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academies
August 27-28, 2018 | London, UK
International Conference on
Healthcare and Health Management
Cardiology and Cardiac Surgery
Joint Event
&
Journal of Public Health Policy and Planning | Volume: 2
Impact of PAD Guideline on Masih Daneshvari Hospital ICU
Seyed Mohammadreza Hashemian
1
, Batoul Khoundabi
and
Ala Farhang
1
Shahid Beheshti University of Medical Sciences, Iran
Background:
The Pain, Agitation, Delirium (PAD) guideline has
been reviewed and compiled by the American Chest Physicians
College and American Respiratory Medicine Association. This
guidelinewastranslatedintoPersianbyresidentsoftheIntensive
Care Unit (ICU) to implement that at Masih Daneshvari hospital.
Aim:
The study attempts to investigate the effects of the
implementation of this guideline on ICU and its impact on
patients.
Materials and Methods:
This study was done as a case-control
study. The variables related to admission in the hospital and
ICU and also the awakening and ventilator characteristics
of patients, were compared between two groups before
and after guideline implementation. 100 patients before
the implementation of the guideline and 120 patients after
the implementation of the guideline were included and the
variables were evaluated and compared in these patients.
Results:
The mean ages of patients in the pre-group and
post-group were 53.7±14.9 and 55.7±16.9 years, respectively
(P=0.894). 70.0% of the participants in the pre-group and 69.2%
in post-group, were men (P=0.930). The median APACHE score
was 24.8 in the pre-group and 20.4 post-group (P=0.863).
The average days spent in the ICU for the pre-group was 8.2
days, and for pre-group were 5.7 days (P=0.043). The average
length of stay in hospital was 20.3 days for the pre-group
and 14.8 days for the post-group. 16% of the patients in the
pre-group were treated with tracheostomy, while after PAD
implementation in post-group, this rate was reduced to 10%
(P=0.04). 16% of the patients in the pre-group had awake days
while receiving a sedative infusion, while that rate in post group
was 80% (P=0.012). 72 (72.0%) patients in the pre-group were
CI sedative while 55(45.8%) patients in post-group were CI
sedative (P=0.043). Also percent of patients in the pre-group
withwas significantly less than patients in post-group (P=0.037).
Conclusions:
The implementation of the protocol has led
to improved hospitalization, ICU, awakening and ventilator
indicators.
e
:
iran.criticalcare@yahoo.com