Large-scale clinical trials networks are best suited for understanding how care is delivered, generating evidence to minimize unnecessary heterogeneity of patient care, and testing different care patterns and medications to improve clinical outcomes. Discovery, the Critical Care Research Network, was launched in 2017 as a combined effort of the United States Critical Illness and Injury Trials (USCIIT), the Critical Care Pharmacotherapy Trials Network (CCPTN), and the Society of Critical Care Medicine (SCCM). In collaboration with our colleagues we hope to contribute evidence to help improve the care of the critically ill and injured
{"title":"Society of critical care medicine discovery: Collaborative critical care research network","authors":"J. Sevransky, O. Gajic","doi":"10.4103/SCCJ.SCCJ_25_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_25_17","url":null,"abstract":"Large-scale clinical trials networks are best suited for understanding how care is delivered, generating evidence to minimize unnecessary heterogeneity of patient care, and testing different care patterns and medications to improve clinical outcomes. Discovery, the Critical Care Research Network, was launched in 2017 as a combined effort of the United States Critical Illness and Injury Trials (USCIIT), the Critical Care Pharmacotherapy Trials Network (CCPTN), and the Society of Critical Care Medicine (SCCM). In collaboration with our colleagues we hope to contribute evidence to help improve the care of the critically ill and injured","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130042047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanan H. Edrees, Z. A. Al Aseri, Y. Mandourah, A. Yousef, I. Qushmaq, K. Maghrabi, F. Al-Hameed, Y. Arabi
Healthcare organizations around the globe are increasingly turning to multicenter quality improvement collaboratives (QICs) to improve patient care and outcomes. Despite the increase in demand and popularity of establishing multi-organizational QICs, there is limited evidence of these collaboratives in Saudi Arabia and in the Middle Eastern region. This article highlights the main components of successful QICs, recommendations to ensure successful QICs, and implications for establishing future collaboratives in Saudi Arabia.
{"title":"Commitment to collaborate: The value of establishing multicenter quality improvement collaboratives in Saudi Arabia","authors":"Hanan H. Edrees, Z. A. Al Aseri, Y. Mandourah, A. Yousef, I. Qushmaq, K. Maghrabi, F. Al-Hameed, Y. Arabi","doi":"10.4103/SCCJ.SCCJ_22_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_22_17","url":null,"abstract":"Healthcare organizations around the globe are increasingly turning to multicenter quality improvement collaboratives (QICs) to improve patient care and outcomes. Despite the increase in demand and popularity of establishing multi-organizational QICs, there is limited evidence of these collaboratives in Saudi Arabia and in the Middle Eastern region. This article highlights the main components of successful QICs, recommendations to ensure successful QICs, and implications for establishing future collaboratives in Saudi Arabia.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130994253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traumatic brain injury (TBI) was referred to as silent epidemic, neglected epidemic, and public health crisis by the World Health Organization due to its growing incidence and global public health, social, and economic burden. Despite the massive technological progress, no definitive treatment was found to cure TBI medically.The available evidence-based protocols are primarily directed toward stabilizing the patient and preventing secondary brain injuries, and their effectiveness has been validated in in high-income countries, but they may not be applicable to low and middle-income countries due to the lack of the appropriate infrastructure and limited human resources. Therefore, discrepancies are predicted between centers in high, low and middle-income countries and further studies are needed to asses the global managment of TBI.
