Long-term mortality of Dutch COVID-19 patients admitted to the intensive care medicine: a retrospective analysis from a national quality registry.

Objective: To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use.

Methods: We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup.

Quality improvement of Dutch ICUs from 2009 to 2021: A registry based observational study.

Purpose: To investigate the development in quality of ICU care over time using the Dutch National Intensive Care Evaluation (NICE) registry.

Materials And Methods: We included data from all ICU admissions in the Netherlands from those ICUs that submitted complete data between 2009 and 2021 to the NICE registry. We determined median and interquartile range for eight quality indicators.

Comparison of Prognostic Accuracy of 3 Delirium Prediction Models.

Background: Delirium is a severe complication in critical care patients. Accurate prediction could facilitate determination of which patients are at risk. In the past decade, several delirium prediction models have been developed.

Nurse Operation Workload (NOW), a new nursing workload model for intensive care units based on time measurements: An observational study.

Background: Several instruments have been developed to measure nursing workload. The commonly used Nursing Activities Score (NAS) and Therapeutic Intervention Scoring System (TISS) are applied to all types of ICU patients. Former research showed that NAS explained 59 to 81% of actual nursing time, whereas the Therapeutic Intervention Scoring System (TISS) described only 43% of the actual nursing time.

The Nursing Activities Score Per Nurse Ratio Is Associated With In-Hospital Mortality, Whereas the Patients Per Nurse Ratio Is Not.

Objectives: Studies have shown contradicting results on the association of nursing workload and mortality. Most of these studies expressed workload as patients per nurse ratios; however, this does not take into account that some patients require more nursing time than others. Nursing time can be quantified by tools like the Nursing Activities Score.

Association between organizational characteristics and adequate pain management at the intensive care unit.

Purpose: Half of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist.

Workload scoring systems in the Intensive Care and their ability to quantify the need for nursing time: A systematic literature review.

Introduction: The Intensive Care Unit is a resource intense service with a high nursing workload per patient resulting in a low ratio of patients per nurse. This review aims to identify existing scoring systems for measuring nursing workload on the Intensive Care and assess their validity and reliability to quantify the needed nursing time.

Methods: We conducted a systematic review of the literature indexed before 01/Mar/2018 in the bibliographic databases MEDLINE, Embase, and Cinahl.

Impact of audit and feedback with action implementation toolbox on improving ICU pain management: cluster-randomised controlled trial.

Background: Audit and feedback (A&F) enjoys widespread use, but often achieves only marginal improvements in care. Providing recipients of A&F with suggested actions to overcome barriers (action implementation toolbox) may increase effectiveness.

Objective: To assess the impact of adding an action implementation toolbox to an electronic A&F intervention targeting quality of pain management in intensive care units (ICUs).

Effect of Bronchoscopy on Gas Exchange and Respiratory Mechanics in Critically Ill Patients With Atelectasis: An Observational Cohort Study.

Atelectasis frequently develops in critically ill patients and may result in impaired gas exchange among other complications. The long-term effects of bronchoscopy on gas exchange and the effects on respiratory mechanics are largely unknown. To evaluate the effect of bronchoscopy on gas exchange and respiratory mechanics in intensive care unit (ICU) patients with atelectasis.

Measuring quality indicators to improve pain management in critically ill patients.

Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement.

Materials And Methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical - surgical, of three months within October 2016-May 2017.

Early Prediction of Intensive Care Unit-Acquired Weakness: A Multicenter External Validation Study.

Objectives: An early diagnosis of intensive care unit-acquired weakness (ICU-AW) is often not possible due to impaired consciousness. To avoid a diagnostic delay, we previously developed a prediction model, based on single-center data from 212 patients (development cohort), to predict ICU-AW at 2 days after ICU admission. The objective of this study was to investigate the external validity of the original prediction model in a new, multicenter cohort and, if necessary, to update the model.

Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care.

Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is delivered in both verbal and written formats, and it includes specific targets and an action plan. However, there is little information to guide operationalization of these factors.

Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit.

Background: The medium care unit (MCU) or "stepdown" unit is an increasingly important, but understudied care environment. With an aging population and more patients with complex multiple diseases, many patients often require a higher level of inpatient care even when full intensive care is not indicated. However, the nurse-to-patient ratio required on a MCU is neither well defined nor clear whether this ratio should be adjusted per shift.

Epidemiology of acute lung injury and acute respiratory distress syndrome in The Netherlands: a survey.

Background: The characteristics, incidence and risk factors for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may depend on definitions and geography.

Methods: A prospective, 3-day point-prevalence study was performed by a survey of all intensive care units (ICU) in the Netherlands (n=96). Thirty-six ICU's responded (37%), reporting on 266 patients, of whom 151 were mechanically ventilated.

Relative adrenal insufficiency as a predictor of disease severity, mortality, and beneficial effects of corticosteroid treatment in septic shock.

Objective: To evaluate the concept of relative adrenal insufficiency necessitating corticosteroid therapy in septic shock.

Design: Retrospective study.

Setting: Medical-surgical intensive care unit of a university hospital.

Predicting a low cortisol response to adrenocorticotrophic hormone in the critically ill: a retrospective cohort study.

Introduction: Identification of risk factors for diminished cortisol response to adrenocorticotrophic hormone (ACTH) in the critically ill could facilitate recognition of relative adrenal insufficiency in these patients. Therefore, we studied predictors of a low cortisol response to ACTH.

Methods: A retrospective cohort study was conducted in a general intensive care unit of a university hospital over a three year period.

Relative adrenal insufficiency: an identifiable entity in nonseptic critically ill patients?

Objective: To determine whether relative adrenal insufficiency (RAI) can be identified in nonseptic hypotensive patients in the intensive care unit (ICU).

Design: Retrospective study in a medical-surgical ICU of a university hospital.

Patients: One hundred and seventy-two nonseptic ICU patients (51% after trauma or surgery), who underwent a short 250 microg ACTH test because of > 6 h hypotension or vasopressor/inotropic therapy.

Immunoparalysis as a cause for invasive aspergillosis?

Aspergillus infections are among the most feared opportunistic infections in humans. These organisms are ubiquitous in nature; protection against infection is usually provided by anatomical barriers and by the immune system. Tissue invasion by Aspergillus is uncommon, occurring primarily in the setting of immunosuppression.

Percutaneous dilatational tracheostomy in the ICU: optimal organization, low complication rates, and description of a new complication.

Study Objectives: To assess short-term and long-term complications of bronchoscopy-guided, percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST) and to report a complication of PDT that has not been described previously.

Design: Prospective survey.

Setting: University teaching hospital.