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Drug Shortages: Analgesic Alternatives to Opioid Drug Shortages

This article was first published in the August 2018 issue of Critical Connections. The Drug Shortages Committee is a multiprofessional group charged with providing resources to members to help optimally manage drug shortages affecting critically ill and injured patients. Committee members share their personal experiences, identify current trends in drug shortages and offer insight into various safety and quality improvement issues.


Models of Peer Support to Remediate Post-Intensive Care Syndrome

"Models of Peer Support to Remediate Post-Intensive Care Syndrome" was published in the February/March 2019 issue of Critical Connections.

The Society of Critical Care Medicine’s international THRIVE Peer Support Collaborative analyzed 17 sites within the collaborative between October 2016 and July 2017, and they identified six general models of peer support.

 


Collaboratives Make It Happen: Three Family and Clinician Partnership Success Stories

"Collaboratives Make It Happen: Three Family and Clinician Partnership Success Stories" was published in the February/March 2019 issue of Critical Connections.
The Society of Critical Care Medicine (SCCM) launched the Patient-Centered Outcomes Research – Intensive Care Unit (PCOR-ICU) Collaborative in 2016 to engage and partner with patients and families in ICUs across the United States.


Pediatric ICU Team Success: Implementing the ICU Liberation Campaign

"Pediatric ICU Team Success: Implementing the ICU Liberation Campaign" was published in the August/September 2018 issue of Critical Connections.

The Society of Critical Care Medicine’s (SCCM) Pediatric ICU (PICU) Liberation Collaborative worked with hospital teams across the United States to optimize pain control and reduce sedative exposure and time on mechanical ventilation.


Letting Kids Be Kids: A Tale of Transforming PICU Immobility Culture

"Letting Kids Be Kids: A Tale of Transforming PICU Immobility Culture" was published in the August/September 2018 issue of Critical Connections.

SCCM’s Pediatric Intensive Care Unit (PICU) Liberation Collaborative was comprised of 8 PICU teams who focused on adapting and adopting the ABCDEF Bundle in the PICU setting.


Improving Value, Quality, and Safety in Your ICU with the ICU Liberation Campaign

"Improving Value, Quality, and Safety in Your ICU with the ICU Liberation Campaign" was published in the August/September 2018 issue of Critical Connections.

Implementing the Society of Critical Care Medicine’s evidence-based ABCDEF bundle can significantly improve the value, quality, and safety of care delivered to patients in your ICUs.


Five Important Things to Know About Pediatric Sepsis

"Five Important Things to Know About Pediatric Sepsis" was published in the August/September 2018 issue of Critical Connections.

Sepsis is about ten times less common in pediatric patients than in adults but nonetheless remains an important and potentially devastating public health problem for infants, children, and adolescents worldwide. Here are five important things to know about pediatric sepsis.


Advancing Research for Effective Alerts to Avoid Alert Fatigue

"Advancing Research for Effective Alerts to Avoid Alert Fatigue" was published in the June/July 2018 issue of Critical Connections.

Quality improvement efforts often focus on fixing problems with the aid of technology, including clinical decision support (CDS); unfortunately, no follow-up assessment of CDS effectiveness has been conducted. The “set it and forget it” mentality results in numerous alerts, which are often sensitive but lack specificity. Oversensitivity results in nonactionable alerts.


Waiver of Informed Consent in Emergency Situations

"Waiver of Informed Consent in Emergency Situations" was published in the June/July 2018 issue of Critical Connections.

Obtaining informed consent for participation in research reinforces the ethical principle of autonomy by providing the opportunity for individuals to make a voluntary choice to participate.
 


Using Multiple Imputation to Avoid Bias From Missing Data in Critical Care Research

"Using Multiple Imputation to Avoid Bias From Missing Data in Critical Care Research" was published in the June/July 2018 issue of Critical Connections.

Missing data is a common, yet often overlooked, source of bias in critical care studies. 1,2 The key concern with missing data is informative missingness, meaning that data are missing for reasons that are related to the study outcome. 2


Research Support for Early Career Investigators

"Research Support for Early Career Investigators" was published in the June/July 2018 issue of Critical Connections.

Early career is never an easy time—there are multiple ongoing challenges, a new work environment, new colleagues, and probably a new electronic medical record (among many other changes)—not the best combination of situational events to encourage the expenditure of time or energy on scientific thinking.