{"title":"Knowledge gaps in the global practice of management of severe traumatic brain injury","authors":"S. Alsolamy, Farah Alotaibi, Y. Arabi","doi":"10.4103/SCCJ.SCCJ_26_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_26_17","url":null,"abstract":"Traumatic brain injury (TBI) was referred to as silent epidemic, neglected epidemic, and public health crisis by the World Health Organization due to its growing incidence and global public health, social, and economic burden. Despite the massive technological progress, no definitive treatment was found to cure TBI medically.The available evidence-based protocols are primarily directed toward stabilizing the patient and preventing secondary brain injuries, and their effectiveness has been validated in in high-income countries, but they may not be applicable to low and middle-income countries due to the lack of the appropriate infrastructure and limited human resources. Therefore, discrepancies are predicted between centers in high, low and middle-income countries and further studies are needed to asses the global managment of TBI.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122367105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: High-fidelity simulation (HFS) has recently been used for undergraduate nursing students to simplify their learning. The aim of the current study was to explore Saudi novice nursing students perceptions of satisfaction and self-confidence with HFS and to determine if there is any correlation between participants' demographic characteristics and satisfaction and self-confidence learning scale. Methods: A descriptive quantitative study was performed to recruit Saudi participants through Saudi Arabian Cultural Mission (SACM). Data were collected over a 3-month period from February, 2017 to May, 2017 through online survey was posted on SACM's official Facebook page. The survey used the Student Satisfaction and Self-Confidence in Learning tool. A total of (n = 76) Saudi undergraduate nursing students were participated. Data were analyzed using SPSS. Results: The findings revealed that satisfaction and self-confidence had a high mean score which indicates that the majority of the students were satisfied and self-confidence with the HFS experience. No significant correlations were found between the demographic characteristics and student satisfaction and self-confidence except that those who are in the prelicensure program had a significantly higher satisfaction score (P = 0.03) than students who had a bachelor or other degrees. Furthermore, a strong correlation between students' satisfaction and self-confidence in learning was found (P < 0.0001) indicating that these factors were correlated. Conclusions: This study has further confirmed that satisfaction and self-confidence are associated with the HFS experience. HFS prepare novice nursing students for real-life experience and promote the transition to a professional career. Nurse educators should be trained in the use of simulation as a teaching strategy. In addition, nursing faculty needs to consider students perception about the simulation when designing, performing, and evaluating.
{"title":"Saudi novice undergraduate nursing students' perception of satisfaction and self-confidence with high-fidelity simulation: A quantitative descriptive study","authors":"Maram Abdullah Alammary","doi":"10.4103/SCCJ.SCCJ_7_18","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_7_18","url":null,"abstract":"Introduction: High-fidelity simulation (HFS) has recently been used for undergraduate nursing students to simplify their learning. The aim of the current study was to explore Saudi novice nursing students perceptions of satisfaction and self-confidence with HFS and to determine if there is any correlation between participants' demographic characteristics and satisfaction and self-confidence learning scale. Methods: A descriptive quantitative study was performed to recruit Saudi participants through Saudi Arabian Cultural Mission (SACM). Data were collected over a 3-month period from February, 2017 to May, 2017 through online survey was posted on SACM's official Facebook page. The survey used the Student Satisfaction and Self-Confidence in Learning tool. A total of (n = 76) Saudi undergraduate nursing students were participated. Data were analyzed using SPSS. Results: The findings revealed that satisfaction and self-confidence had a high mean score which indicates that the majority of the students were satisfied and self-confidence with the HFS experience. No significant correlations were found between the demographic characteristics and student satisfaction and self-confidence except that those who are in the prelicensure program had a significantly higher satisfaction score (P = 0.03) than students who had a bachelor or other degrees. Furthermore, a strong correlation between students' satisfaction and self-confidence in learning was found (P < 0.0001) indicating that these factors were correlated. Conclusions: This study has further confirmed that satisfaction and self-confidence are associated with the HFS experience. HFS prepare novice nursing students for real-life experience and promote the transition to a professional career. Nurse educators should be trained in the use of simulation as a teaching strategy. In addition, nursing faculty needs to consider students perception about the simulation when designing, performing, and evaluating.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124991585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Al-Hababi, Eisa Eid Al-Enazi, Raed Hassan Al-Hababi, Abdul N. Jomaa, Salah Saleh Al-Sager, A. Al-Ahmari
