1
|
The Impact of the Society of Critical Care Medicine's Flagship Journal: Critical Care Medicine: Reflections of Critical Care Pioneers. Crit Care Med 2023; 51:164-181. [PMID: 36661447 DOI: 10.1097/ccm.0000000000005728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
On the 50th anniversary of the Society of Critical Care Medicine's journal Critical Care Medicine, critical care pioneers reflect on the importance of the journal to their careers and to the development of the field of adult and pediatric critical care.
Collapse
|
2
|
Alqahtani JS, AlAhmari MD, Al-Otaibi HM, AlRabeeah SM, Al Khathlan NA, Aldhahir AM, Alqahtani AS, Alwadeai KS, Algarni SS, Siraj RA, Alqarni AA, Almeshari MA, Alghamdi SM, AlTaweel M, Alnasser M, Sreedharan JK, Almojaibel AA, Alahmari M, Aldabayan YS, Bin Sheeha BH, Alahmadi FH, Alsulayyim AS, Alzahrani EM. Needs Assessment for the Establishment of Master's Degree Programs in Respiratory Care in the Kingdom of Saudi Arabia. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1113-1121. [PMID: 36171911 PMCID: PMC9512035 DOI: 10.2147/amep.s377559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite recent advancements in the respiratory care (RC) profession, no single institution in the Kingdom of Saudi Arabia (KSA) offers a master's degree program in RC. METHODS A nationwide and validated survey was used to explore the current needs and interests in establishing RC master's degree programs in the KSA. The process included representatives from the healthcare industry, universities, and professional societies. RESULTS A total of 1250 stakeholders across the KSA completed the survey. The sample includes 722 (58%) males, 504 (40%) respiratory therapists, 547 (44%) students, 138 (11%) leaders, and 61 (5%) were academic respondents. Most respondents were from Central 491 (39%) and Eastern 307 (25%) regions, with 1003 (80%) of the total sample worked or studied in governmental sectors. A total of 574 (82%) of the leaders and RTs had Bachelor degree and 430 (61%) of them had 1-5 years working experience. According to 80% of the employers and employees, only 0-5% of the RTs in their organization had a master's degree. The calculated mean % of the agreement (agree/strongly agree) on the needs was 83% in all needs' assessment items, which shows a great support for establishing a master's in RC to meet the personal, professional and society needs. The mean % of the agreement for the level of interests among all participants was 86%, indicating a great level of interests in establishing a master degree in RC. The agreement % on the needs assessment and level of interests in establishing a master degree in RC in KSA were ≥80% in each stakeholder group. CONCLUSION There are obvious needs and interests in establishing master's degree programs in RC in the KSA. A master's degree in RC should be established to address the growing needs for advanced RC services throughout the nation and enhance RC research.
Collapse
Affiliation(s)
- Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| | - Mohammed D AlAhmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
- Dammam Medical Complex, Dammam Health Network – Eastern Health Cluster, Dammam, 32245, Saudi Arabia
| | - Hajed M Al-Otaibi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Saad M AlRabeeah
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| | - Noor A Al Khathlan
- Respiratory Care Department, Imam Abdulrahman bin Faisal University, Dammam, 34212, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
| | - Abdullah S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| | - Khalid S Alwadeai
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Saleh S Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 14611, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rayan A Siraj
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, 31982, Saudi Arabia
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Saeed M Alghamdi
- Respiratory Care Program, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, 24382, Saudi Arabia
| | - Mohammed AlTaweel
- Respiratory Care Department, AlMaarefa University, Riyadh, 13713, Saudi Arabia
| | - Musallam Alnasser
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| | - Jithin K Sreedharan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| | - Abdullah A Almojaibel
- Respiratory Care Department, Imam Abdulrahman bin Faisal University, Dammam, 34212, Saudi Arabia
| | - Mushabbab Alahmari
- Department of Respiratory Therapy, Faculty of Applied Medical Sciences, University of Bisha, Bisha, 67714, Saudi Arabia
| | - Yousef S Aldabayan
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, 31982, Saudi Arabia
| | - Bodor H Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11564, Saudi Arabia
| | - Fahad H Alahmadi
- Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, 42353, Saudi Arabia
| | - Abdullah S Alsulayyim
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
- National Heart and Lung Institute, Imperial College London, London, SW7 2BX, UK
| | - Eidan M Alzahrani
- Department of Physiotherapy, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia
| |
Collapse
|
3
|
