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  1. Article ; Online: Interventions for improving critical care in low- and middle-income countries: a systematic review.

    Wagstaff, Duncan / Arfin, Sumaiya / Korver, Alba / Chappel, Patrick / Rashan, Aasiyah / Haniffa, Rashan / Beane, Abi

    Intensive care medicine

    2024  

    Abstract: Purpose: To systematically review the typology, impact, quality of evidence, barriers, and facilitators to implementation of Quality Improvement (QI) interventions for adult critical care in low- and middle-income countries (LMICs).: Methods: MEDLINE, ...

    Abstract Purpose: To systematically review the typology, impact, quality of evidence, barriers, and facilitators to implementation of Quality Improvement (QI) interventions for adult critical care in low- and middle-income countries (LMICs).
    Methods: MEDLINE, EMBASE, Cochrane Library and ClinicalTrials.gov were searched on 1st September 2022. The studies were included if they described the implementation of QI interventions for adult critical care in LMICs, available as full text, in English and published after 2000. The risks of bias were assessed using the ROB 2.0/ROBINS-I tools. Intervention strategies were categorised according to a Knowledge Translation framework. Interventions' effectiveness were synthesised by vote counting and assessed with a binomial test. Barriers and facilitators to implementation were narratively synthesised using the Consolidated Framework for Implementation Research.
    Results: 78 studies were included. Risk of bias was high. The most common intervention strategies were Education, Audit & Feedback (A&F) and Protocols/Guidelines/Bundles/Checklists (PGBC). Two multifaceted strategies improved both process and outcome measures: Education and A&F (p = 0.008); and PGBC with Education and A&F (p = 0.001, p < 0.001). Facilitators to implementation were stakeholder engagement, organisational readiness for implementation, and adaptability of interventions. Barriers were lack of resources and incompatibility with local systems. There was a lack of evidence from low-income countries.
    Conclusions: The evidence for QI in critical care in LMICs is sparse and at high risk of bias but suggests that multifaceted interventions are most effective. Co-designing interventions with and engaging stakeholders, communicating relative advantages, employing local champions and adapting to feedback can improve implementation. Hybrid study designs, process evaluations and adherence to reporting guidelines would improve the evidence base.
    Language English
    Publishing date 2024-05-15
    Publishing country United States
    Document type Systematic Review
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-024-07377-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Development of a core outcome set for general intensive care unit patients-Need for a broader context?

    Pari, Vrindha / Beane, Abigail / Salluh, Jorge I F / Dongelmans, Dave A

    Acta anaesthesiologica Scandinavica

    2022  Volume 66, Issue 4, Page(s) 539–540

    MeSH term(s) Critical Care ; Humans ; Intensive Care Units ; Outcome Assessment, Health Care
    Language English
    Publishing date 2022-02-11
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80002-8
    ISSN 1399-6576 ; 0001-5172
    ISSN (online) 1399-6576
    ISSN 0001-5172
    DOI 10.1111/aas.14031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 22: Show issues Location:
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  3. Article ; Online: The burden of anxiety, depression, and stress, along with the prevalence of symptoms of PTSD, and perceptions of the drivers of psychological harms, as perceived by doctors and nurses working in ICUs in Nepal during the COVID-19 pandemic; a mixed method evaluation.

    Kc, Shirish / Gooden, Tiffany E / Aryal, Diptesh / Koirala, Kanchan / Luitel, Subekshya / Haniffa, Rashan / Beane, Abi

    BMC health services research

    2024  Volume 24, Issue 1, Page(s) 450

    Abstract: Background: The COVID-19 pandemic resulted in significant physical and psychological impacts for survivors, and for the healthcare professionals caring for patients. Nurses and doctors in critical care faced longer working hours, increased burden of ... ...

    Abstract Background: The COVID-19 pandemic resulted in significant physical and psychological impacts for survivors, and for the healthcare professionals caring for patients. Nurses and doctors in critical care faced longer working hours, increased burden of patients, and limited resources, all in the context of personal social isolation and uncertainties regarding cross-infection. We evaluated the burden of anxiety, depression, stress, post-traumatic stress disorder (PTSD), and alcohol dependence among doctors and nurses working in intensive care units (ICUs) in Nepal and explored the individual and social drivers for these impacts.
    Methods: We conducted a mixed-methods study in Nepal, using an online survey to assess psychological well-being and semi-structured interviews to explore perceptions as to the drivers of anxiety, stress, and depression. Participants were recruited from existing national critical care professional organisations in Nepal and using a snowball technique. The online survey comprised of validated assessment tools for anxiety, depression, stress, PTSD, and alcohol dependence; all tools were analysed using published guidelines. Interviews were analysed using rapid appraisal techniques, and themes regarding the drivers for psychological distress were explored.
    Results: 134 respondents (113 nurses, 21 doctors) completed the online survey. Twenty-eight (21%) participants experienced moderate to severe symptoms of depression; 67 (50%) experienced moderate or severe symptoms of anxiety; 114 (85%) had scores indicative of moderate to high levels of stress; 46 out of 100 reported symptoms of PTSD. Compared to doctors, nurses experienced more severe symptoms of depression, anxiety, and PTSD, whereas doctors experienced higher levels of stress than nurses. Most (95%) participants had scores indicative of low risk of alcohol dependence. Twenty participants were followed up in interviews. Social stigmatism, physical and emotional safety, enforced role change and the absence of organisational support were perceived drivers for poor psychological well-being.
    Conclusion: Nurses and doctors working in ICU during the COVID-19 pandemic sustained psychological impacts, manifesting as stress, anxiety, and for some, symptoms of PTSD. Nurses were more vulnerable. Individual characteristics and professional inequalities in healthcare may be potential modifiable factors for policy makers seeking to mitigate risks for healthcare providers.
    MeSH term(s) Humans ; Stress Disorders, Post-Traumatic/diagnosis ; COVID-19/epidemiology ; Depression/diagnosis ; Pandemics ; Prevalence ; Alcoholism/epidemiology ; Nepal/epidemiology ; Anxiety/diagnosis ; Intensive Care Units
    Language English
    Publishing date 2024-04-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-024-10724-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review.

