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This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstractcontains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on thereliability of the study and the conclusions drawn.

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Organizational data such as bed occupancy rate and nurse-to-patient ratio are related to clinical outcomes and to the efficient use of intensive care unit (ICU) resources. Standards for these performance indicators are provided in guidelines. We studied the effects of a multifaceted feedback strategy to improve the adherence to these standards.

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This guidance outlines British Thoracic Society (BTS) recommended follow up of patients witha clinico-radiological diagnosis of COVID-19 pneumonia. The COVID-19 swab status of patients is not relevant to this guidance. The entry point to this guidance is a clinical diagnosis of COVID-19 pneumonia with consistent radiological changes. This document may require updating as more information becomes available. This version was published on Monday 11 May2020. Please check the BTS website for the most up to date version of this document.This guidance focuses on the radiological follow up of the pneumonic process and the subsequent diagnosis and management of respiratory complications of COVID-19 pneumonia.

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Objective
To determine whether a nurse-led preventive, complex psychological intervention, initiated in the ICU, reduces patient-reported PTSD symptom severity at 6 months.

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Centra had the opportunity of sending 14 staff to the course, ICU Liberation and Animation: Operationalizing the Pain, Agitation, and Delirium Guidelines through the ABCDEF Bundle at Vanderbilt University. The ICU team included our Medical
Director of ICU, Dr. Jeremy Hardison, ICU nurse managers, bedside ICU nurses, Clinical Nurse Specialist, and Directors of Physical Therapy and Respiratory Therapy. What a great opportunity this was to come together as a team and learn from each other to improve outcomes and prevent ICU Delirium and PICS.

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Wang et al.’s review of the Post-Intensive Care Syndrome (PICS) accomplishes three goals: 1) it describes PICS as an enormous public health problem with far-reaching consequences; 2) it summarizes gaps in knowledge about functional impairments in PICS; and 3) it envisions the role of geriatric psychiatry in clinical care and research to improve patient and family outcomes in PICS.

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Within the last couple of decades, advances in critical care medicine have led to increased survival of critically ill patients, as well as the discovery of notable, long-term health challenges in survivors and their loved ones. The terms post-intensive care syndrome (PICS) and PICS-family (PICS-F) have been used in non-neurocritical care populations to characterize the cognitive, psychiatric, and physical sequelae associated with critical care hospitalization in survivors and their informal caregivers (e.g., family and friends who provide unpaid care). In this review, we first summarize the literature on the cognitive, psychiatric, and physical correlates of PICS and PICS-F in non-neurocritical patient populations and draw attention to their long-term negative health consequences. Next, keeping in mind the distinction between disease-related neurocognitive changes and those that are associated directly with the experience of a critical illness, we review the neuropsychological sequelae among patients with common neurocritical illnesses. We acknowledge the clinical factors contributing to the difficulty in studying PICS in the neurocritical care patient population, provide recommendations for future lines of research, and encourage collaboration among critical care physicians in all specialties to facilitate continuity of care and to help elucidate mechanism(s) of PICS and PICS-F in all critical illness survivors. Finally, we discuss the importance of early detection of PICS and PICS-F as an opportunity for multidisciplinary interventions to prevent and treat new neuropsychological deficits in the neurocritical care population.

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Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU.All critical care survivors should be evaluated for PICS and those having signs and symptoms of it should be managed by a multidisciplinary team which includes critical care physician, neuro-psychiatrist, physiotherapist and respiratory therapist,with the use of pharmacological and non-apharmacological interventions. This can be achieved through an organizational change and improvement, knowing the high rate of incidence of PICS and its adverse effects on the survivor’s life and daily activities and its effect on the survivor’s family.

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A guide to using and understanding the Family and Medical Leave Act

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Picture cards and questions designed to evaluate a patients' ability to focus.

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Advertisement for HealthUnlocked showing statistic and testimonials to highlight and illustrate benefits.

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MRC-sumscore is a valid, reliable, objective, and easy method to evaluate the global muscle strength including PICS related to COVID-19. It provides beneficial information about the clinical course. Its bedside applicability without necessitating any device makes MRC-sumscore a valuable tool in the follow-up of patients with PICS.