Almeshari MA, Alshehri Z, Alqahtani JS, Alasmari AM, Alzahrani AA, Alahmadi FH, Alsulayyim AS, Alenezi FK, Alwadeai KS. The Status of Respiratory Care Education in Saudi Arabia: A National Survey of Program Directors. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:619-628. [PMID: 35712027 PMCID: PMC9196280 DOI: 10.2147/amep.s360658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Respiratory Care Practitioner (RCP) is a vital healthcare professional in Saudi Arabia (SA). Many factors regarding the education of RCPs in SA are unknown, including the number of active institutions, levels of education and barriers to promoting the profession. METHODS A cross sectional-based survey was conducted between June 1st, 2020 and September 20th, 2020 in SA to explore the status of RCPs education. Institutions that offered RCP programs were identified through the Ministry of Education and Ministry of Defense academic programs websites. The RCP program directors were invited to participate in an electronic survey. RESULTS Among the 74 institutions searched, 23 indicated that they offered RC programs. Only 13 (56.52%) responded to the survey. Among all programs, four (17.39%) were inactive, 17 (73.91%) were governmental institutions, and only one (4.35%) obtained a national accreditation. From the 13 respondents, there were 1297 students enrolled and 123 full-time faculty members. None of the institutions reported offering postgraduate RC degrees. The respondents reported many barriers; however, shortage of staff (76.92%), lack of postgraduate programs (69.23%), lack of research activity (69.23%), and ineffective communications between institutions (61.54%) were the most reported barriers. CONCLUSION The RC education in SA is developing but not well distributed throughout the country. The shortage of staff and the limited number of postgraduate degree holders potentially contributed to the delay in establishing postgraduate RC degrees, obtaining accreditation, and implementing subspecialties to advance the profession in terms of research and quality of care.
Collapse
Affiliation(s)
- Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ziyad Alshehri
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ali M Alasmari
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Ahmed A Alzahrani
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Fahad H Alahmadi
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Abdullah S Alsulayyim
- Department of Respiratory Care, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Faraj K Alenezi
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid S Alwadeai
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
4
|
Abstract
The respiratory care (RC) profession in Saudi Arabia is over 40-year-old. Although there have been major advancements in the profession, no history and enough information are available about its development and evolvement at current. This paper describes the history and development of the field of RC and future prospects for the profession in Saudi Arabia. A comprehensive review and assessment were conducted through direct contact, interviews, and a review of existing documents in the Medical Services Division of the Ministry of Defense, the Ministry of Health, The Ministry of Civil Services, representative hospitals, academic institutions, and other relevant texts. The data obtained were evaluated for its relevance and grouped on a thematic basis. This is currently the first paper about the history and development of the RC profession in Saudi Arabia over the last 45 years.
Collapse
Affiliation(s)
- Hajed M Al-Otaibi
- Respiratory Care Department, College of Applied Medical Sciences, University of Dammam, Dammam, Saudi Arabia
| | - Mohammed Dhafer AlAhmari
- Respiratory Care Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| |
Collapse
|
5
|
Alotaibi G. Status of respiratory care profession in Saudi Arabia: A national survey. Ann Thorac Med 2015; 10:55-60. [PMID: 25593609 PMCID: PMC4286847 DOI: 10.4103/1817-1737.146878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/22/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND: Respiratory care (RC) is an allied health profession that involves assessing and treating patients who have pulmonary diseases. Research indicates that respiratory therapists’ (RT's) involvement in caring for patients with respiratory disorders improves important outcome measures. In Kingdome of Saudi Arabia (KSA), RC has been practiced by RTs for more than 30 years. OBJECTIVE: We sought to investigate the status of the RC workforce in Saudi Arabia in terms of demographic distribution, number, education, and RC service coverage. METHODS: We used a specially designed survey to collect data. A list of 411 working hospitals in KSA was obtained. All hospitals were contacted to inquire if RC is practiced by RTs. Data were collected from hospitals that employ RTs. RESULTS: Only 88 hospitals, 21.4% of total hospitals in the country, have RTs. Out of the 244 Ministry of Health (MOH) hospitals, only 31 hospitals (12.7%) employ RTs. There are 1,477 active RTs in KSA. Twenty-five percent of them, or 371, are Saudis. The majority of the RT workforce (60%) work for non-MOH government hospitals, and almost half the total RTs work in Riyadh province. About 60% of RTs work in critical care settings. RC coverage of critical care was 44.5% of ideal. The overall RT-to-ICU bed ratio was 1:11. The ratio was 1:9 for non-MOH government hospitals, and 1:20 for MOH hospitals. CONCLUSIONS: We report the first insightful data on RC workforce in KSA. These data should be used by educational institutions and health policy makers to plan better RC coverage in the country.
