Displaying publications 1 - 20 of 345 in total

  1. Mallhi TH, Khan AH, Sarriff A, Adnan AS, Khan YH
    J Bras Nefrol, 2016 12;38(4):483-484.
    PMID: 28001178 DOI: 10.5935/0101-2800.20160078
    Matched MeSH terms: Intensive Care Units*
  2. Al-Bayaty FH, Baharudin N, Hassan MIA
    Dent Med Probl, 2021 10 2;58(3):385-395.
    PMID: 34597481 DOI: 10.17219/dmp/132979
    This overview was conducted to highlight the importance of adequate oral hygiene for patients severely affected by coronavirus disease 2019 (COVID-19) due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These are patients who were admitted to the intensive care unit (ICU) to receive oxygen through mechanical ventilation due to severe pneumonia as a complication of COVID-19. Various dental plaque removal methods for ventilated patients were discussed with regard to their efficacy. The use of chemical agents was also considered to determine which one might be proposed as the best choice. Also, oral care programs or systems that can be implemented by ICU nurses or staff in the case of these ventilated patients were suggested based on evidence from the literature. These interventions aim to reduce microbial load in dental plaque/biofilm in the oropharynx as well as the aspiration of the contaminated saliva in order to prevent the transmission of the dental plaque bacteria to the lungs or other distant organs, and reduce the mortality rate.
    Matched MeSH terms: Intensive Care Units
  3. Neufeld VR, Hall JH, Hoo AA
    Med J Malaya, 1966 Dec;21(2):164-8.
    PMID: 4227388
    Matched MeSH terms: Intensive Care Units*
  4. Wan Mohd Annuar WSH, Pien LS, Makhtar A
    Enferm Clin, 2021 04;31 Suppl 2:S377-S380.
    PMID: 33849204 DOI: 10.1016/j.enfcli.2020.09.029
    The objective is to identify the available literature on parents' experiences in caring for children in the Paediatric Intensive Care Unit (PICU). Original research on parents experience in caring their child in PICU were identified from five online databases, namely CINAHL, Science Direct, Proquest, Cochrane, and Pubmed (2008-2018) using the terms "parent," "experience," "children", "paediatric intensive care" and "caring." We included articles addressing the parent's experiences while their child was admitted to PICU their needs and participation in the care of the child. Twenty-two papers have met the criteria for inclusion. Further review of these articles resulted in summarised topics - PICU parents' experience, parental stressors, and parental needs. Current research demonstrates a diversity of parent's experiences while caring for their child; however, little is known about interventions to improve and support parents who are in a difficult situation when their child being treated in PICU.
    Matched MeSH terms: Intensive Care Units, Pediatric*
  5. Boo NY
    Med J Malaysia, 1994 Mar;49(1):1-3.
    PMID: 8057980
    Matched MeSH terms: Intensive Care Units, Neonatal/trends; Intensive Care Units, Neonatal/statistics & numerical data
  6. Adam BA, Liam CK, Abdul Wahab AS
    Med J Malaysia, 1989 Jun;44(2):134-9.
    PMID: 2626120
    A scoring system based on therapeutic intervention on critically ill patients called the therapeutic intervention scoring system (TISS) was used to assess the quantity of care provided in a medical intensive care unit. Besides observing the unit census, the severity of illness and the work load were studied. The survival rate was 77 percent. The non-survivors had admission TISS points higher than the survivors and their mean daily TISS was more than 20 points. The survivors at discharge had a mean TISS of five points. The work load showed that a nurse can effectively manage two patients who together may accumulate 24 TISS points per day. TISS points per patient rather than bed occupancy is a better indicator of the nurse's work load. Admission criteria and procedures before death certification are outlined.
    Comment in: Delilkan AE. Therapeutic intervention scoring system in medical intensive care. Med J Malaysia. 1989 Dec;44(4):361-2
    Matched MeSH terms: Intensive Care Units/manpower; Intensive Care Units/standards*
  7. Rahim RH, Barnett T
    Int J Nurs Pract, 2009 Dec;15(6):580-4.
