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Reducing night-time...
Reducing night-time discharge from intensive care. A nationwide improvement project with public display of ICU outcomes
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- Parenmark, Fredric (författare)
- Linköpings universitet,Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Gavle Cent Hosp, Dept Anaesthesia & Intens Care, Gavle, Sweden;Linkoping Univ, Fac Heath Sci, Dept Med & Heath Sci, Linkoping, Sweden,Institutionen för medicin och hälsa,Medicinska fakulteten,Uppsala Univ, Sweden; Gavle Cent Hosp, Sweden
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- Karlstrom, Goran (författare)
- Swedish Intens Care Registry, Karlstad, Sweden
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- Nolin, Thomas (författare)
- Cent Hosp Kristianstad, Dept Anaesthesia & Intens Care, Kristianstad, Sweden
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- Fredrikson, Mats (författare)
- Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten
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- Walther, Sten (författare)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- Engelska.
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Ingår i: Journal of critical care. - : Elsevier BV. - 0883-9441 .- 1557-8615. ; 49, s. 7-13
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Purpose: Discharge from an intensive care unit (ICU) during the night is an independent risk factor for adverse outcomes. A quality improvement project was conducted with the aim of reducing the incidence and the associated mortality after night-time discharge. Materials and methods: ICUs that submitted data to the Swedish Intensive Care Registry (SIR) agreed to appoint night-time discharge as a national quality indicator with detailed public display on the internet of various discharge proportions and outcomes. The registry was then examined for trends during a 10-year period with use of multilevel mixed-effects models. Results: We analysed 163,371 patients who were discharged alive from 70 ICUs to a general ward within the same hospital during 2006-2015. The prevalence of night-time discharge fell from 7.0% (95% CI: 52 to 8.7%) in 2006 to 4.9% (95% CI: 43 to 5.5%) in 2015 (P = .035 for trend). The original increased risk of death within 30 days after night-time discharge in 2006-2010, OR 1.20 (95% CI: 1.01 to 1.42), disappeared in 2011-2015, OR 1.06 (95% CI: 0.96 to 1.17). Conclusions: During the 10-year period of the quality improvement project, the annual prevalence and risk of death within 30-days after night-time discharge were reduced. The public display and feedback of audit data could have helped in achieving this.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Intensive Care
- Critical Care
- Auditing
- Quality improvement
- Critical Care Management
- Outcome study
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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