Collapse
Affiliation(s)
- Ghazi Alotaibi
- Assistant Professor of Respiratory Care, College of Applied Medical Sciences, University of Dammam, Saudi Arabia
| |
Collapse
|
6
|
[Organization of mechanical ventilation in French Intensive care units]. ACTA ACUST UNITED AC 2013; 32:736-41. [PMID: 24140026 PMCID: PMC7126612 DOI: 10.1016/j.annfar.2013.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/27/2013] [Indexed: 11/24/2022]
Abstract
Objectifs Dans le domaine de la ventilation en réanimation, préciser le matériel, la formation des équipes, la maintenance et les référentiels disponibles. Type d’étude Enquête déclarative. Méthodes Entre septembre et décembre 2010, ont été recueillis : répartition et type des ventilateurs (ventilateurs lourds, de dépannage, ventilation non invasive (VNI) et de transport), formation des médecins et des soignants, maintenance, présence de référentiels. Les résultats sont présentés en médiane/extrêmes ou proportions. Résultats Les 62 unités analysées étaient équipées de 15 ventilateurs (médiane, extrêmes 1−50), de plusieurs marques 47 (76 %) fois. Des ventilateurs étaient spécifiquement disponibles pour la VNI 22 fois (35 %), le dépannage 49 (79 %) fois, et le transport dans 100 % des unités. Les soignants étaient formés par les médecins dans 54 unités (87 %) ou par un industriel dans 29 unités (47 %). Les médecins étaient formés par les médecins séniors dans 55 unités (89 %) ou par un industriel dans 21 unités (34 %). Les formations étaient ponctuelles dans 24 (39 %) unités ou semestrielles 16 (26 %) fois. L’entretien était effectué par le personnel de réanimation dans 39 (63 %) unités, par du personnel dédié (17 [27 %] cas), du personnel biomédical (14 [23 %] cas). Un référentiel pour l’entretien existait dans 48 (77 %) unités, le réglage du ventilateur 22 (35 %) fois et en cas de panne 20 (32 %) fois. Conclusion Cette première enquête montre une grande hétérogénéité des pratiques et de distribution du matériel. La formation et la connaissance des équipements sont des cibles pour l’amélioration de la sécurité.
Collapse
|
7
|
Cataletto M, Abramson S, Meyerson K, Arney T, Bollmeier S, Dennis R, Hargrove JK, Harver A, Wissing D, Williams D. The Certified Asthma Educator (AE-C). ACTA ACUST UNITED AC 2012. [DOI: 10.1177/2150129711432631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The Centers for Disease Control and Prevention report that the number of individuals with asthma in the United States has increased by 4.3 million, or 12.3%, between 2001 and 2009, creating an increasing burden on our health care system. Effective patient education is a key component of asthma management. The National Asthma Educator Certification Board (NAECB) promotes “optimal asthma management and quality of life by advancing excellence in asthma education through the Certified Asthma Educator process.” Methods: Following completion of the asthma educator certification examination, applicants were invited to participate in a voluntary, anonymous Web-based survey. The survey was developed and approved by the Executive and Research Committees of the NAECB, with the objective of reviewing the experience of applicants seeking initial certification and of those seeking recertification. Results: Completed surveys were obtained from 988 applicants. Seventy-six percent of respondents were first-time test takers; the remaining respondents were repeat test takers. Eighty percent reported having passed the examination. Approximately 85% felt that the time allotted for the examination was “just right”; the level of difficulty was “ just right” for 65% of the respondents, and the clarity of the examination questions was rated as “good” or “excellent” by 72% of the respondents. Seventy-two percent responded that the examination reflected the role of the asthma educator and 88.1% would recommend the examination to others interested in asthma education. Open-ended responses highlighted benefits and barriers. Discussion: The asthma educator certification examination is reflective of the professional responsibilities of the asthma educator. Benefits and barriers are discussed in the context of published literature.