    PMID: 19958414 DOI: 10.1111/j.1440-172X.2009.01800.x
    Nosocomial infection is a common cause of morbidity and mortality for hospitalized neonates. This report describes measures taken to reduce the prevalence of nosocomial infection within a 34-bed neonatal intensive care unit in Malaysia. Interventions included a one-to-one education programme for nursing staff (n = 30); the education of cleaners and health-care assistants allocated to work in the unit; and the introduction of routine (weekly) screening procedure for all infants with feedback given to staff. The education programme for nurses focused on the application of standard precautions to three common clinical procedures: hand washing, tracheobronchial suctioning and nasogastric tube feeding. These were evaluated using competency checklists. The prevalence of nosocomial blood and respiratory tract infections declined over the 7-month study period. This study highlights the importance of education in contributing to the control of nosocomial infection in the neonatal intensive care unit.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  8. Hassan Y, Aziz NA, Awang J, Aminuldin AG
    J Clin Pharm Ther, 1992 Dec;17(6):347-51.
    PMID: 1287026
    In a 6-month study period, 170 pharmacist interventions in an intensive care unit (ICU) were analysed. Of the interventions, 68.8% were solicited and 31.2% were initiated by the pharmacists. The majority of the interventions were initiated by specialists (69.4%) followed by the medical officers (15.9%) and nurses (9.4%). Most of the interventions occurred during the grand rounds (75.9%), followed by ward visits (12.9%) and communication through the satellite pharmacy (10.5%). The most frequent type of intervention made was for indication or therapeutic efficacy followed by general product information, drug regimen, laboratory assessment, disease state, pharmaceutical availability and adverse drug reaction or side effect. It was also found that 83.7% of pharmacists' suggestions were accepted, 6.4% were accepted with changes, and 9.9% were not accepted. The majority of the interventions were made by direct verbal communications followed by telephone and written communications. In conclusion the study indicates that pharmacist therapeutic recommendations form an important integral element of patient care in an ICU.
    Matched MeSH terms: Intensive Care Units*
  9. Yap PSX, Chong CW, Ahmad Kamar A, Yap IKS, Choo YM, Lai NM, et al.
    Sci Rep, 2021 01 14;11(1):1353.
    PMID: 33446779 DOI: 10.1038/s41598-020-80278-1
    Emerging evidence has shown a link between the perturbations and development of the gut microbiota in infants with their immediate and long-term health. To better understand the assembly of the gut microbiota in preterm infants, faecal samples were longitudinally collected from the preterm (n = 19) and term (n = 20) infants from birth until month 12. 16S rRNA gene sequencing (n = 141) and metabolomics profiling (n = 141) using nuclear magnetic resonance spectroscopy identified significant differences between groups in various time points. A panel of amino acid metabolites and central metabolism intermediates significantly correlated with the relative abundances of 8 species of bacteria were identified in the preterm group. In contrast, faecal metabolites of term infants had significantly higher levels of metabolites which are commonly found in milk such as fucose and β-hydroxybutyrate. We demonstrated that the early-life factors such as gestational age, birth weight and NICU exposures, exerted a sustained effect to the dynamics of gut microbial composition and metabolism of the neonates up to one year of age. Thus, our findings suggest that intervention at this early time could provide 'metabolic rescue' to preterm infants from aberrant initial gut microbial colonisation and succession.
    Matched MeSH terms: Intensive Care Units, Neonatal*
  10. Yong SY, Siop S, Kho WM
    Nurs Open, 2021 01;8(1):200-209.
    PMID: 33318828 DOI: 10.1002/nop2.619
    Aims: To determine the prevalence, characteristics of EM activities, the relationship between level of activity and mode of ventilation and adherence rate of EM protocol.

