The Children’s Intracranial Injury Decision Aid (CHIIDA) is a tool designed to stratify children with mild traumatic brain injury (mTBI). The aim of this study was to assess the utility and predictive value of CHIIDA in the assessment of the need for intensive care unit (ICU) admission in pediatric patients with mTBI.

This prospective observational study included 425 children below 18 years of age admitted to the ICU of a tertiary care hospital with mTBI (Glasgow Coma Scale 13 to 15). The primary outcome was the composite of neurosurgical intervention, intubation for more than 24 hours for TBI, or death from TBI. Sensitivity, specificity, predictive values and likelihood ratios were calculated at CHIIDA scores 0 and 2.

Among 425 children with mTBI, 210 (49%) had a CHIIDA score 0, 16 (4%) scored 2 points, and 199 (47%) scored more than 2 points. Thirty-six (8.47%) patients experienced the primary outcome, and there were 3 deaths. A cutoff CHIIDA >0 to admit to ICU had a sensitivity of 97.22% (95% confidence interval [CI], 97.05%-97.39%) and a negative predictive value of 99.54% (95% CI, 99.50%-99.56%). A cutoff of score >2 had a sensitivity of 97.22% (95% CI, 97.05%-97.39%), and negative predictive value of 99.56% (95% CI, 99.54%-99.59%). The post-test probability at cutoff score of 0 and 2 was 16.65% and 16.27%, respectively.

CHIIDA score does not serve as reliable triage tool for identifying children with TBI who do not require ICU admission.

CHIIDA score does not serve as reliable triage tool for identifying children with TBI who do not require ICU admission.Registered nurses play a critical role in delivering effective palliative and end-of-life patient care. Previous literature has cited that registered nurses report a lack of adequate palliative care training in academic and continuing education programs. Providing care to patients at the end of life requires knowledge in a variety of areas such as nonpharmacologic symptom management, cultural considerations, and pain management. This study aimed to investigate the impact of a professional development intervention among registered nurses on their educational needs in providing palliative care. Using a 1-group pretest-posttest design, a convenience sample of registered nurses completed an electronic survey containing demographic questions and the End-of-Life Professional Caregiver Survey. The professional development intervention consisted of an 8-hour training conducted by a content expert on palliative patient care addressing the competencies developed by the End-of-Life Nursing Education Consortium. The results revealed a significant increase in participant knowledge in providing quality palliative care to patients (P less then .001). Education programs on quality palliative and end-of-life patient care can effectively improve the care delivered to this patient population.

To evaluate the effect of a tracheal intubation safety bundle on adverse tracheal intubation-associated events across 15 PICUs.

Multicenter time-series study.

PICUs in the United States.

All patients received tracheal intubations in ICUs.

We implemented a tracheal intubation safety bundle as a quality-improvement intervention that includes 1) quarterly site benchmark performance report and 2) airway safety checklists (preprocedure risk factor, approach, and role planning, preprocedure bedside “time-out,” and immediate postprocedure debriefing). selleck kinase inhibitor We define each quality-improvement phase as baseline (-24 to -12 mo before checklist implementation), benchmark performance reporting only (-12 to 0 mo before checklist implementation), implementation (checklist implementation start to time achieving > 80% bundle adherence), early bundle adherence (0-12 mo), and sustained (late) bundle adherence (12-24 mo). Bundle adherence was defined a priori as greater than 80% of checklist use for tracheal intubations uality-improvement bundle was associated with a decrease in the adverse tracheal intubation-associated event that was sustained for 24 months.

Effective implementation of a quality-improvement bundle was associated with a decrease in the adverse tracheal intubation-associated event that was sustained for 24 months.

Standard nursing interventions, especially bed-baths, in ICUs can lead to complications or adverse events defined as a physiologic change that can be life-threatening or that prolongs hospitalization. However, the frequency and type of these adverse events are rarely reported in the literature. The primary objective of our study was to describe the proportion of patients experiencing at least one serious adverse event during bed-bath. The secondary objectives were to determine the incidence of each type of serious adverse event and identify risk factors for these serious adverse events.

Prospective multicenter observational study.

Twenty-four ICUs in France, Belgium, and Luxembourg.

The patients included in this study had been admitted to an ICU for less than 72 hours and required at least one of the following treatments invasive ventilation, vasopressors, noninvasive ventilation, high-flow oxygen therapy. Serious adverse events were defined as cardiac arrest, accidental extubation, desaturation and/ong care between 11 and 20 minutes (p = 0.005), duration of nursing care greater than 40 minutes (p = 0.04) with a reference duration of nursing care between 20 and 40 minutes.

Serious adverse events were observed in one-half of patients and concerned one-fifth of nurses, confirming the need for caution. Further studies are needed to test systematic serious adverse event prevention strategies.

Serious adverse events were observed in one-half of patients and concerned one-fifth of nurses, confirming the need for caution. Further studies are needed to test systematic serious adverse event prevention strategies.

The epidemiology of chronic critical illness is not well known. We aimed to estimate the prevalence, mortality, and costs associated with chronic critical illness in Japan.

A nationwide inpatient administrative database study in Japan from April 2011 to March 2018.

Six hundred seventy-nine acute-care hospitals with ICU beds in Japan.

Adult patients who met our definition for chronic critical illness one of six eligible clinical conditions (prolonged acute mechanical ventilation, tracheotomy, stroke, traumatic brain injury, sepsis, and severe wound) plus at least 8 consecutive days in an ICU.

None.

Among 2,395,016 ICU admissions during the study period, 216,434 (9.0%) met the definition for chronic critical illness. The most common eligible condition was prolonged acute mechanical ventilation (73.9%), followed by sepsis (50.6%), tracheostomy (23.8%), and stroke (22.8%). Overall inhospital mortality was 28.6%. The overall age-specific population prevalence was 42.0 per 100,000. The age-specific population prevalence steadily increased with age, reaching 109.