On Friday November 13th at 9:20 pm, three kamikaze bombs went off around the Stade de France a stadium in Saint-Denis just outside Paris, 4 different shootings took place and bombings in Paris and hundreds of people were held hostage in a theater.This multi-site terrorist attack was the first of this magnitude in France. Drawing the lessons of these attacks and those which occurred in other countries from a health perspective is essential to continuously adapt and improve the French response to possible future attacks. Several issues would need to be further explored: Management of uncertainties: When to trigger the plans: after the 1st attack, the 2nd? When do attacks end and when to release mobilized resources? Management of victims: How to ensure that all victims are secured or taken care of? How to provide assistance when attacks are ongoing? Management of teams: Proper follow-up of persons involved in the response: health professionals, police and firemen, emergency call centers but also civil servants within administration that contributed to the response. Communication: Reactivity of all is a key element to secure appropriate resource is mobilized for the response. All actors have to be able to communicate quickly in a secured way.

/pdf/french-ministry-of-health-s-response-to-paris-attacks-of-13-4r2393zmf9.pdf

French Ministry of Health’s response to Paris attacks of 13 November 2015

AIM: To evaluate the effect of blast injury on the otologic and hearing state over time. SETTING: Otology unit of a tertiary referral center. METHODS: Seventy-three patients aged 16 to 73 years who sustained physical trauma from an explosion underwent otologic and audiologic examination 3-4 months and one year later. RESULTS: At the first examination, high-frequency sensorineural hearing loss was detected in 57 patients (78%), mixed hearing loss in 13 (19%), and low-tone conductive hearing loss in two (3%). Conductive hearing loss had improved by one year, while the cochlear hearing loss, in most cases, did not. Only 7% of the patients with tinnitus reported improvement after one year. CONCLUSIONS: The permanent otologic damage caused by blast injury cannot be determined before one year after the traumatic event. Language: en

Otologic and audiologic lesions due to blast injury.

Aim
To study family satisfaction with care in an Intensive Care Unit (ICU) and its association with nursing workload estimated by the Nursing Activities Score (NAS).

Background
Few previous studies have investigated the association between workload in ICUs and family satisfaction.

Methods
Family Satisfaction ICU 24 (FS ICU-24) questionnaires were distributed to 161 family members (106 respondents). Questionnaires’ score, NAS measurements and Simplified Acute Physiology Score II (SAPS-II) data were analysed.

Results
The mean total level of family satisfaction was equal to 80.72% (±9.59). Family members were more satisfied with the level of care compared with decision making. NAS values revealed a shortage of nurses in the morning shift. Moreover, there was a statistically significant positive correlation between NAS and total satisfaction after adjusting for age, length of stay and SAPS-II.

Conclusions
Improvements in clinical practice require the measurement of care quality which particularly includes family satisfaction. Our results indicated that family members were less satisfied with decision making.

Implications for nursing management
Nurse managers should plan for the successful involvement of family members in the decision-making process. Higher levels of nurse staffing might improve the care provided.

Nursing Activities Score as a predictor of family satisfaction in an adult intensive care unit in Greece.

This study aimed to compare clinical characteristics, evolution and severity of adult patients admitted to public and private Intensive Care Units. It is a retrospective, longitudinal and quantitative analysis of 600 patients admitted to four Intensive Care Units of Sao Paulo, Brazil. Differences were found between patients admitted in private and public hospitals regarding the following variables: age, origin, length of stay and mortality in the critical unit, cardiologic, hematologic, neurologic and renal failures and some comorbidities. The results reveal the importance of analyzing in detail clinical characteristics and healthcare of patients admitted in public institutions, because of the high mortality found. The Intensive Care Nurse can contribute to change this scenario, because she/ he plays a leading role in planning and providing resources for intensive care. DESCRIPTORS: Public sector. Private sector. Intensive Care Units. Clinical evolution. Nursing.

/pdf/clinical-characteristics-and-severity-of-patients-admitted-2tm58mx2wn.pdf

Clinical characteristics and severity of patients admitted to public and private icus

Field triage in disasters.

The use of the vascular catheters is one of the most important and required interventions in ICUs One of these options is the peripherally inserted central catheter (PICC), which is inserted by habilitated nurses in patients who are in these conditions in the ICU

/pdf/peripherally-inserted-central-catheter-in-critically-ill-1zwvnho9pf.pdf

Peripherally inserted central catheter in critically ill patients

/pdf/risk-of-factors-for-readmission-in-the-intensive-care-unit-5ce0m8ffgf.pdf

Risk of factors for readmission in the intensive care unit

Although nosocomial infection rates are prospectively collected and widely known, little is known about compliance rates to preventive measures that are assumed to be implemented for nosocomial infection control. Monitoring and improving compliance rates to preventive measures can help maintain nosocomial infection rates within acceptable ranges and even prevent outbreaks.

/pdf/quality-improvement-tools-pdca-cycle-enhances-compliance-to-33ku3pxqk3.pdf

Quality improvement tools (PDCA cycle) enhances compliance to nosocomial infection preventive measures: experience of a medical-surgical ICU

The increasing costs of treatment in intensive care units (ICUs) and the need to use resources efficiently require adequacy between nursing staff and nursing workload, as a high cost is attributed to the nurse staff of ICUs. The intensity of the nursing work effort should be considered because staffing needs vary according to the amount of patients being cared for, as well as the type of care provided for each of those patients. As the intensity of the nursing work effort increases, the amount of nursing staff required to properly care for patients also increases.

/pdf/nursing-in-the-icu-comparison-of-the-nas-and-time-on-bedside-21njw4i65r.pdf

Nursing in the ICU: comparison of the NAS and time on bedside

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Papers

Peripherally inserted central catheter in critically ill patients

Risk of factors for readmission in the intensive care unit

Quality improvement tools (PDCA cycle) enhances compliance to nosocomial infection preventive measures: experience of a medical-surgical ICU

Nursing in the ICU: comparison of the NAS and time on bedside