    Background: Mobilizing ICU patients remains a challenge, despite its safety, feasibility and positive short-term outcomes.

    Design: A cross-sectional point prevalence study.

    Methods: All patients who were eligible and admitted to the adult ICUs during March 2018 were recruited. Data were analysed by using the Statistical Package for Social Sciences version 24 for Windows.

    Results: The prevalence of EM practice was 65.6%. The most frequently reported avoidable and unavoidable factors inhibit mobility were deep sedation and vasopressor infusion, respectively. Level II of activity was the most common level of activity performed in ICU patients. The invasive ventilated patient had 12.53 the odds to stay in bed as compared to non-invasive ventilated patient. An average adherence rate of EM protocol was 52.5%.

    Matched MeSH terms: Intensive Care Units*
  11. Annuar WSHWM, Ludin SM, Amran NA
    Enferm Clin, 2021 04;31 Suppl 2:S67-S71.
    PMID: 33849233 DOI: 10.1016/j.enfcli.2020.10.021
    The objective of study is to explore the experiences of parents taking care of their critically ill child at the Neonatal Intensive Care Unit (NICU) or the Paediatric Intensive Care Unit (PICU) in the Malaysian hospital. A total of ten parents were interviewed and selected for purposive sampling. The data was analysed using a thematic analysis based on the Colaizzi's approach. The study identified four emerging themes from data that included participation in care, participation in decision-making, challenges and coping mechanisms throughout the child's hospitalisation. Parents have emphasised the importance of their participation in the care and decision-making of their child. They also have their own coping mechanisms that would make their journey less traumatic. Nurses need to enhance their communication skills and improve nurse-parent relationships.
    Matched MeSH terms: Intensive Care Units, Neonatal; Intensive Care Units, Pediatric
  12. Alkhawaldeh JMA, Soh KL, Mukhtar FBM, Peng OC, Anshasi HA
    Nurs Crit Care, 2020 03;25(2):84-92.
    PMID: 31840391 DOI: 10.1111/nicc.12489
    BACKGROUND: The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear.

    PURPOSE: The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses.

    METHODS: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019.

    RESULTS: Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive-behavioural skills training and mindfulness-based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses.

    CONCLUSION: Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention-related adverse events.

    RELEVANCE TO CLINICAL PRACTICE: This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

    Matched MeSH terms: Intensive Care Units*
  13. Li A, Ling L, Qin H, Arabi YM, Myatra SN, Egi M, et al.
    Am J Respir Crit Care Med, 2022 Nov 01;206(9):1107-1116.
    PMID: 35763381 DOI: 10.1164/rccm.202112-2743OC
    Rationale: Directly comparative data on sepsis epidemiology and sepsis bundle implementation in countries of differing national wealth remain sparse. Objectives: To evaluate across countries/regions of differing income status in Asia 1) the prevalence, causes, and outcomes of sepsis as a reason for ICU admission and 2) sepsis bundle (antibiotic administration, blood culture, and lactate measurement) compliance and its association with hospital mortality. Methods: A prospective point prevalence study was conducted among 386 adult ICUs from 22 Asian countries/regions. Adult ICU participants admitted for sepsis on four separate days (representing the seasons of 2019) were recruited. Measurements and Main Results: The overall prevalence of sepsis in ICUs was 22.4% (20.9%, 24.5%, and 21.3% in low-income countries/regions [LICs]/lower middle-income countries/regions [LMICs], upper middle-income countries/regions, and high-income countries/regions [HICs], respectively; P 
    Matched MeSH terms: Intensive Care Units*
  14. Henry Basil J, Premakumar CM, Mhd Ali A, Mohd Tahir NA, Mohamed Shah N
    Drug Saf, 2022 Dec;45(12):1457-1476.
    PMID: 36192535 DOI: 10.1007/s40264-022-01236-6
    INTRODUCTION: Neonates are at greater risk of preventable adverse drug events as compared to children and adults.