    Kruse, Clemens Scott / Beane, Amanda

    Journal of medical Internet research

    2018  Volume 20, Issue 2, Page(s) e41

    Abstract: Background: Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several ... ...

    Abstract Background: Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature.
    Objective: The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes.
    Methods: We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR).
    Results: We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively.
    Conclusions: A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames.
    MeSH term(s) Electronic Health Records/standards ; Humans ; Medical Informatics/methods ; Treatment Outcome
    Language English
    Publishing date 2018-02-05
    Publishing country Canada
    Document type Journal Article ; Systematic Review
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1439-4456
    ISSN (online) 1438-8871
    ISSN 1439-4456
    DOI 10.2196/jmir.8793
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: What intensive care registries can teach us about outcomes.

    Beane, Abi / Salluh, Jorge I F / Haniffa, Rashan

    Current opinion in critical care

    2020  Volume 27, Issue 5, Page(s) 537–543

    Abstract: Purpose of review: Critical care registries are synonymous with measurement of outcomes following critical illness. Their ability to provide longitudinal data to enable benchmarking of outcomes for comparison within units over time, and between units, ... ...

    Abstract Purpose of review: Critical care registries are synonymous with measurement of outcomes following critical illness. Their ability to provide longitudinal data to enable benchmarking of outcomes for comparison within units over time, and between units, both regionally and nationally is a key part of the evaluation of quality of care and ICU performance as well as a better understanding of case-mix. This review aims to summarize literature on outcome measures currently being reported in registries internationally, describe the current strengths and challenges with interpreting existing outcomes and highlight areas where registries may help improve implementation and interpretation of both existing and new outcome measures.
    Recent findings: Outcomes being widely reported through ICU registries include measures of survival, events of interest, patient-reported outcomes and measures of resource utilization (including cost). Despite its increasing adoption, challenges with quality of reporting of outcomes measures remain. Measures of short-term survival are feasible but those requiring longer follow-ups are increasingly difficult to interpret given the evolving nature of critical care in the context of acute and chronic disease management. Furthermore, heterogeneity in patient populations and in healthcare organisations in different settings makes use of outcome measures for international benchmarking at best complex, requiring substantial advances in their definitions and implementation to support those seeking to improve patient care.
    Summary: Digital registries could help overcome some of the current challenges with implementing and interpreting ICU outcome data through standardization of reporting and harmonization of data. In addition, ICU registries could be instrumental in enabling data for feedback as part of improvement in both patient-centred outcomes and in service outcomes; notably resource utilization and efficiency.
    MeSH term(s) Critical Care ; Critical Illness/therapy ; Delivery of Health Care ; Humans ; Outcome Assessment, Health Care ; Registries
    Language English
    Publishing date 2020-12-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000865
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4999: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  6. Article ; Online: Intensive Care in Sub-Saharan Africa: A National Review of the Service Status in Ethiopia.

    Kifle, Fitsum / Boru, Yared / Tamiru, Hailu Dhufera / Sultan, Menbeu / Walelign, Yenegeta / Demelash, Azeb / Beane, Abigail / Haniffa, Rashan / Gebreyesus, Alegnta / Moore, Jolene

    Anesthesia and analgesia

    2024  Volume 134, Issue 5, Page(s) 930–937

    Abstract: Background: The burden of critical illness in low-income countries is high and expected to rise. This has implications for wider public health measures including maternal mortality, deaths from communicable diseases, and the global burden of disease ... ...

