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      Clinical Dashboard in the Intensive Care Unit: Need-Assessment and Survey about Attitudes and Acceptance of Tele-ICU from the Viewpoint of Nurses and Clinicians in the Intensive Care Unit

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          Abstract

          Background:

          One of the most worrying aspects of medical area in developing countries is the Intensive Care Unit (ICU). This study aimed to evaluate the acceptability of the clinical dashboard by the users, prior to final use and their attitude towards this technology, as well as to examine the specific needs that Tele-ICU technology can cover in the form of a clinical dashboard.

          Materials and Methods:

          This study was conducted at Shahid Bahonar Hospital of Kerman, Southeastern Iran, with three ICUs, the first, second, and third sections of which had 10, 12, and 24 beds, respectively. Taking survey and need assessment of care providers, qualitative and quantitative analyses were undertaken to identify key positive and negative themes. The data were analyzed by SPSS software version 18.

          Results:

          About 82% of care providers in the ICU participated in this survey. The number of participants based on the groups in the survey was 98 (81.7%) of the nurses and respiratory therapists group, 20 (80%) from the group of anesthesiologists and 20 (87%) from the group of anesthesiologist assistants who participated in the survey. About 51% of the survey participants completed the description section either partially or totally. On average, among all groups, the group of anesthesiologists had the most and the nurses had the least knowledge about telemedicine and Tele-ICU, whereas the anesthesiologist assistants had the most and the nurses and respiratory therapists group had the least knowledge about clinical dashboards.

          Conclusion:

          This study showed that the level of knowledge and awareness of care providers, especially nurses and respiratory therapists in the ICU in terms of telemedicine and Tele-ICU is low and care providers are in doubt that telemedicine technology could have a positive or negative impact on human resource shortages, yet agreed that it would have a negative effect on the privacy of the patients and care providers. In addition, the ICU care providers agree that Tele-ICU can positively affect the quality of patient care, staff satisfaction, reduce the cost of care, and ease and reduce the time for patient counseling. This suggests the need for further research and education of system impact beyond patient outcomes related to this new technology.

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          Most cited references25

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          Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population?

          Two important areas of medicine, care of the critically ill and management of pulmonary disease, are likely to be influenced by the aging of the US population. To estimate current and future requirements for adult critical care and pulmonary medicine physicians in the United States. Analysis of existing population, patient, and hospital data sets and prospective, nationally representative surveys of intensive care unit (ICU) directors (n = 393) and critical care specialists (intensivists) and pulmonary specialists (pulmonologists) (n = 421), conducted from 1996 to 1999. Influence of patient, physician, regional, hospital, and payer characteristics on current practice patterns; forecasted future supply of and demand for specialist care through 2030. Separate models for critical care and pulmonary disease. Base-case projections with sensitivity analyses to estimate the impact of future changes in training and retirement, disease prevalence and management, and health care reform initiatives. In 1997, intensivists provided care to 36.8% of all ICU patients. Care in the ICU was provided more commonly by intensivists in regions with high managed care penetration. The current ratio of supply to demand is forecast to remain in rough equilibrium until 2007. Subsequently, demand will grow rapidly while supply will remain near constant, yielding a shortfall of specialist hours equal to 22% of demand by 2020 and 35% by 2030, primarily because of the aging of the US population. Sensitivity analyses suggest that the spread of current health care reform initiatives will either have no effect or worsen this shortfall. A shortfall of pulmonologist time will also occur before 2007 and increase to 35% by 2020 and 46% by 2030. We forecast that the proportion of care provided by intensivists and pulmonologists in the United States will decrease below current standards in less than 10 years. While current health care reform initiatives and modification of existing practice patterns may temporarily forestall this problem, most anticipated effects are minor in comparison with the growing disease burden created by the aging US population. JAMA. 2000;284:2762-2770.
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            A review and analysis of intensive care medicine in the least developed countries.

            To give critical care clinicians in Western nations a general overview of intensive care medicine in less developed countries and to stimulate institutional or personal initiatives to improve critical care services in the least developed countries. In-depth PubMed search and personal experience of the authors. In view of the eminent burden of disease, prevalence of critically ill patients in the least developed countries is disproportionately high. Despite fundamental logistic (water, electricity, oxygen supply, medical technical equipment, drugs) and financial limitations, intensive care medicine has become a discipline of its own in most nations. Today, many district and regional hospitals have units where severely ill patients are separately cared for, although major intensive care units are only found in large hospitals of urban or metropolitan areas. High workload, low wages, and a high risk of occupational infections with either the human immunodeficiency virus or a hepatitis virus explain burnout syndromes and low motivation in some health care workers. The four most common admission criteria to intensive care units in least developed countries are postsurgical treatment, infectious diseases, trauma, and peripartum maternal or neonatal complications. Logistic and financial limitations, as well as insufficiencies of supporting disciplines (e.g., laboratories, radiology, surgery), poor general health status of patients, and in many cases delayed presentation of severely sick patients to the intensive care unit, contribute to comparably high mortality rates. More studies on the current state of intensive care medicine in least developed countries are needed to provide reasonable aid to improve care of the most severely ill patients in the poorest countries of the world.
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              Dashboards for improving patient care: review of the literature.

              This review aimed to provide a comprehensive overview of the current state of evidence for the use of clinical and quality dashboards in health care environments.
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                Author and article information

                Journal
                Tanaffos
                Tanaffos
                Tanaffos
                Tanaffos
                Tanaffos
                National Research Institute of Tuberculosis and Lung Disease
                1735-0344
                2345-3729
                February 2019
                : 18
                : 2
                : 142-151
                Affiliations
                [1 ]Medical Informatics Department, Mashhad University of Medical Sciences, Mashhad, Iran,
                [2 ]Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,
                [3 ]Department of Anesthesiology and Critical care Medicine, Kerman University of Medical Sciences, Kerman, Iran,
                [4 ]Computer Science Department, School of Mathematical Science, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran.
                Author notes
                Correspondence to: Etminani K, Address: Medical Informatics Department, Mashhad University of Medical Sciences, Mashhad, Iran, Email address: Etminanik@ 123456mums.ac.ir
                Article
                Tanaffos-18-142
                7230120
                8c190678-98cc-45b1-bace-55c1af2796bc
                Copyright© 2019 National Research Institute of Tuberculosis and Lung Disease

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Original Article

                intensive care unit,telemedicine,tele-icu,clinical dashboard,icu staff

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