    OBJECTIVE: This study aimed to estimate and critically appraise the evidence on the prevalence, causes and severity of medication administration errors (MAEs) amongst neonates in Neonatal Intensive Care Units (NICUs).

    METHODS: A systematic review and meta-analysis was conducted by searching nine electronic databases and the grey literature for studies, without language and publication date restrictions. The pooled prevalence of MAEs was estimated using a random-effects model. Data on error causation were synthesised using Reason's model of accident causation.

    RESULTS: Twenty unique studies were included. Amongst direct observation studies reporting total opportunity for errors as the denominator for MAEs, the pooled prevalence was 59.3% (95% confidence interval [CI] 35.4-81.3, I2 = 99.5%). Whereas, the non-direct observation studies reporting medication error reports as the denominator yielded a pooled prevalence of 64.8% (95% CI 46.6-81.1, I2 = 98.2%). The common reported causes were error-provoking environments (five studies), while active failures were reported by three studies. Only three studies examined the severity of MAEs, and each utilised a different method of assessment.

    CONCLUSIONS: This is the first comprehensive systematic review and meta-analysis estimating the prevalence, causes and severity of MAEs amongst neonates. There is a need to improve the quality and reporting of studies to produce a better estimate of the prevalence of MAEs amongst neonates. Important targets such as wrong administration-technique, wrong drug-preparation and wrong time errors have been identified to guide the implementation of remedial measures.

    Matched MeSH terms: Intensive Care Units, Neonatal*
  15. Leong EL, Chew CC, Ang JY, Lojikip SL, Devesahayam PR, Foong KW
    BMC Health Serv Res, 2023 Jun 13;23(1):627.
    PMID: 37312146 DOI: 10.1186/s12913-023-09660-9
    BACKGROUND: Admission to an intensive care unit (ICU) is a stressful experience for patients and their family members. While the focus of management is primarily on medical care, there can be other areas which are overlooked. The purpose of this study was to investigate the needs and experiences of ICU patients and family members.

    METHOD: This qualitative study involved four trained researchers conducting in-depth interviews (IDI) based on a semi-structured interview guide. The participants were ICU patients and family members. All IDIs were audio-recorded and transcribed verbatim. Four researchers independently analyzed the data via thematic analysis with the aid of QDA Miner Lite®. The themes and subthemes were generated and confirmed by literature and expert opinion.

    RESULTS: Six IDIs were conducted with three patients and three family members, whose ages ranged from 31 to 64 years old. One pair of participants consisted of a patient and his respective family member, while the other four participants did not have a familial relationship with each other. Three main themes emerged from the analysis: (I) critical care services; (II) physical spaces; and (III) monitoring technology. Medical, psychological, physical, and social needs for critical care services were expressed by both patients and family members. Patients' needs in clinical spaces were highlighted as a conducive ICU environment with ambient temperature and controlled noise levels. In non-clinical spaces, family members expressed a need for more chairs in the waiting area. Participants expressed the need for call bells as well as patients' negative perceptions of medical equipment alarms in the ICU when it pertained to monitoring technology.

    CONCLUSION: This study provides an in-depth view at the needs and experiences of ICU patients and family members who have a variety of unmet needs. This understanding is critical for guiding ICU personnel and stakeholders in their efforts to humanize ICU care.

    Matched MeSH terms: Intensive Care Units*
  16. Wong RS, Ismail NA
    PLoS One, 2016;11(3):e0151949.
    PMID: 27007413 DOI: 10.1371/journal.pone.0151949
    There are not many studies that attempt to model intensive care unit (ICU) risk of death in developing countries, especially in South East Asia. The aim of this study was to propose and describe application of a Bayesian approach in modeling in-ICU deaths in a Malaysian ICU.
    Matched MeSH terms: Intensive Care Units
  17. Tsan SEH, Ng KT, Lau J, Viknaswaran NL, Wang CY
    Braz J Anesthesiol, 2020 11 09;70(6):667-677.
    PMID: 33288219 DOI: 10.1016/j.bjan.2020.08.009
    OBJECTIVES: Positioning during endotracheal intubation (ETI) is critical to ensure its success. We aimed to determine if the ramping position improved laryngeal exposure and first attempt success at intubation when compared to the sniffing position.

