Survey of information technology in Intensive Care Units in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>The Intensive Care Unit (ICU) is a data-rich environment where information technology (IT) may enhance patient care. We surveyed ICUs in the province of Ontario, Canada, to determine the availability, implementation and variability of information systems.</p> <p>Methods</p> <p>A self-administered internet-based survey was completed by ICU directors between May and October 2006. We measured the spectrum of ICU clinical data accessible electronically, the availability of decision support tools, the availability of electronic imaging systems for radiology, the use of electronic order entry and medication administration systems, and the availability of hardware and wireless or mobile systems. We used Fisher's Exact tests to compare IT availability and Classification and Regression Trees (CART) to estimate the optimal cut-point for the number of computers per ICU bed.</p> <p>Results</p> <p>We obtained responses from 50 hospitals (68.5% of institutions with level 3 ICUs), of which 21 (42%) were university-affiliated. The majority electronically accessed laboratory data and imaging reports (92%) and used picture archiving and communication systems (PACS) (76%). Other computing functions were less prevalent (medication administration records 46%, physician or nursing notes 26%; medication order entry 22%). No association was noted between IT availability and ICU size or university affiliation. Sites used clinical information systems from15 different vendors and 8 different PACS systems were in use. Half of the respondents described the number of computers available as insufficient. Wireless networks and mobile computing systems were used in 23 ICUs (46%).</p> <p>Conclusion</p> <p>Ontario ICUs demontrate a high prevalence of the use of basic information technology systems. However, implementation of the more complex and potentially more beneficial applications is low. The wide variation in vendors utilized may impair information exchange, interoperability and uniform data collection.</p

A study of the perceived risks, benefits and barriers to the use of SDD in adult critical care units (the SuDDICU study)

Peer reviewedPublisher PD

Clinical stakeholders' opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units : an international Delphi study

Peer reviewedPublisher PD

Research Data Management and the Canadian Academic Library: An Organizational Consideration of Data Management and Data Stewardship

Research data management (RDM) has become a professional imperative for Canada’s academic librarians. Recent policy considerations by our national research funding agencies that address the ability of Canadian universities to effectively manage the massive amounts of research data they now create has helped library and university administrators recognize this gap in the research enterprise and identify RDM as a solution. RDM is not new to libraries, though. Rather, it draws on existing and evolving organizational functions in order to improve data collection, access, use, and preservation. A successful research data management service requires the skills and knowledge found in a library’s research liaisons, collections experts, policy analysts, IT experts, archivists and preservationists. Like the library, research data management is not singular but multi-faceted. It requires collaboration, technology and policy analysis skills, and project management acumen. This paper examines research data management as a vital information, technical, and policy service in academic libraries today. It situates RDM not only as actions and services but also as a suite of responsibilities that require a high level of planning, collaboration, and judgment, thereby binding people to practice. It shows how RDM aligns with the skill sets and competencies of librarianship and illustrates how RDM spans the library’s organizational structure and intersects with campus stakeholders allied in the research enterprise

What is best and at what cost? Cross-national differences in the treatment of ageing-related diseases Norwegian perspective from a comparative OECD-project

Aggregated medical spending differs widely across countries and large variations exist in the frequency and the mix of medical services provided, as well as the type of technology applied. The outcomes (mostly measured as survival rates) do not, however vary to the same extent as the spending. Policy makers in many countries compare their spending to each other, with no clear consensus about how systems are effective in treating patients. In each of these debates the issue of what medical care is buying arises: When countries spend more or less on health care, how does that affect resource allocation in the medical sector and ultimately the health outcomes? The goal of the project1 was to examine how different medical care systems will affect the allocation of resources in the medical sector. As the existing available macro data at an international level does not allow for satisfactory answers to such questions, this project wanted to use a microeconomic approach. An international comparison of treatments of conditions in older populations that lead to high expenditures could help to identify treatments that might be more effective in improving outcomes at lower cost. Therefore the project focused on international comparisons of treatments for a spectrum of conditions in older populations with high aggregate medical spending, well identified episodes of care, high prevalence and high policy relevance. Norway participated in studies on myocardial infarction and breast cancer 2. The choice of focus on older patients was partly motivated by the fact that in the future the elderly will probably take an increasingly proportion of the total spending in the health care sector. See documentation from the main project: http://www.oecd.org/EN/document/0,,EN-document-194-5-no-27-32316-0,00.htmlMedical care; allocation of resources; acute myocardial infarction; breast cancer; international comparisons of treatments