Introduction: Hepatitis B virus (HBV) infection is a major global health problem, causing chronic hepatitis, cirrhosis, hepatocellular carcinoma (HCC) and other chronic liver diseases. HBV infection is endemic in many parts of Kingdom of Saudi Arabia. Occult HBV infection (OBI) is a challenging clinical problem characterized by the absence of Hepatitis B surface Antigen (HBsAg) and low viral DNA load. Aims: This study aim is to investigate an epidemiological survey for the prevalence of OBI among Saudi healthy general population and two of most common HBV infection risks, hemodialysis and HIV patients in Riyadh Regional Laboratory. Methods: Three groups of samples were tested. 5025 blood samples healthy group were collected from Saudi citizens for pre-marriage screening testing. Second group is comprised of 658 adult patients with end-stage renal disease undergoing regular hemodialysis. Third group is comprised from 479 patients who had been previously confirmed for HIV infection. Results: Of 5025 healthy people enrolled into the study, 212 (4.2%) seropositive for HBsAg and/or anti HBc. Of them, 114/212 (53.8%) resolved infection with detectable anti-HBs (>10 mIU/mL), and 58/212 (27.36 %) had active HBV infection with detectable HBsAg. While, 40/212 (18.9%) were defined as OBI and HBV DNA was detected in two OBI patients. In 658 hemodialysis (HD) patients, 196 (27.96%) seropositive for HBsAg and/or anti-HBc. Of them 122/196 (66.3%) resolved infection with detectable anti-HBs (>10 mIU/mL), and 17/196 (9.24%) with active HBV infection with detectable HBsAg. OBI only detected in 32/196 (17.4%), HBV DNA was detected in 3 patients. Lastly, in 479 HIV patients, 152 seropositive for HBsAg and/or anti HBc. Of them 11/152 (7.23%) had active HBV infection with detectable HBsAg and 78 (51.3%) resolved infection with detectable anti-HBs (>10 mIU/mL). OBI detected in 63/152 (41.4%) and only 6 patients showed HBV DNA was detected. There were no statistically significant differences in the OBI prevalence between healthy population and HD prevalence while showed significance difference in HIV OBI prevalence compared to healthy group. Conclusions: this study proof that OBI is frequently encountered among healthy and high risk group individuals in Saudi Arabia and more support should be provided for the vaccination especially of high-risk groups, such as HIV and HD patients.
{"title":"Serological characterization of occult hepatitis B Virus infection in Riyadh regional laboratory","authors":"F. Al-Hababi, Eisa Eid Al-Enazi, Raed Hassan Al-Hababi, Abdul N. Jomaa, Salah Saleh Al-Sager, A. Al-Ahmari","doi":"10.4103/SCCJ.SCCJ_3_18","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_3_18","url":null,"abstract":"Introduction: Hepatitis B virus (HBV) infection is a major global health problem, causing chronic hepatitis, cirrhosis, hepatocellular carcinoma (HCC) and other chronic liver diseases. HBV infection is endemic in many parts of Kingdom of Saudi Arabia. Occult HBV infection (OBI) is a challenging clinical problem characterized by the absence of Hepatitis B surface Antigen (HBsAg) and low viral DNA load. Aims: This study aim is to investigate an epidemiological survey for the prevalence of OBI among Saudi healthy general population and two of most common HBV infection risks, hemodialysis and HIV patients in Riyadh Regional Laboratory. Methods: Three groups of samples were tested. 5025 blood samples healthy group were collected from Saudi citizens for pre-marriage screening testing. Second group is comprised of 658 adult patients with end-stage renal disease undergoing regular hemodialysis. Third group is comprised from 479 patients who had been previously confirmed for HIV infection. Results: Of 5025 healthy people enrolled into the study, 212 (4.2%) seropositive for HBsAg and/or anti HBc. Of them, 114/212 (53.8%) resolved infection with detectable anti-HBs (>10 mIU/mL), and 58/212 (27.36 %) had active HBV infection with detectable HBsAg. While, 40/212 (18.9%) were defined as OBI and HBV DNA was detected in two OBI patients. In 658 hemodialysis (HD) patients, 196 (27.96%) seropositive for HBsAg and/or anti-HBc. Of them 122/196 (66.3%) resolved infection with detectable anti-HBs (>10 mIU/mL), and 17/196 (9.24%) with active HBV infection with detectable HBsAg. OBI only detected in 32/196 (17.4%), HBV DNA was detected in 3 patients. Lastly, in 479 HIV patients, 152 seropositive for HBsAg and/or anti HBc. Of them 11/152 (7.23%) had active HBV infection with detectable HBsAg and 78 (51.3%) resolved infection with detectable anti-HBs (>10 mIU/mL). OBI detected in 63/152 (41.4%) and only 6 patients showed HBV DNA was detected. There were no statistically significant differences in the OBI prevalence between healthy population and HD prevalence while showed significance difference in HIV OBI prevalence compared to healthy group. Conclusions: this study proof that OBI is frequently encountered among healthy and high risk group individuals in Saudi Arabia and more support should be provided for the vaccination especially of high-risk groups, such as HIV and HD patients.