    METHODS: PubMed, EMBASE, and Cochrane CENTRAL databases were searched systematically from inception until January 2020. Our primary outcomes included laryngeal exposure as measured by Cormack-Lehane Grade 1 or 2 (CLG 1/2), CLG 3 or 4 (CLG 3/4), and first attempt success at intubation. Secondary outcomes were intubation time, use of airway adjuncts, ancillary maneuvers and complications during ETI.

    RESULTS: Seven studies met our inclusion criteria, of which 4 were RCTs and 3 were cohort studies. The meta-analysis was conducted by pooling the effect estimates for all 4 included RCTs (n=632). There were no differences found between ramping and sniffing positions for odds of CLG 1/2, CLG 3/4, first attempt success at intubation, intubation time, use of ancillary airway maneuvers and use of airway adjuncts, with evidence of high heterogeneity across studies. However, the ramping position in surgical patients is associated with increased likelihood of CLG 1/2 (OR=2.05, 95% CI 1.26 to 3.32, p=0.004) and lower likelihood of CLG 3/4 (OR=0.49, 95% CI 0.30 to 0.79, p=0.004), moderate quality of evidence.

    CONCLUSION: Our meta-analysis demonstrated that the ramping position may benefit surgical patients undergoing ETI by improving laryngeal exposure. Large-scale well-designed multicentre RCTs should be carried out to further elucidate the benefits of the ramping position in the surgical and intensive care unit patients.

    Matched MeSH terms: Intensive Care Units
  18. Stoppe C, Patel JJ, Zarbock A, Lee ZY, Rice TW, Mafrici B, et al.
    Crit Care, 2023 Oct 18;27(1):399.
    PMID: 37853490 DOI: 10.1186/s13054-023-04663-8
    BACKGROUND: Based on low-quality evidence, current nutrition guidelines recommend the delivery of high-dose protein in critically ill patients. The EFFORT Protein trial showed that higher protein dose is not associated with improved outcomes, whereas the effects in critically ill patients who developed acute kidney injury (AKI) need further evaluation. The overall aim is to evaluate the effects of high-dose protein in critically ill patients who developed different stages of AKI.

    METHODS: In this post hoc analysis of the EFFORT Protein trial, we investigated the effect of high versus usual protein dose (≥ 2.2 vs. ≤ 1.2 g/kg body weight/day) on time-to-discharge alive from the hospital (TTDA) and 60-day mortality and in different subgroups in critically ill patients with AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria within 7 days of ICU admission. The associations of protein dose with incidence and duration of kidney replacement therapy (KRT) were also investigated.

    RESULTS: Of the 1329 randomized patients, 312 developed AKI and were included in this analysis (163 in the high and 149 in the usual protein dose group). High protein was associated with a slower time-to-discharge alive from the hospital (TTDA) (hazard ratio 0.5, 95% CI 0.4-0.8) and higher 60-day mortality (relative risk 1.4 (95% CI 1.1-1.8). Effect modification was not statistically significant for any subgroup, and no subgroups suggested a beneficial effect of higher protein, although the harmful effect of higher protein target appeared to disappear in patients who received kidney replacement therapy (KRT). Protein dose was not significantly associated with the incidence of AKI and KRT or duration of KRT.

    CONCLUSIONS: In critically ill patients with AKI, high protein may be associated with worse outcomes in all AKI stages. Recommendation of higher protein dosing in AKI patients should be carefully re-evaluated to avoid potential harmful effects especially in patients who were not treated with KRT.

    TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov (NCT03160547) on May 17th 2017.

    Matched MeSH terms: Intensive Care Units
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