By Dr. Dinis Reis Miranda, Dr. David W. Ryan, Dr. Wilmar B. Schaufeli, Dr. Václav Fidler (auth.), Dr. Dinis Reis Miranda, Dr. David W. Ryan, Dr. Wilmar B. Schaufeli, Dr. Václav Fidler (eds.)
From the point of view of a future health economist, the extensive care unit (leU) is a very attention-grabbing phenomenon. it's the epitome of "high-tech" medication and often portrayed because the position the place life-saving miracles are normally wrought. however the well known imagina tion can also be stuck up within the darker aspect, whilst agonizing judgements must be made to prevent futile and inhuman continuation of expen sive remedies. My analytical pursuits led me to strategy those matters via asking what the facts tells us approximately which leu actions are very bene ficial in courting to their bills and which aren't. This fast interprets right into a a little bit diversified query, particularly, which sufferers are such a lot properly handled in an leu and which now not. Unfor tunately, it's very demanding to reply to those questions since it has seasoned ved very tricky to enquire those matters within the demeanour that is now considered as the "gold standard:' particularly through undertaking rando mized medical trials or replacement classes of motion. i believe it is a pity, and i'm in no way confident that it'd be unethical to take action in lots of circumstances, simply because there's large edition in perform and ge nuine doubt as to which practices are top -the stipulations that must be fulfilled prior to this sort of trial is justifiable.
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Additional resources for Organisation and Management of Intensive Care: A Prospective Study in 12 European Countries
8). The Independent Variables It was prospectively decided that each of the five substudies in EURICUS-I should contribute two independent variables to the analysis of hypothesis testing. After analysis of the data and modeling of the relevant variables, those variables judged to most strongly represent the data in each substudy (two per substudy) were included in the analysis. The inclusion of two variables per sub study, instead of the (stepwise) inclusion of all variables modeled, was based on two methodologic considerations: (1) inclusion of all the variables would make the analysis extremely difficult from a technical point of view; (2) inclusion of all the variables (more and less meaningful) might lead to a kind of "fishing expedition" through which less meaningful associations could unduly dominate the conclusions of the study.
It is noteworthy that these two ratios are calculated differently and measure two different things: the planned PIN ratio is derived from management characteristics at ICU level (numbers of beds and numbers of nurses) and indicates the mean number of nurses available per ICU bed for a given annual rate of occupancy. The operating PIN ratio indicates the annual nursing consumption per average patient-day and is computed by aggregating at ICU level the actual use of nursing resources at patient level.
The working situation of nurses is described in terms of: (a) nursing staff characteristics, including sex, part-time vs full-time employment, age and experience; (b) job characteristics, as measured by the "Well-Being of ICU Nurses" questionnaire, including the characteristics of about 40 tasks and activities performed by nurses. These are divided into four categories: operational tasks (nursing and medical care of patients), organizing tasks (job-related cooperation/ meetings with others), preparatory tasks and supportive tasks; (c) stress-related characteristics, assessed by the 15 scales of the "Work and Well-Being" questionnaire, including workload, burnout, perceived performance, coping resources and involvement.
Organisation and Management of Intensive Care: A Prospective Study in 12 European Countries by Dr. Dinis Reis Miranda, Dr. David W. Ryan, Dr. Wilmar B. Schaufeli, Dr. Václav Fidler (auth.), Dr. Dinis Reis Miranda, Dr. David W. Ryan, Dr. Wilmar B. Schaufeli, Dr. Václav Fidler (eds.)