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- Bellomo, Rinaldo, et al.
(författare)
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A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards*
- 2012
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Ingår i: Critical Care Medicine. - 1530-0293. ; 40:8, s. 2349-2361
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Deteriorating ward patients are at increased risk. Electronic automated advisory vital signs monitors may help identify such patients and improve their outcomes. SETTING: A total of 349 beds, in 12 general wards in ten hospitals in the United States, Europe, and Australia. PATIENTS: Cohort of 18,305 patients. DESIGN: Before-and-after controlled trial. INTERVENTION: We deployed electronic automated advisory vital signs monitors to assist in the acquisition of vital signs and calculation of early warning scores. We assessed their effect on frequency, type, and treatment of rapid response team calls; survival to hospital discharge or to 90 days for rapid response team call patients; overall type and number of serious adverse events and length of hospital stay. MEASUREMENTS AND MAIN RESULTS: We studied 9,617 patients before (control) and 8,688 after (intervention) deployment of electronic automated advisory vital signs monitors. Among rapid response team call patients, intervention was associated with an increased proportion of calls secondary to abnormal respiratory vital signs (from 21% to 31%; difference [95% confidence interval] 9.9 [0.1-18.5]; p = .029). Survival immediately after rapid response team treatment and survival to hospital discharge or 90 days increased from 86% to 92% (difference [95% confidence interval] 6.3 [0.0-12.6]; p = .04). Intervention was also associated with a decrease in median length of hospital stay in all patients (unadjusted p < .0001; adjusted p = .09) and more so in U.S. patients (from 3.4 to 3.0 days; unadjusted p < .0001; adjusted ratio [95% confidence interval] 1.03 [1.00-1.06]; p = .026). The time required to complete and record a set of vital signs decreased from 4.1 ± 1.3 mins to 2.5 ± 0.5 mins (difference [95% confidence interval] 1.6 [1.4-1.8]; p < .0001). CONCLUSIONS: Deployment of electronic automated advisory vital signs monitors was associated with an improvement in the proportion of rapid response team-calls triggered by respiratory criteria, increased survival of patients receiving rapid response team calls, and decreased time required for vital signs measurement and recording (NCT01197326).
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| 2. |
- Sandin, Gustav A, 1983, et al.
(författare)
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Making the most of LCA in technical inter-organisational R&D projects
- 2014
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Ingår i: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526 .- 1879-1786. ; 70, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- In technical Research and Development (R&D) projects, a Life Cycle Assessment (LCA) of the technology under development is sometimes carried out. Particularly in inter-organisational R&D projects, the roles of LCAs tend to be unclear and arbitrary, and as a consequence, LCA work is not adequately designed for the needs of the project. There is a need for research on how to choose an appropriate role for LCA in such projects and how to plan LCA work accordingly.We have identified some possible roles of LCA in inter-organisational R&D projects and used experiences from LCA work in different such projects to identify four project characteristics that are decisive for what roles the LCA can have. The project characteristics are: (i) the project's potential influence on environmental impacts, (ii) the degrees of freedom available for the technical direction of the project, (iii) the project's potential to provide required input to the LCA, and (iv) access to relevant audiences for the LCA results. We discuss how evaluation of these project characteristics can help project commissioners, project managers and LCA practitioners to deliberately choose appropriate roles of LCA in inter-organisational R&D projects and plan projects for efficient use of LCA.
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