(Re) evaluating Critical Care Nurse Support Program(s) in a Tertiary Care Hospital: Intersecting the Art and Science of Nursing

There is a growing critical care nurse staffing shortage with increases in nurse vacancy rates. Moral distress has been exacerbated by the SARS-CoV-2 (COVID-19) pandemic and, in particular, impacting critical care nurses. COVID-19 is a significant contributor to staffing shortages and continued nursing crisis. Thus, the impetus for the Problem of Practice (PoP): the lack of support to address the psychological, emotional, and spiritual distress suffered by critical care registered nurses in a tertiary care hospital in Central Ontario. To comprehend the realities of working in the intensive care units, leaders must first understand nurses’ lived experiences, narratives, and what it means to work on the frontline in an intensive care unit. The Organizational Improvement Plan (OIP) is underpinned by interpretive phenomenology and authentic and transformational leadership approaches. Lewin’s three-stage force field model of change theory is utilized for leading change and Burke and Litwin’s performance change model for the organizational analysis. The overall goal of the OIP is to implement a change plan that brings leaders and critical care registered nurses together to co-create support program(s) to address critical care nurses’ psychological, emotional, and spiritual distress, decrease nurse attrition, and enhance critical care nurses’ well-being

Breastfeeding resources for mothers of preterm infants in Canadian neonatal intensive care units (NICUs): An environmental scan

Supportive breastfeeding resources are needed in neonatal intensive care units (NICUs) to effectively promote breastfeeding among mothers of preterm infants, yet researchers have not examined the existence of such support in a Canadian context. The purpose of this study was to determine, using an environmental scan, the types and frequencies of breastfeeding resources available to mothers of preterm infants in Canadian NICUs. Semi-structured interviews were conducted with 33 key informants from 29 level 3 NICUs across Canada. Six categories of resources were identified via content analysis: breastfeeding-friendly layout, breastfeeding support personnel, breastfeeding education for mothers, breast pump-related resources, coordination of post-discharge breastfeeding support, and breastfeeding-related policies. Several resources were reported by informants to exist in a high proportion of NICUs, such as privacy measures and breast pump availability, whereas other resources were reported in lower frequencies, such as the presence of peer counsellors and breastfeeding-related policies

Mechanomorphosis: Science, Management, and “Human Machinery” in Industrial Canada, 1900–45

By the early 20th century, the changes taking place in western industrial capitalist nations prompted an adaptive shift in the socioeconomic delineation of human bodies, and in scientific theories about how they worked and how they could be put to work. Just as the rising social sciences borrowed from medicine to convey images of social malaise, medicine increasingly appropriated an industrial vocabulary to conceptualize bodily health. Depicted variously as a machine, a motor, a factory in itself, the human body absorbed industrial symbolism. Modern industry demanded an intensification of labour that made bodily efficiency paramount. The corresponding definition of health also shifted, from emphasis on physical endurance, which could be secured by simple replacement of outworn workers, to optimum labour efficiency, which had to be actively instilled in all workers, present and future. Scientific management programs were easily integrated with regulatory medical notions concerning the human body and human nature, as science, medicine and technology combined forces to promote a machine ethic that equated modernity, progress, efficiency, and national health. This paper considers the relationship between changing conceptualizations of the human body, developing medical influence and state regulation of health, and attempts to “Taylorize” the labour process in early 20th century Canada

Relationship Between Role Conflict, Role Ambiguity, and Interprofessional Team Collaboration Among Nurses Caring For Older Adults in the Intensive Care Unit (ICU)

The purpose of this cross-sectional study was to examine the relationship between role conflict (RC), role ambiguity (RA) and interprofessional team collaboration (ITC) among nurses caring for older adults in intensive care units (ICU). Using random sample (n = 403) selected from the primary study by Fox (2014), Pearsons correlations showed statistically significant relationship between RA, RC, as well as between ITC and highest level of nursing education resource availability, and institutional values. There was no statistical significant relationship between gender and ITC. Using regression analysis and controlling for the extraneous variables, a significant regression equation was found (F(7, 403) = 21.19, p < 0.0); whereas RA had a statistical significantly relationship with ITC, RC and the extraneous variables were not significantly associated with ITC. Results suggest a need to reduce role to improve interprofessional collaboration. Further research is needed to identify other variables related to interprofessional team collaboration