    Abstract Background: The burden of critical illness in low-income countries is high and expected to rise. This has implications for wider public health measures including maternal mortality, deaths from communicable diseases, and the global burden of disease related to injury. There is a paucity of data pertaining to the provision of critical care in low-income countries. This study provides a review of critical care services in Ethiopia.
    Methods: Multicenter structured onsite surveys incorporating face-to-face interviews, narrative discussions, and on-site assessment were conducted at intensive care units (ICUs) in September 2020 to ascertain structure, organization, workforce, resources, and service capacity. The 12 recommended variables and classification criteria of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) taskforce criteria were utilized to provide an overview of service and service classification.
    Results: A total of 51 of 53 (96%) ICUs were included, representing 324 beds, for a population of 114 million; this corresponds to approximately 0.3 public ICU beds per 100,000 population. Services were concentrated in the capital Addis Ababa with 25% of bed capacity and 51% of critical care physicians. No ICU had piped oxygen. Only 33% (106) beds had all of the 3 basic recommended noninvasive monitoring devices (sphygmomanometer, pulse oximetry, and electrocardiography). There was limited capacity for ventilation (n = 189; 58%), invasive monitoring (n = 9; 3%), and renal dialysis (n = 4; 8%). Infection prevention and control strategies were lacking.
    Conclusions: This study highlights major deficiencies in quantity, distribution, organization, and provision of intensive care in Ethiopia. Improvement efforts led by the Ministry of Health with input from the acute care workforce are an urgent priority.
    MeSH term(s) Critical Care ; Critical Illness/therapy ; Ethiopia/epidemiology ; Humans ; Intensive Care Units ; Multicenter Studies as Topic ; Workforce
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000005799
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Implementing an ICU registry in Ethiopia-Implications for critical care quality improvement.

    Sultan, Menbeu / Zewdie, Ayalew / Priyadarshani, Dilanthi / Hassen, Ephrem / Tilahun, Melkamu / Geremew, Tigist / Beane, Abi / Haniffa, Rashan / Berenholtz, Sean M / Checkley, William / Hansoti, Bhakti / Laytin, Adam D

    Journal of critical care

    2024  Volume 81, Page(s) 154525

    Abstract: Purpose: Intensive care units (ICUs) in low- and middle-income countries have high mortality rates, and clinical data are needed to guide quality improvement (QI) efforts. This study utilizes data from a validated ICU registry specially developed for ... ...

    Abstract Purpose: Intensive care units (ICUs) in low- and middle-income countries have high mortality rates, and clinical data are needed to guide quality improvement (QI) efforts. This study utilizes data from a validated ICU registry specially developed for resource-limited settings to identify evidence-based QI priorities for ICUs in Ethiopia.
    Materials and methods: A retrospective cohort analysis of data from two tertiary referral hospital ICUs in Addis Ababa, Ethiopia from July 2021-June 2022 was conducted to describe casemix, complications and outcomes and identify features associated with ICU mortality.
    Results: Among 496 patients, ICU mortality was 35.3%. The most common reasons for ICU admission were respiratory failure (24.0%), major head injury (17.5%) and sepsis/septic shock (13.3%). Complications occurred in 41.0% of patients. ICU mortality was higher among patients with respiratory failure (46.2%), sepsis (66.7%) and vasopressor requirements (70.5%), those admitted from the hospital ward (64.7%), and those experiencing major complications in the ICU (62.3%).
    Conclusions: In this study, ICU mortality was high, and complications were common and associated with increased mortality. ICU registries are invaluable tools to understand local casemix and clinical outcomes, especially in resource-limited settings. These findings provide a foundation for QI efforts and a baseline to evaluate their impact.
    MeSH term(s) Humans ; Retrospective Studies ; Quality Improvement ; Ethiopia/epidemiology ; Hospital Mortality ; Intensive Care Units ; Critical Care ; Shock, Septic ; Sepsis/epidemiology ; Sepsis/therapy ; Registries ; Respiratory Insufficiency
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2024.154525
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  8. Book: 3D animation

    Beane, Andy

    essentials

    2012  

    Author's details Andy Beane
    Language English
    Size XVI, 336 S., Ill., graph. Darst.
    Publisher John Wiley & Sons
    Publishing place Indianapolis, Ind
    Document type Book
    ISBN 9781118147481 ; 1118147480
    Database Former special subject collection: coastal and deep sea fishing

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  9. Article ; Online: Development and internal validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU).

    Haniffa, R / Beane, A / Baker, T / Riviello, E D / Schell, C O / Dondorp, A M

    Acta anaesthesiologica Scandinavica

    2018  Volume 62, Issue 3, Page(s) 407–408

    MeSH term(s) Hospital Mortality ; Intensive Care Units
    Language English
    Publishing date 2018-01-24
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80002-8
    ISSN 1399-6576 ; 0001-5172
    ISSN (online) 1399-6576
    ISSN 0001-5172
    DOI 10.1111/aas.13080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Critically ill COVID-19 patients in Africa: it is time for quality registry data.

    Pisani, Luigi / Waweru-Siika, Wangari / Sendagire, Cornelius / Beane, Abi / Haniffa, Rashan

    Lancet (London, England)

    2021  Volume 398, Issue 10299, Page(s) 485–486

    MeSH term(s) Africa ; COVID-19/therapy ; Critical Care ; Critical Illness ; Data Accuracy ; Humans ; Registries
    Language English
    Publishing date 2021-07-13
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)01549-X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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