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Rheumatologic and autoimmune disease patients often present with very complex manifestations that can be confusing and challenging to accurately diagnose. Clinicians increasingly depend on both common and arcane laboratory testing to facilitate arriving at a confident final diagnosis, even though most diagnoses are made through thorough history taking and careful physical examination.
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This was a comprehensive, interdisciplinary, 2-year quality improvement project to reduce continuous sedation infusions and improve the recognition and prevention of delirium in patients with acute lung injury. It resulted in less infusion use, more days per patient without sedation, and more patient days awake and not delirious, although the median proportion of days with delirium per patient actually increased.
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This large, multicenter, quality improvement project showed a dramatic reduction in mortality among patients with severe sepsis or septic shock after implementation of a sepsis treatment bundle.
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In this study, closed-loop, titrated pressure support ventilation was associated with a significantly shorter time course until patients passed a spontaneous breathing trial and were successfully extubated compared to a standardized weaning protocol.
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In mechanically ventilated ICU patients, availability of music via headphones resulted in a greater reduction in anxiety and sedation exposure.
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Handoffs have been extensively examined as a potential source of communication failure. Such studies typically focus on how to best share details of care when patient responsibility is transferred from one clinical care team to another.