Prevalence of alarms in intensive care units, and its relationship with nursing staff levels

Background The average number of alarms per patient on each day in Intensive Care Unit (ICU) was very high with poor specificity, high sensitivity and high false positive rate. The large number of false alarms has caused healthcare professionals to turn down the volume of audible signals, adjust the alarm setting beyond limits that are safe and appropriate for the patient, and ignore or even deactivate alarms, resulting in sentinel events and patient deaths. The objectives of the present study were to examine the prevalence of ICU cardiac and technical alarms and the relationship between that prevalence and available nursing staff levels. Methods The study collected all cardiac and technical alarm data from the bedside physiological monitor through the central monitoring system at the nurses' station, over a five-week period. The prevalence of these alarms and the correlation with different shifts of duty was analysed. The relationship between nursing staff levels and the number of these alarms was also analysed. Results There was a positive correlation between the number of cardiac and technical alarms per bed per hour in three different shifts (Night and Morning, Morning and Afternoon, and, Afternoon and Night: All p-value < 0.001). The effect of these alarms on the present shift will affect the number of alarms in the subsequent three shifts. Besides, the number of cardiac and technical alarms is not related to the nursing staff levels. Conclusions This study describes the prevalence of cardiac and technical alarms from a different perspective, by examining the prevalence of physiological monitor cardiac and technical alarms in ICUs (but not their sound amplitude) and its relationship with nursing staff levels, the finding against many people thinking that the cardiac and technical alarms should be fewer when the nursing staffing level is high in the unit.published_or_final_versio

Anthropometric Measurement of Patients Admitted to an Intensive Care Unit

Background Visual estimation is the usual method that many healthcare professional use to estimate the body weight of patients in the Intensive Care Unit (ICU), but this method has been shown to be significantly inaccurate. This study aimed to explores the feasibility of using fibula length to estimate the acute body weight of patients admitted to an ICU. Methods The study collected all ICU records in which patient’s body weight was estimated by the equation: Males: 153.1 – (0.26 x age) – 11 + (1.05 x fibular length) Females: 153.1 – (0.26 x age) – 22 + (1.05 x fibular length). The body weight(BW) then estimated by: BW= 20 x [estimated body height (in metres)]2. The degree of agreement between the estimated body weight by anthropometric measurement methods and the actual recorded body weight in the patient’s medical record within the four weeks immediately before ICU admission were assessed by the Bland-Altman plot. Results Paired sample t-tests showed there were statistically significant differences between the patient’s estimated and actual height and weight (p-value = 0.0001 for both). Conclusions The study found the use of fibula length alone had a similar percentage of bias when compared with visual estimation by healthcare professionals to estimate the actual body weight of the patients admitted to ICU.published_or_final_versio

An ab initio study on the ground and low-lying doublet electronic states of SbO₂

2006-2007 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Establishment of HKU lung cancer lines in Hong Kong - an ongoing conjoint effort and progress report

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Design and evaluation of a Facebook game for self-directed e-learning

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The effect of pre-operative information in relieving anxiety in oral surgery patients

Appropriate stress management of patients is essential for smooth running of invasive or surgical dental procedures conducted under local anaesthesia. Objective: The current study analysed the effectiveness of pre-operative information provision for anxiety reduction during dentoalveolar surgery in patients with high- or low-trait anxiety. Methods: Patients scheduled for oral surgical procedures performed by six private dental practitioners were invited to participate in the study. They were randomly assigned to four groups and received the following pre-operative information: (i) basic information only, (ii) basic information with details of the operative procedures, (iii) basic information with details of the expected recovery, and (iv) basic information with details of both the operative procedures and recovery. The participants' trait anxiety level was measured with the Depression Anxiety Stress Scales (DASS), then they were divided into high- or low-trait anxiety groups with the method of median-split on the basis of the DASS score. Self-rated anxiety was recorded immediately before, during and 10 min after the surgical procedures. Results: High-trait anxiety subjects gave higher self-reported anxiety levels (repeated-measures ANOVA, P < 0.05). Pre-operative provision of details about the expected recovery only or details concerning both the operative procedures and recovery led to significant reduction in self-reported anxiety among the participants throughout the procedure (P < 0.01). However, information on operative procedures led to anxiety reduction in low (P < 0.05) but not high-trait anxiety participants. Conclusion: Provision of pre-operative information of the recovery process leads to significant anxiety reduction in all patients who undergo surgical/invasive procedures with local anaesthesia. © Blackwell Munksgaard, 2004.postprin

A woman with persistent vaginal bleeding after suction evacuatin of the uterus

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Promotor hypermethylation of the CpG Islands of human Ras Association Domain Family 1A gene (RASSF1A) in adenocarcinoma of lung in Hong Kong Chinese - a comparison between smokers and non-smokers

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Evaluating Students' Perception of a Three-Dimensional Virtual World Learning Environment

Three-dimensional virtual environments have gained wide popularity due to improvement in graphic rendering technology and networking infrastructure. Many education institutions have been trying to leverage the potential of 3D virtual environments in their application in education. In this research, we aim to evaluate the students’ perception of virtual environments in teaching and learning activities. We set up a virtual classroom, where a short presentation was delivered to students through virtual projectors in Second Life, the most widely adopted 3D virtual environment. The students filled in a questionnaire after the class. We found that the students gave a statistically higher evaluation to 3D virtual environments in terms of satisfaction and enjoyment, while comparable scores between 3D and traditional learning environment in terms of concentration, perceived usefulness, and learning and understanding were obtained. Our results show that virtual learning environment is of great potential in e-learning. Some recommendations in using the virtual environment for learning activities are given.published_or_final_versio

Inpatient emergencies encountered by an infectious disease consultative service

The spectrum of infections disease (ID) emergencies in hospitalized patients was assessed in a prospective study of 3,626 inpatient ID consultations in a 1,350-bed teaching hospital. ID emergencies, defined by a need or anticipated need for advanced life support or by irreversible organ damage leading to permanent functional loss, were encountered in 175 patients. Infections of the central nervous system (26.3%), cardiovascular system (14.9%), alimentary system (13.1%), and lower respiratory tract (7.4%) and adverse reactions to antimicrobial agents (7.4%) were most common. In 18.9% of the cases, the referring clinicians were unaware of the emergency at the time of referral. Drug reactions (46.1%), severe alimentary and peritoneal infections (32.0%), upper respiratory tract infections (28.6%), and skin and soft-tissue infections (27.3%) were most frequently missed. The emergency ID conditions were not recognized because they had an atypical presentation (51.5%), were not commonly seen in the referring specialty (24.2%), were due to rare organisms (15.2%), or had unusual anatomical sites of involvement (9.1%). A close liaison between clinicians and the ID team is crucial for recognition of ID emergencies at their early stages so that appropriate investigations and management can be instituted expediently, before the occurrence of irreversible damage.published_or_final_versio