBP retrieved this evidence summary:
Surgical Site Infection: Post-anesthesia and Post Operative Management. 2015.

It references a systematic review: Blondet JJ, Beilman GJ. Glycemic control and prevention of perioperative infection. Curr Opin Crit Care. 2007;13(4):421-427.
This review references studies documenting effect of perioperative hyperglycemia on post-surgical infection and mortality.

Additional references
PubMed: hyperglycemi* AND (postoperative OR post-operative OR perioperative) AND (complications OR mortality OR morbidity
Retrieves many references.  It is more efficient to begin with the systematic reviews from this search:
hyperglycemi* AND (postoperative OR post-operative OR perioperative) AND (complications OR mortality OR morbidity))systematic[sb]
Some of these reviews will evaluate effect of controling blood glucose in the postoperative period, but they should also address the literature documenting the problem.

How was the Morse scale developed and how were the criteria selected?

Morse JM, et al.  A prospective study to identify the fall-prone patient.  Soc Sci Med. 1989;28(1):81-6.
The objective of this study was to validate the Morse Scale in predicting patient risk of falling.  The introduction and methods sections describe the instrument, which was derived from previous work by Morse and colleagues analyzing characteristics of patients prone to falls (Morse JM, et al.  Characteristics of the fall-prone patient.  Gerontologist.  1987;27:516.)