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127546933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: During cardiopulmonary resuscitation, family members are usually pushed out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Some health organizations worldwide such as American Heart Association and the Resuscitation Council in the UK supports family-witnessed resuscitation (FWR) and urge hospitals to develop policies to ease this process. The opinions on FWR vary widely among various cultures, and some hospitals are not applying such polices yet. This is the first study which explores the Saudi family members' opinion for family witness resuscitation in adult critical care setting. Objectives: To investigate whether patient's next of kin would like to have been present in the resuscitation room during attempted cardiopulmonary resuscitation (CPR) of their relative and their experience or knowledge of what is involved in CPR. Subjects and Methods: A retrospective, descriptive telephone survey of families of patients who had admitted in critical cares areas from January 2016 to June 2016. A family presence survey was developed to determine the desires, beliefs, and concerns about FWR. Results: Out of the 235 respondents, 143 (60.9%) wanted to be present in the room of their loved one just before death while CPR was going on. One hundred and eighty-two (77.4%) of the respondents believed that the family members should be with their loved one before death. More than half, i.e., 141 (60.0%) of the respondents believed that their presence might have eased the suffering of the deceased. One hundred and fifty-seven (66.8%) of the family members thought that their presence with the deceased in their last moments could have helped their sorrows and sadness. Conclusion: Most relatives of patients requiring CPR would like to be offered the possibility of being in the resuscitation room; this could have several benefits, so this study suggests that institutions should consider establishing programs of witnessed cardiopulmonary resuscitation for family members.
{"title":"Saudi family perceptions of family-witnessed resuscitation in the adult critical care setting","authors":"A. Alshaer, Khalid Alfaraidy, Florence Morcom, Wasaif Alqahtani, Zahra Alsadah, Atheer Almutairi","doi":"10.4103/sccj.sccj_5_18","DOIUrl":"https://doi.org/10.4103/sccj.sccj_5_18","url":null,"abstract":"Background: During cardiopulmonary resuscitation, family members are usually pushed out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Some health organizations worldwide such as American Heart Association and the Resuscitation Council in the UK supports family-witnessed resuscitation (FWR) and urge hospitals to develop policies to ease this process. The opinions on FWR vary widely among various cultures, and some hospitals are not applying such polices yet. This is the first study which explores the Saudi family members' opinion for family witness resuscitation in adult critical care setting. Objectives: To investigate whether patient's next of kin would like to have been present in the resuscitation room during attempted cardiopulmonary resuscitation (CPR) of their relative and their experience or knowledge of what is involved in CPR. Subjects and Methods: A retrospective, descriptive telephone survey of families of patients who had admitted in critical cares areas from January 2016 to June 2016. A family presence survey was developed to determine the desires, beliefs, and concerns about FWR. Results: Out of the 235 respondents, 143 (60.9%) wanted to be present in the room of their loved one just before death while CPR was going on. One hundred and eighty-two (77.4%) of the respondents believed that the family members should be with their loved one before death. More than half, i.e., 141 (60.0%) of the respondents believed that their presence might have eased the suffering of the deceased. One hundred and fifty-seven (66.8%) of the family members thought that their presence with the deceased in their last moments could have helped their sorrows and sadness. Conclusion: Most relatives of patients requiring CPR would like to be offered the possibility of being in the resuscitation room; this could have several benefits, so this study suggests that institutions should consider establishing programs of witnessed cardiopulmonary resuscitation for family members.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"2007 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128917005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a 29-year-old female patient known to have lupus nephritis on immunosuppression and peritoneal dialysis who developed large bilateral spontaneous pneumothorax and mediastinal emphysema. The patient showed signs of tension pneumothorax and pneumomediastinum; however, she adamantly refused chest tubes insertion. Recovery was noted within 18 h of high-flow oxygen with normalization of chest image.
