The test of change goal was to shorten the time between the last respiratory therapist (RT) assessment/bronchodilator treatment given in the emergency.

Slides:



Advertisements
Similar presentations
2014 Standard Definitions and Metric Goals. Consensus Statement Definitions for consistent emergency department metrics were introduced and signed on.
Advertisements

80 (7.3%) patients who were initially admitted to either a general bay or to the TB cohorting bay AND were eventually transferred to the other one during.
New Referral Received: Admit to Ward Ward Administrator: Gives Family Form 1 Gives Family Form 2 To Family Family: Completes Family Form 1 To Ward Administrator.
 To identify the Emergency Department efficiency measures for Inpatient admissions.  To demonstrate an understanding of the process of determining median.
Discharge Pathway Preparation for admission Hospital ward to make contact with the person as far in advance as possible so that arrangements can be made.
3 STUDENT ASSESSMENT DEPARTMENT
Pathway of care for people with learning disabilities Consent to treatment Does the person have the capacity to consent? Can the decision wait until the.
‘Environment’ Glossary Administrative categories from UK National Health Service.
The Royal College of Emergency Medicine Assessing for Cognitive Impairment in Older People Clinical Audit National findings The Royal College of.
Effect of nasal positive expiratory pressure (PEP) on 6-min walk test (6MWT) distance and pre- to post-exercise increase in lung volumes in each individual.
Forest plot of the diagnostic yield of combined transbronchial needle aspiration (TBNA) and transbronchial lung biopsy (TBLB) in patients with sarcoidosis.
Introduction Conclusion
 Categorisation of direct and indirect admissions to the intensive care unit (ICU) from emergency departments (EDs), using source of admission.  Categorisation.
The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.
Wednesday 7 June – Tuesday 13 June
Spearman rank correlation between absolute humidity and the patient's core temperature with the Humid-Heat device. Spearman rank correlation between absolute.
Matrix used to calculate the kappa statistic.
Trigger delays and leaks.
Patients with exacerbations of chronic obstructive pulmonary disease admitted to hospital according to the day of the week (A), and presenting to the emergency.
Assessing for Cognitive Impairment
Forest plot showing the number of adults (at the top) and children (lower down) who were admitted to hospital after treatment in the emergency department.
Picture of bubble PEP devices.
Flow chart of pressure support test and spontaneous breathing trial (SBT). Flow chart of pressure support test and spontaneous breathing trial (SBT). The.
Admissions, attendances and activities in the emergency department
Simplified Markov diagram of a patient admitted to the ward with no respiratory support. Simplified Markov diagram of a patient admitted to the ward with.
Claudio Sandroni a,., Giorgia Ferro a,
An example of delayed cycling during pressure-support ventilation of a patient with COPD, on a Puritan Bennett 7200 ventilator, which has a flow-termination.
Simulated screenshot of flow starvation in volume control continuous mandatory ventilation. Simulated screenshot of flow starvation in volume control continuous.
A: Computed tomogram shows bilateral dependent consolidation in a patient with ARDS, as well as ground-glass opacities in the non-dependent lung. A: Computed.
A: The Parker Flex-Tip tube (left) has a flexible tip pointing toward the center of the distal lumen. A: The Parker Flex-Tip tube (left) has a flexible.
Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, Area Under the Curve, and 95% CIs for the 0, 10, 25, 50, and 100 SatSeconds.
Representative tracings of transcutaneous CO2 (PtcCO2), Spo2, and heart rate during an apnea test designed to raise Paco2 to 100 mm Hg. At baseline, PtcCO2.
Trigger and synchronization windows.
Kaplan-Meier curves depicting the probability of survival from study enrollment in patients receiving conventional chest physical therapy (CCPT) (solid.
Typical pressure-time curves during forced expiration against an occluded airway in cystic fibrosis (CF) patients and healthy controls. Typical pressure-time.
Top: Stress index (SI) in a patient early in the course of ARDS
Serial chest x-rays of our patient.
Algorithm of the typical evolution of disease in patients with progressive neuromuscular disorders (gray boxes) and assessments and interventions that.
Example of Aerogen Solo Nebulizer before use with a fill volume of 3 mL normal saline (arrow 1) (A); the same nebulizer after random premature cessation.
Negative pressures calculated with the Rosen and Hillard formula
We connected the supplemental oxygen supply at 3 places: near the ventilator, near the exhalation valve, and on the nasal mask port. We connected the supplemental.
