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This volume reviews the state of the art in caring for patients dying in the ICU, focusing on both clinical aspects of managing pain and other symptoms, as well as ethical and societal issues that affect the standards of care recieved, The book also addresses the changing epidemiology of death in this setting related to managed care, practical skills needed to provide the highest quality of care to terminal patients, communicating with patients and families, the mechanics of withdrawing life supporting therapies, and the essential role of palliative care specialists in the ICU. The book briefly describes unique issues that arise when caring for patients with some of the more common diseases that preciptate death in the ICU. Contributors for the book were chosed because they have experience caring for patients in the ICU, and are also doing curent research to find ways to improve care for terminal patients in this setting.
The origin of modern intensive care units (ICUs) has frequently
been attributed to the widespread provision of mechanical
ventilation within dedicated hospital areas during the 1952
Copenhagen polio epidemic. However, modern ICUs have developed to
treat or monitor patients who have any severe, life-threatening
disease or injury. These patients receive specialized care and
vital organ assistance such as mechanical ventilation,
cardiovascular support, or hemodialysis. ICU patients now typically
occupy approximately 10% of inpatient acute care beds, yet the
structure and organization of these ICUs can be quite different
across hospitals. In The Organization of Critical Care: An
Evidence-Based Approach to Improving Quality, leaders provide a
concise, evidence-based review of ICU organizational factors that
have been associated with improved patient (or other) outcomes.The
topics covered are grouped according to four broad domains: (1) the
organization, structure, and staffing of an ICU; (2) organizational
approaches to improving quality of care in an ICU; (3) integrating
ICU care with other healthcare provided within the hospital and
across the broader healthcare system; and (4) planning for the
future delivery of critical care. Each chapter summarizes a
different aspect of ICU organization and includes a summary of key
messages targeting individual clinicians and healthcare decision
makers. Each chapter also concludes with a description of areas
where future research in the field is needed. A long overdue
contribution to the field, The Organization of Critical Care: An
Evidence-Based Approach to Improving Quality is an indispensable
guide for all clinicians and health administrators concerned with
achieving state-of-the-art outcomes for intensive care.
The origin of modern intensive care units (ICUs) has frequently
been attributed to the widespread provision of mechanical
ventilation within dedicated hospital areas during the 1952
Copenhagen polio epidemic. However, modern ICUs have developed to
treat or monitor patients who have any severe, life-threatening
disease or injury. These patients receive specialized care and
vital organ assistance such as mechanical ventilation,
cardiovascular support, or hemodialysis. ICU patients now typically
occupy approximately 10% of inpatient acute care beds, yet the
structure and organization of these ICUs can be quite different
across hospitals. In The Organization of Critical Care: An
Evidence-Based Approach to Improving Quality, leaders provide a
concise, evidence-based review of ICU organizational factors that
have been associated with improved patient (or other) outcomes. The
topics covered are grouped according to four broad domains: (1) the
organization, structure, and staffing of an ICU; (2) organizational
approaches to improving quality of care in an ICU; (3) integrating
ICU care with other healthcare provided within the hospital and
across the broader healthcare system; and (4) international
perspectives on critical care delivery. Each chapter summarizes a
different aspect of ICU organization and targets individual
clinicians and healthcare decision makers. A long overdue
contribution to the field, The Organization of Critical Care: An
Evidence-Based Approach to Improving Quality is an indispensable
guide for all clinicians and health administrators concerned with
achieving state-of-the-art outcomes for intensive care.
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