Comparison of Morbidity, Mortality, and Costs of VAP Patients with Non-VAP Patients in the Tertiary Referral Hospital of Kerman, Iran.

Background: Ventilator-associated pneumonia is the most common type of nosocomial infection in ICUs. Hence, this study shall focus on the morbidity, mortality, and costs associated with this infection among ICU patients. Materials and Methods: The current research is a prospective descriptive-analytical study. The study population included patients admitted to the Tertiary Referral Hospital of Kerman University of Medical Sciences who were enrolled in the study according to inclusion criteria and demographic characteristics data, length of stay in ICU and general wards, and direct and indirect medical expenses such as unemployment and rehabilitation cost, etc. Results: Nine of the 144 patients studied died. (4 in the Ventilator-Associated Pneumonia (VAP) group and 5 in the non-VAP group). Among them, the prevalence of Acinetobacter Baumannii was significantly higher than other bacteria (P-Value=0.001). The duration of hospitalization in the ICU (18±9 vs. 9.5±6 days) and recovery time (21.6±9 9.6 vs. 13.2±7 days) were higher in the VAP group (P-Value<0.05). Moreover, the duration of hospitalization in the general ward was 15.4±8 days in the VAP group and 10.6±6 days in the non-VAP group (P-Value<0.05). The cost of treatment in the VAP group ($7952.28) was significantly higher than in the non-infected group ($4400.98). The average rehabilitation cost in the VAP group was $2571.42 and in the non-affected group was $1530.88. The financial loss due to the delay in work starting was $482 in the non-VAP group which was significantly less than the VAP group ($792). Conclusion: Having VAP can significantly increase mortality, length of stay in the ICU as well as increase direct and indirect costs for patients.

Informational Needs of the Families of Patients Discharged From Intensive Care Units: A Case of Iran.

BACKGROUND: thousands of patients are admitted to intensive care units annually, which is a stressful event. Many of these patients still require particular care after discharge. In many countries, families play an essential role in taking care of these patients after discharge. This study aimed to determine the informational needs of families of patients discharged from Intensive Care Units (ICU), Kerman, southeast Iran. METHODS: this study had a cross-sectional design. Families were selected using the information extracted from patients' medical records. One hundred forty family members of the ICU discharged patients participated in the survey using convenience sampling. Data collection tools were a validated researcher-made questionnaire about informational needs and a demographic characteristics form. RESULTS: the mean score of family informational needs was 31.18 ± 3.97 out of 40. Most families required a high level of information in all dimensions. However, the maximum need was associated with self-care subscale (4.89 out of 5), and the minimum need was associated with defecation (3.13 out of 5). CONCLUSION: the families of patients discharged from intensive care units required much information about different areas of care particularly self-care. Health care providers, especially nurses, should be aware of the informational needs of the ICU patients' families post-discharge to provide better care.

Assessment of Leg Massage on Hemodynamic Parameters of Intensive Care Patients: A Parallel Single-Blinded Randomized Controlled Trial.

OBJECTIVE: We aimed to determine the effectiveness of leg massage by a nurse and patients' families on hemodynamic parameters in patients admitted to intensive care units. METHODS: This parallel single-blinded randomized clinical trial involved 75 patients admitted to the intensive care units at Shahid Bahonar Hospital in Kerman, Iran. Patients were assigned to 3 groups by the minimization method (massage by a nurse, massage by the patient's family, and the control group). Swedish massage was used on both legs (each leg for 5 minutes) once a day for 6 days, and the hemodynamic parameters of patients were measured before intervention, at the end of intervention, and 1 week later. RESULTS: The results showed that mean arterial pressure decreased in all 3 groups 1 week after intervention, which was not statistically significant. Mean heart rate also decreased in all 3 groups 1 week after intervention, which was statistically significant except for massage by family. Mean arterial oxygen saturation significantly decreased in all 3 groups 1 week after intervention but remained normal. The 3 hemodynamic parameters did not differ significantly among the 3 groups. CONCLUSION: According to the results of this study, the use of massage has no effect on hemodynamic parameters.

Clinical Dashboard in the Intensive Care Unit: Need-Assessment and Survey about Attitudes and Acceptance of Tele-ICU from the Viewpoint of Nurses and Clinicians in the Intensive Care Unit.

BACKGROUND: One of the most worrying aspects of medical area in developing countries is the Intensive Care Unit (ICU). This study aimed to evaluate the acceptability of the clinical dashboard by the users, prior to final use and their attitude towards this technology, as well as to examine the specific needs that Tele-ICU technology can cover in the form of a clinical dashboard. MATERIALS AND METHODS: This study was conducted at Shahid Bahonar Hospital of Kerman, Southeastern Iran, with three ICUs, the first, second, and third sections of which had 10, 12, and 24 beds, respectively. Taking survey and need assessment of care providers, qualitative and quantitative analyses were undertaken to identify key positive and negative themes. The data were analyzed by SPSS software version 18. RESULTS: About 82% of care providers in the ICU participated in this survey. The number of participants based on the groups in the survey was 98 (81.7%) of the nurses and respiratory therapists group, 20 (80%) from the group of anesthesiologists and 20 (87%) from the group of anesthesiologist assistants who participated in the survey. About 51% of the survey participants completed the description section either partially or totally. On average, among all groups, the group of anesthesiologists had the most and the nurses had the least knowledge about telemedicine and Tele-ICU, whereas the anesthesiologist assistants had the most and the nurses and respiratory therapists group had the least knowledge about clinical dashboards. CONCLUSION: This study showed that the level of knowledge and awareness of care providers, especially nurses and respiratory therapists in the ICU in terms of telemedicine and Tele-ICU is low and care providers are in doubt that telemedicine technology could have a positive or negative impact on human resource shortages, yet agreed that it would have a negative effect on the privacy of the patients and care providers. In addition, the ICU care providers agree that Tele-ICU can positively affect the quality of patient care, staff satisfaction, reduce the cost of care, and ease and reduce the time for patient counseling. This suggests the need for further research and education of system impact beyond patient outcomes related to this new technology.