Five Ways to Find Research Opportunities Outside Academia

"Five Ways to Find Research Opportunities Outside Academia" was published in the June/July 2018 issue of Critical Connections.
Research is vital to advancements in care and improving human health outcomes in all settings, including critical care.


ICU Capacity Strain: The Need for Standardization of Definitions

"ICU Capacity Strain: The Need for Standardization of Definitions" was published in the June/July 2018 issue of Critical Connections.
There is an increasing appreciation in the medical community that capacity of the intensive care unit (ICU) is a vital issue in regard to patient recovery, quality of care, and patient and staff satisfaction.


Exploring Ethics: How to Deal with Challenging Family Situations

"How to Deal with Challenging Family Situations" was published in the May/June/July 2019 issue of Critical Connections. The Exploring Ethics column features a case study and analysis meant to help readers gain a better appreciation of ethical issues facing critical care practitioners. 


Mentorship During Fellowship: A Real-World Experience

This article was first published in the May/June/July 2019 issue of Critical Connections.

Mentorship programs have a proven and well-established benefit for professional development. In 2018, the Society of Critical Care Medicine’s (SCCM) Postgraduate and Fellowship Education Committee surveyed 1,157 SCCM members who self-identified as program directors.


The Role of Mentorship for Women in Critical Care Medicine

This article was first published in the May/June/July 2019 issue of Critical Connections.

As recognition grows about the disparities that exist for women in the workplace, it creates an opportunity to
discuss ways to advance and support women in critical care. In this article, Dr. Sreedharan, Dr. Baldisseri, and Schirin Tang, MD, share their advice.


Perspectives on Mentorship

This article was first published in the May/June/July 2019 issue of Critical Connections.

As an experienced provider who has changed roles several times, I have several perspectives on the role of mentorship in the development of a practitioner. Early in my career, despite exposure to topics and various management styles in training, I rapidly found that I had to develop my own methods. It was sometimes easy to mimic those of my training mentors, but some situations were more challenging. Mentors within pharmacy, nursing, and medicine helped me immensely, both at the start of my career and periodically throughout.


Enhancing Diversity and Professional Development Through Mentorship

This article was first published in the May/June/July 2019 issue of Critical Connections.

Fostering diversity is an ideal that we strive to achieve in our profession. However, if asked to recall specific examples from the past year in which we have actively participated in promoting diversity in the critical care workforce, many of us might fall short. Women and certain ethnic minorities (specifically, Blacks, Hispanics, American Indians, and Hawaiian/Pacific Islanders) continue to be underrepresented in a variety of medical and allied health professions.1,2 Representation of other identity categories relevant to the practice of medicine, such as socioeconomic class, sexual orientation, gender identity, disability, and religion, remains unknown. Critical care practitioners care for patients and families during the most vulnerable moments of their lives and play an important role in the crucial conversations surrounding the goals of their care. In such situations, cultural sensitivity plays an important role in the outcomes and satisfaction of patients and families with the care provided. Our success in this field is closely related to our ability to create a culture that identifies, fosters, and encourages the professional development of minority leaders.


Drug Shortages: Peripheral Vasopressors: Friend or Foe?

This article was first published in the May/June/July 2019 issue of Critical Connections. The Drug Shortages column addresses recent events and issues related to drug shortages.

Hemodynamic emergencies are common in the critical care arena. Once fluid resuscitation fails to meet targeted perfusion goals, vasopressor agents are warranted. Although it is ideal for patients to have central venous access for administration of vasopressors, the opportunity to gain this access before administration may not be feasible. At these times, clinicians may be forced to initiate vasopressor agents through peripheral intravenous (PIV) access to stabilize the patient before obtaining central venous access.


Coding Corner: Revisiting Neonatal and Pediatric Critical Care Services

This article was first published in the May/June/July 2019 issue of Critical Connections. Coding Corner addresses the continuing changes in coding and billing. 

Neonatal and pediatric critical care coding guidelines have been modified over the years, but the definitions remain the same. The patient must meet the same clinical criteria as for the adult critical care codes 99291 and 99292. Critical care can be provided by a physician(s) or other qualified healthcare professional(s) of medical care for critically ill or injured patients.