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The effect of a managerial-based intervention on the occurrence of out-of-range-measurements and mortality in intensive care units.
- Source :
-
Journal of critical care [J Crit Care] 2004 Sep; Vol. 19 (3), pp. 130-4. - Publication Year :
- 2004
-
Abstract
- Purpose: To evaluate the effect of an organization-based managerial intervention on performance of intensive care units (ICUs).<br />Methods and Participants: Prospective multicentre cluster-randomized study with an intervention at the level of ICU staff was carried out. The intervention comprised a set of managerial changes, concerning the nurses' level of skill discretion and participation in decision-making introduced during a period of six months. The ICU-performance was monitored before, during and after the intervention, in terms of mortality and occurrence of out-of-range-measurements (ORMs). The ORMs were defined as a derangement of systolic blood pressure (BP), heart rate (HR), oxygen saturation (SaO2) and urine output (Diur). Data were statistically analyzed by logistic regression with random effects due to ICUs.<br />Results: The overall ICU and hospital mortalities were 14% and 20%, the incidence of BP, HR, O2 and Diur ORM was respectively 46%, 38%, 28% and 48%. After adjusting for SAPSII, admission type and age the regression analyses revealed a positive effect of the intervention for all the six outcome variables.<br />Conclusions: The intervention reduced both the ICU and hospital mortalities and the incidences of the out-of-range measurements. Registering ORMs provides a feasible method for evaluating ICU performance and could help to optimize individual patient care.
Details
- Language :
- English
- ISSN :
- 0883-9441
- Volume :
- 19
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of critical care
- Publication Type :
- Academic Journal
- Accession number :
- 15484172
- Full Text :
- https://doi.org/10.1016/j.jcrc.2004.07.005