Determining a discernable pattern in intensive care unit and coronary care unit readmissions: a quality improvement project

Abstract Background: Unplanned readmissions to the intensive care unit (ICU) are a significant clinical concern associated with more severe illnesses, longer lengths of stay, higher costs, and higher risk for hospital and overall mortality (Boots, 2013; Brown, Ratcliffe, Kahn, & Halpern, 2012; Elliot, Crookes, Worrall-Carter, & Page, 2011; Kramer, Higgins, & Zimmerman, 2013; Rosenberg, Hofer, Hayward, Strachan, & Watts, 2001; & Schorr, 2012). Objective: This quality improvement project was intended to identify a discernable pattern or characteristic associated with unplanned readmissions to the intensive care unit/coronary care unit. Methods: This retrospective cohort study used all patients discharged and subsequently readmitted to the critical care units in the same hospital stay at a Northwest Arkansas hospital were included in the cohort. Results: The most frequent readmission diagnoses were respiratory (33.3%) and cardiac (31.1%) related. The most common reasons for readmission were respiratory decompensation (28.9%), post-operation complications (20.0%), and post-cardiac catheterization complications (15.6%). The majority of patients readmitted were male (80%), over the age of 65 (73.3%) and originally came from the emergency department (51.1%). Discharge and readmission times were not found to be significant in this particular study. Vitals at readmission to ICU/CCU were more unstable than at discharge from ICU/CCU. Conclusions: Identifying the patient characteristics and risk factors associated with readmission can provide a path to improving patient outcomes and implementing interventions to reduce the number of readmissions into the ICU; in turn reducing costs, mortality, and length of stay. Several patient and admission characteristics were associated with readmission

Hamstring muscles: Architecture and innervation

Knowledge of the anatomical organization of the hamstring muscles is necessary to understand their functions, and to assist in the development of accurate clinical and biomechanical models. The hamstring muscles were examined by dissection in six embalmed human lower limbs with the purpose of clarifying their gross morphology. In addition to obtaining evidence for or against anatomical partitioning ( as based on muscle architecture and pattern of innervation), data pertaining to architectural parameters such as fascicular length, volume, physiological cross-sectional area, and tendon length were collected. For each muscle, relatively consistent patterns of innervation were identified between specimens, and each was unique with respect to anatomical organization. On the basis of muscle architecture, three regions were identified within semimembranosus. However, this was not completely congruent with the pattern of innervation, as a primary nerve branch supplied only two regions, with the third region receiving a secondary branch. Semitendinosus comprised two distinct partitions arranged in series that were divided by a tendinous inscription. A singular muscle nerve or a primary nerve branch innervated each partition. In the biceps femoris long head the two regions were supplied via a primary nerve branch which divided into two primary branches or split into a series of branches. Being the only muscle to cross a single joint, biceps femoris short head consisted of two distinct regions demarcated by fiber direction, with each innervated by a separate muscle nerve. Architecturally, each muscle differed with respect to parameters such as physiological cross-sectional area, fascicular length and volume, but generally all partitions within an individual muscle were similar in fascicular length. The long proximal and distal tendons of these muscles extended into the muscle bellies thereby forming elongated musculotendinous junctions. Copyright (C) 2005 S. Karger AG, Basel

Kansas corporation law relating to accounting

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Bibliography: p. 80-81.Not availabl

Si(gh)te an (re)building : architectonic reconstructions of a corrupt landscape

M.S.Christopher Jarret

Inhaltliche und formelle Untersuchung dreier gleichnamiger Schwänke und Fastnachtspiele von Hans Sachs

Germanic Studie

The quantitative effect of pyrocatechol on spontaneous activity of the subesophageal ganglion of Periplaneta americana (L.

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Not availabl