{"title":"Lupus nephritis with spontaneously resolved bilateral pneumothorax and mediastinal emphysema","authors":"S. Abdulaziz, E. Althenayan","doi":"10.4103/SCCJ.SCCJ_21_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_21_17","url":null,"abstract":"We report a 29-year-old female patient known to have lupus nephritis on immunosuppression and peritoneal dialysis who developed large bilateral spontaneous pneumothorax and mediastinal emphysema. The patient showed signs of tension pneumothorax and pneumomediastinum; however, she adamantly refused chest tubes insertion. Recovery was noted within 18 h of high-flow oxygen with normalization of chest image.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127399139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Amr, A. Yousef, Mohammad F. Amirah, M. H. Alkurdi
Objective: Pressure ulcers present a major health challenge worldwide, and critically ill patients are considered to be at the greatest risk for pressure ulcer development. A study was undertaken to evaluate the effectiveness of pressure ulcer prevention measures (“PRESSURE bundle”) compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in critically ill patients in an Intensive Care Unit (ICU) in Riyadh, Saudi Arabia. Methods: Patients were assigned to the standard care group (n = 330) or the “PRESSURE bundle” group (n = 360). The follow-up period for both treatment groups was 2 months. A pre-post study design was used where data were collected in two samples. Patients were aged 16 years or over and included all new patients admitted to the ICU who did not have but were considered at risk of developing, sacral pressure ulcers (Braden scale score <18). Results: In the PRESSURE care bundle group, there was a significant reduction (P < 0.001) in the incidence of newly developed sacral pressure ulcers in the 2 months treatment period (n = 1, 0.3%) compared with the standard care group (n = 16, 4.6%). There was also a significant reduction (P < 0.001) in the prevalence of sacral pressure ulcers in the PRESSURE care bundle group (4.75%) compared with the standard care group (22.7%) when prevalence figures were compared at the end of the treatment periods. Conclusion: The application of a group of pressure ulcer prevention measures (“PRESSURE bundle”) coincided with a reduction in incidence and prevalence of sacral pressure ulcers in critically ill patients who are at risk for developing pressure ulcers.
{"title":"A pre-post study evaluating the effectiveness of a new initiative, the “PRESSURE Bundle,” Compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in Critically Ill Patients in an intensive care unit in Riyadh, Saudi Arabia","authors":"A. Amr, A. Yousef, Mohammad F. Amirah, M. H. Alkurdi","doi":"10.4103/SCCJ.SCCJ_29_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_29_17","url":null,"abstract":"Objective: Pressure ulcers present a major health challenge worldwide, and critically ill patients are considered to be at the greatest risk for pressure ulcer development. A study was undertaken to evaluate the effectiveness of pressure ulcer prevention measures (“PRESSURE bundle”) compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in critically ill patients in an Intensive Care Unit (ICU) in Riyadh, Saudi Arabia. Methods: Patients were assigned to the standard care group (n = 330) or the “PRESSURE bundle” group (n = 360). The follow-up period for both treatment groups was 2 months. A pre-post study design was used where data were collected in two samples. Patients were aged 16 years or over and included all new patients admitted to the ICU who did not have but were considered at risk of developing, sacral pressure ulcers (Braden scale score <18). Results: In the PRESSURE care bundle group, there was a significant reduction (P < 0.001) in the incidence of newly developed sacral pressure ulcers in the 2 months treatment period (n = 1, 0.3%) compared with the standard care group (n = 16, 4.6%). There was also a significant reduction (P < 0.001) in the prevalence of sacral pressure ulcers in the PRESSURE care bundle group (4.75%) compared with the standard care group (22.7%) when prevalence figures were compared at the end of the treatment periods. Conclusion: The application of a group of pressure ulcer prevention measures (“PRESSURE bundle”) coincided with a reduction in incidence and prevalence of sacral pressure ulcers in critically ill patients who are at risk for developing pressure ulcers.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131563520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Awad Al-omari, W. Alhazzani, Maha F. Al-Subaie, Z. Memish, Hesham S Abdelwahed, J. Ma, M. Alamri, Saleem Alenazi, Haifa Al-Shammari, Hazem Aljomaah, Samer Salih, S. Al-Obeid