Pulse oximetry tracings from a 60-y-old woman with a COPD exacerbation who was admitted to the ICU in ventilatory failure. Pulse oximetry tracings from.
Schematic representation of the proposed definition of prolonged mechanical ventilation (PMV) in neonates and children. Schematic representation of the.
Change in mean pulmonary arterial pressure after a 5-min inhalation of the Rho kinase inhibitor Y in rats with hypoxic pulmonary hypertension, with.
Areas under the receiver operating characteristic (ROC) curves for both the training and testing data sets based on a number of hidden-layer perceptrons.
Process control chart of the mean monthly time between emergency department assessment/bronchodilator treatment and emergency department discharge. Process.
The Boussignac continuous positive airway pressure (CPAP) is a small plastic cylinder that attaches to a face mask. The Boussignac continuous positive.
A: Optimal cutoff point (circled) at which visual analog scale score categorizes subjects with versus those without bronchial obstruction. A: Optimal cutoff.
Change in trigger delay during invasive (A) and noninvasive ventilation (B) with variable leak. Change in trigger delay during invasive (A) and noninvasive.
A: Pressure ulcer on the left cheek of a patient after 1 week of prone positioning using a commercially available endotracheal tube (ETT) holder. A: Pressure.
Frail Older Persons Intervention and Therapy Team (FITT)
Kaplan-Meier curve for the probability of noninvasive ventilation (NIV) failure relative to continuous use of NIV and stratified for Acute Physiology and.
Calculated negative pressure developed in the lung plotted against the outside diameter of the suction catheter to the inside diameter of the airway. Calculated.
Survival of subjects listed for heart transplantation with and without spirometry. Survival of subjects listed for heart transplantation with and without.
Airway pressure and flow graphics illustrate delayed cycling.
PaO2/FIO2, leukocyte count, and C-reactive protein during the first 10 days after out-of-hospital cardiac arrest, in subjects with or without early-onset.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) ABCD scheme for classifying patients with COPD with separate appraisal of air-flow limitation.
A: Work of breathing before and after nebulized terbutaline delivered via standard nebulization method versus delivered during continuous positive airway.
Sequence plot visualizing the development of symptom frequency for the cohort at the individual level between 2006 and Sequence plot visualizing.
The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.
Number of ventilator starts (including both noninvasive ventilation [NIV] and invasive mechanical ventilation subjects) based on age and etiology of ARF.
Representative tidal volume (VT) and breathing frequency (f) patterns of subjects with COPD and normal subjects during cardiopulmonary exercise testing.
Plot of the surface tension (γ) and area.
Progression of spontaneous breathing trials administered during inspiratory muscle strength training study interventions. Progression of spontaneous breathing.
Efficiency of aerosol bronchodilator delivery during continuous high-flow system at different CPAP and flow levels. Efficiency of aerosol bronchodilator.
Cerebral magnetic resonance imaging of our patient performed at ∼7
Percent of extremely-low-birth-weight (ELBW) babies alive and off mechanical ventilation at 7 days, and median days on mechanical ventilation for ELBW.
A: On the first admission, chest radiograph revealed diffuse bilateral pulmonary infiltrations. A: On the first admission, chest radiograph revealed diffuse.
Arterial blood gas measurement of oxygen tension.
Time taken to perform the Glittre activities of daily living (Glittre ADL) test by severity of COPD obstruction according to Global Initiative for Chronic.
Presentation transcript:

The test of change goal was to shorten the time between the last respiratory therapist (RT) assessment/bronchodilator treatment given in the emergency department (TED) and the first in-patient assessment/treatment (TMW). The test of change goal was to shorten the time between the last respiratory therapist (RT) assessment/bronchodilator treatment given in the emergency department (TED) and the first in-patient assessment/treatment (TMW). Before the test of change, TED was the last bronchodilator treatment ordered and given before the decision to admit. With the intervention, TED moves to T*ED (still the time of the last emergency department RT intervention) and ensures that assessment for bronchodilator treatment continues to occur every 2 h after the in-patient licensed independent practitioner (LIP) writes the in-patient orders, even if there is a delay in admission. TDC is the recorded time of discharge from the emergency department and admission to the medical ward. ED = emergency department. Jennifer R Cockerham et al. Respir Care 2016;61:1573-1579 (c) 2012 by Daedalus Enterprises, Inc.