Collapse
Affiliation(s)
- Mary Cataletto
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Stuart Abramson
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Karen Meyerson
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Traci Arney
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Suzanne Bollmeier
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Rose Dennis
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Joyce Keith Hargrove
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Andrew Harver
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Dennis Wissing
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | - Dennis Williams
- From the Winthrop University Hospital, Mineola, New York (MC)
- Texas Children’s Hospital, Houston, Texas (SA)
- Asthma Network of Western Michigan, Grand Rapids, Michigan (KM)
- Crazy About Kids Pulmonary Services, Gilbert, Arizona (TA)
- St Louis College of Pharmacy, St Louis, Missouri (SB)
| | | |
Collapse
|
8
|
Decreased mortality resulting from a multicomponent intervention in a tertiary care medical intensive care unit. Crit Care Med 2011; 39:284-93. [PMID: 21076286 DOI: 10.1097/ccm.0b013e3181ffdd2f] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate whether a multicomponent intervention, particularly increasing staff, can achieve reductions in patient mortality in an already high-intensity, Leapfrog-compliant medical intensive care unit. DESIGN Retrospective, observational study. SETTING Medical intensive care unit of a tertiary care, academic medical center. PATIENTS A total of 1,263 patients admitted between April 19, 2004 and April 18, 2006 (before the organizational change) were compared with 2,424 patients admitted between September 5, 2006 and September 4, 2008. INTERVENTIONS A multicomponent intervention including the physical move from a 10-bed to a 29-bed medical intensive care unit with larger patient rooms, the initiation of 24-hr critical care specialist coverage in the medical intensive care unit, an increase in the respiratory therapist:patient ratio, and the addition of a clinical pharmacist to the multidisciplinary team. MEASUREMENTS AND MAIN RESULTS Measurements were made based on mortality in the intensive care unit and in-hospital. Patient comorbidity as measured by the Charlson score did not change after the intervention (2.7 ± 2.7 vs. 2.8 ± 2.6, p = .62), nor did the acuity of illness as measured by the case mix index (3.0 ± 3.7 vs. 3.1 ± 3.8, p = .69). The unadjusted medical intensive care unit mortality decreased from 18.4% to 14.9% (p = .006), as did in-hospital mortality (from 25.8% to 21.7%, p = .005). The reduction in medical intensive care unit mortality was consistent in the multivariable regression with adjustment for multiple possible confounders (odds ratio = 0.74, 95% confidence interval: 0.61-0.91, p = .003), as was the reduction in hospital mortality (odds ratio = 0.74, 95% confidence interval: 0.62-0.88, p = .001). In mechanically ventilated patients, there was an increase in median 28-day ventilator-free days (21, interquartile range 0-25 vs. 22, interquartile range 0-26, p = .04). An increase in median medical intensive care unit (2.4, interquartile range 1.1-5.2 vs. 2.7, interquartile range 1.3-5.9), p = .009) but not hospital (8.3, interquartile range 4.1-17.0 vs. 8.2, interquartile range 4.0-16.8; p = .851) length of stay in days occurred with the intervention. The mean daily dosing of fentanyl and lorazepam decreased after the intervention. CONCLUSIONS A multicomponent reorganization of medical intensive care unit services was associated with important reductions in mortality for medical intensive care unit patients, as well as an increased number of ventilator-free days. Substantial and sustained changes in clinically important outcomes may be obtained from organizational changes.
Collapse
|