Introduction: Acinetobacter baumannii is a Gram-negative Coccobacillus and is a frequent cause of hospital-acquired infections. Because some strains of A. baumannii are resistant to many antibiotics (i.e., extensively drug-resistant A. baumannii, or XDRAB), selecting antibiotics to treat infected patients is challenging. Clinical outcomes in critically ill patients with XDRAB infections are poor. In this study, we evaluated the clinical effectiveness of colistin as monotherapy and in combination with other antibiotics. Patients and Methods: A retrospective cohort study was performed on 94 critically ill patients (age ≥18 years) to assess the clinical effectiveness of treating XDRAB infections with colistin, either in monotherapy or combination with tigecycline, meropenem, or both. Clinical and microbiological data were obtained from patient records. We included patients suffering from XDRAB ventilation-associated pneumonia (VAP), or ventilator-associated tracheobronchitis (VAT), or VAT with bacteremia. Results: The mean age of the patients was 53.3 years (±23.7 years), and the mean Acute Physiology and Chronic Health Evaluation II score was 22.7 (standard deviation = 7.1). VAP and VAT with bacteremia were found in 84% and 16% of patients, respectively. Half (51%) of patients achieved microbiological clearance. The median Intensive Care Unit (ICU) stay was 29 days (interquartile range [IQR]: 17, 55) and the median mechanical ventilation (MV) duration was 21 days (IQR: 12, 42). MV duration and ICU length of stay were lower in the group of patients treated with colistin and meropenem than in those treated with colistin alone. Mortality was significantly lower in patients who received (colistin and tigecycline 30%) than in those who were treated with monotherapy (75%) with an odd ratio 0.03 (95% confidence interval: 0.00, 0.32; P < 0.01). Conclusions: Colistin-based combination treatment regimens mainly with tigecycline or with tigecycline and meropenem were associated with better treatment outcomes of XDRAB-induced VAP and VAT with bacteremia than colistin monotherapy.
{"title":"Colistin monotherapy versus colistin-based combination therapy in the treatment of extensive drug-resistant Acinetobacter baumannii infections: A retrospective cohort study","authors":"Awad Al-omari, W. Alhazzani, Maha F. Al-Subaie, Z. Memish, Hesham S Abdelwahed, J. Ma, M. Alamri, Saleem Alenazi, Haifa Al-Shammari, Hazem Aljomaah, Samer Salih, S. Al-Obeid","doi":"10.4103/SCCJ.SCCJ_18_17","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_18_17","url":null,"abstract":"Introduction: Acinetobacter baumannii is a Gram-negative Coccobacillus and is a frequent cause of hospital-acquired infections. Because some strains of A. baumannii are resistant to many antibiotics (i.e., extensively drug-resistant A. baumannii, or XDRAB), selecting antibiotics to treat infected patients is challenging. Clinical outcomes in critically ill patients with XDRAB infections are poor. In this study, we evaluated the clinical effectiveness of colistin as monotherapy and in combination with other antibiotics. Patients and Methods: A retrospective cohort study was performed on 94 critically ill patients (age ≥18 years) to assess the clinical effectiveness of treating XDRAB infections with colistin, either in monotherapy or combination with tigecycline, meropenem, or both. Clinical and microbiological data were obtained from patient records. We included patients suffering from XDRAB ventilation-associated pneumonia (VAP), or ventilator-associated tracheobronchitis (VAT), or VAT with bacteremia. Results: The mean age of the patients was 53.3 years (±23.7 years), and the mean Acute Physiology and Chronic Health Evaluation II score was 22.7 (standard deviation = 7.1). VAP and VAT with bacteremia were found in 84% and 16% of patients, respectively. Half (51%) of patients achieved microbiological clearance. The median Intensive Care Unit (ICU) stay was 29 days (interquartile range [IQR]: 17, 55) and the median mechanical ventilation (MV) duration was 21 days (IQR: 12, 42). MV duration and ICU length of stay were lower in the group of patients treated with colistin and meropenem than in those treated with colistin alone. Mortality was significantly lower in patients who received (colistin and tigecycline 30%) than in those who were treated with monotherapy (75%) with an odd ratio 0.03 (95% confidence interval: 0.00, 0.32; P < 0.01). Conclusions: Colistin-based combination treatment regimens mainly with tigecycline or with tigecycline and meropenem were associated with better treatment outcomes of XDRAB-induced VAP and VAT with bacteremia than colistin monotherapy.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126239797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abbas Al Mutair, Fadillah Al Obaidan, Mohammed Al-Muhaini, Khulud Al Salman, Samer Al Mosajen
