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Delirium, or acute brain dysfunction, is a syndrome that affects many patients in the intensive care unit (ICU). A number of modifiable and non-modifiable risk factors contribute to the development of delirium, such as illness severity, receipt of benzodiazepine medications, and metabolic alterations.
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Gershengorn and colleagues used prospectively collected data from the Project IMPACT database (a nationwide, voluntary, proprietary database for assessing performance of U.S. ICUs with respect to patient outcomes and numerous other variables) to examine the question of whether the use of arterial catheters (ACs) in critically ill, mechanically ventilated patients was associated with improved survival or other documentable benefits.
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Pain defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage1 is a common symptom experienced by critically ill patients.
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When a team of physicians, nurse practitioners, case managers, and social workers provided care for at-risk members of Priority Health health plan in their homes, emergency department visits and inpatient admissions for patients in the program dropped by 47%.
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A multidisciplinary team at CareSource, a Dayton, OH-based health plan, coordinates care for at-risk pregnant women and follows them for a year, or longer, after the birth.
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Margaret Leonard, who recently was presented the Lifetime Achievement Award by the Case Management Society of America, points out that the Affordable Care Act and other legislation all include the concept of care coordination.
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Case managers are beginning to get the recognition they deserve and National Case Management Week Oct. 12-18 is the time to celebrate all the contributions that case managers bring to the healthcare arena.
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Like many hospitals around the country, Mercy San Juan Medical Center in Carmichael, CA, has seen a steady increase in patients presenting to the ED with mental health problems. Officials attribute the problem to dwindling resources for mental health care and, in particular, the closing of an inpatient psychiatric unit in the region in 2009. Many of the patients who previously would have been stabilized in the inpatient unit are now showing up in the ED.