Background: Health-care professionals work long hours, handle demanding patient loads, and make important decisions under conditions of uncertainty. These uncertain conditions have been shown to be associated with negative emotional and psychological outcomes for health-care professionals. In addition, they have been shown to lead to anxiety, depression, and other psychological and interpersonal strains, ultimately compromising the quality of patient care. Purpose: The purpose of this study is to evaluate the mental health issues of health-care providers including anxiety, depression, behavioral control, positive effect, and general distress. Methods: This is a cross-sectional study using a self-administered questionnaire. The questionnaire was distributed to health-care providers working at governmental and private health sectors in Saudi Arabia from January to April 2016. The questionnaire included a demographic survey and the Mental Health Inventory. Forty-five (45%) staff members completed the questionnaire. Results: Health-care professionals scored higher within the psychological distress, anxiety, depression, and loss of behavioral emotional control domains, indicating greater psychological distress. Females scored more on the depression domain than male participants. Further, physicians scored higher on the general positive effect domain than other health-care providers. Non-Saudi health-care providers scored higher on psychological distress scale than Saudi participants. Multiple regression analysis indicated that general positive effect, emotional ties, and life satisfaction were predictors of psychological well-being; on the other hand, anxiety, depression, and loss of behavioral/emotional control were predictors of psychological distress. Conclusion: High psychological distress may result from stressors associated with high work demands, workload, staff shortage, fear of infection, licensing board, fear of losing job, fear of reaction from leadership, peer, and patients and their families. Implication for Nursing Policy: Organizational supportive programs should be developed to enhance the psychological well-being of health-care professionals. These programs may decrease staff stress, anxiety, and depression and contribute to improve psychological well-being.
{"title":"Cross-Sectional study of the overall emotional functioning of health-care providers in Saudi","authors":"Abbas Al Mutair, Fadillah Al Obaidan, Mohammed Al-Muhaini, Khulud Al Salman, Samer Al Mosajen","doi":"10.4103/SCCJ.SCCJ_2_18","DOIUrl":"https://doi.org/10.4103/SCCJ.SCCJ_2_18","url":null,"abstract":"Background: Health-care professionals work long hours, handle demanding patient loads, and make important decisions under conditions of uncertainty. These uncertain conditions have been shown to be associated with negative emotional and psychological outcomes for health-care professionals. In addition, they have been shown to lead to anxiety, depression, and other psychological and interpersonal strains, ultimately compromising the quality of patient care. Purpose: The purpose of this study is to evaluate the mental health issues of health-care providers including anxiety, depression, behavioral control, positive effect, and general distress. Methods: This is a cross-sectional study using a self-administered questionnaire. The questionnaire was distributed to health-care providers working at governmental and private health sectors in Saudi Arabia from January to April 2016. The questionnaire included a demographic survey and the Mental Health Inventory. Forty-five (45%) staff members completed the questionnaire. Results: Health-care professionals scored higher within the psychological distress, anxiety, depression, and loss of behavioral emotional control domains, indicating greater psychological distress. Females scored more on the depression domain than male participants. Further, physicians scored higher on the general positive effect domain than other health-care providers. Non-Saudi health-care providers scored higher on psychological distress scale than Saudi participants. Multiple regression analysis indicated that general positive effect, emotional ties, and life satisfaction were predictors of psychological well-being; on the other hand, anxiety, depression, and loss of behavioral/emotional control were predictors of psychological distress. Conclusion: High psychological distress may result from stressors associated with high work demands, workload, staff shortage, fear of infection, licensing board, fear of losing job, fear of reaction from leadership, peer, and patients and their families. Implication for Nursing Policy: Organizational supportive programs should be developed to enhance the psychological well-being of health-care professionals. These programs may decrease staff stress, anxiety, and depression and contribute to improve psychological well-being.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127970657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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