A5084755393- Family and Patient Care in Intensive Care Units
- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Healthcare Decision-Making and Restraints
- Intensive Care Unit Cognitive Disorders
- Urinary Bladder and Prostate Research
- Palliative Care and End-of-Life Issues
- Tracheal and airway disorders
- Dysphagia Assessment and Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Sepsis Diagnosis and Treatment
- Urinary Tract Infections Management
- Frailty in Older Adults
- Hemodynamic Monitoring and Therapy
- Heart Failure Treatment and Management
- Central Venous Catheters and Hemodialysis
- Cerebrospinal fluid and hydrocephalus
- Healthcare Technology and Patient Monitoring
- Esophageal and GI Pathology
- Traumatic Brain Injury and Neurovascular Disturbances
- Neurological Disorders and Treatments
- Pelvic floor disorders treatments
- Emergency and Acute Care Studies
- Childhood Cancer Survivors' Quality of Life
- Diabetic Foot Ulcer Assessment and Management
UF Health Shands Hospital
2013-2025
University of Florida Health
2017-2024
University of Florida
2013-2021
University of Florida Health Science Center
2017-2020
Vanderbilt University
2013
Harvard University
2013
Hester
2013
Office of Patient Care Services
2012
The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit mobility protocols. Currently no study has investigated role increased in neurointensive population. This was a single-institution prospective intervention trial to investigate effectiveness among patients.All admitted tertiary center over 16-month period (April 2010 through July 2011) were evaluated. consisted...
Background and Purpose— Dysphagia can lead to pneumonia subsequent death after acute stroke. However, no prospective study has demonstrated reduced prevalence implementation of a dysphagia screen. Methods— We performed single-center interrupted time series trial quality initiative improve screening. Subjects included all patients with ischemic or hemorrhagic stroke admitted our institution over 42 months 31-month (n=1686) preintervention an 11-month (n=648) postintervention period. The...
BACKGROUND: Mobile stroke units, also sometimes called Stroke Treatment Units (MSTUs) are changing the paradigm of acute care and considered to be an extension time is brain concept. Of <20 active Programs in United States, most rooted urban settings. In July 2023, first MSTU Florida was launched Alachua County, implementing a unique innovative rendezvous process with rural emergency medical services (EMS). We compared outcome metrics between MSTU, including patients, standard EMS...
Object To date, there has been a shortage of evidence-based quality improvement initiatives that have shown positive outcomes in the neurosurgical patient population. A single-institution prospective intervention trial with continuous feedback was conducted to investigate implementation urinary tract infection (UTI) prevention bundle decrease catheter-associated UTI rate. Methods All patients admitted adult neurological intensive care unit (neuro ICU) during 30-month period were included....
To investigate a progressive mobility program in neurocritical care population with the hypothesis that benefits and outcomes of (e.g., decreased length stay) would have significant positive economic impact.Retrospective analysis clinical outcome data before, immediately following, 2 years after implementation Progressive Upright Mobility Protocol Plus (UF Health Shands Hospital, Gainesville, FL) involving series planned movements sequential manner an additional six levels rehabilitation...
OBJECTIVES: To determine the performance of Modified Early Warning Score and Score-Sepsis Recognition to predict sepsis, morbidity, mortality in neurocritically ill patients. DESIGN: Retrospective cohort study. SETTING: Single tertiary-care academic medical center. PATIENTS: Consecutive adult patients admitted neuro-ICU from January 2013 December 2016. INTERVENTIONS: Observational MEASUREMENTS AND MAIN RESULTS: Baseline clinical characteristics, infections/sepsis, neurologic worsening, were...
Background: Delivery of palliative care in neurointensive units (neuro-ICUs) can be inconsistent, often due to absence formal triggers. The Care and Communication Bundle (CCB) Quality Indicators provides a standardized process deliver effective services ICUs, but application these indicators this setting has not yet been systemically assessed. Objectives: To evaluate the fit CCB neuro-ICU through novel scoring system identify barriers adherence. Design: standards for were delineated....
BACKGROUND: Stroke is a medical emergency requiring timely intervention to optimize patient outcomes. The only treatments currently Food and Drug Administration approved for acute stroke are intravenous (IV) thrombolytics, which require obtaining specific history be administered safely. This may overlooked in the prehospital setting or lost during handoff between services (EMS) personnel hospital staff, delaying treatment. We evaluated whether utilization of "stroke alert sticker" by EMS...
Decades of advancements in critical care medicine have led to dramatic mortality and morbidity reductions intensive units (ICU). Unfortunately, significant advances neuromuscular neurocognitive functional recovery lagged behind [1], despite broad evidence demonstrating that patients who survive admissions may long-term function declines, increased [2]. Early mobility programs (EMP) been shown improve patient clinical outcomes; however, a lack associated with financial outcomes has served...
Introduction: Emergency Department Length of Stay (EDLOS) impacts outcomes critically ill intracerebral hemorrhage (ICH) patients with the risk dying while hospitalized increasing 40% when an intensive care unit (ICU) bed is delayed beyond 4h. The NINDS recommends admission to destination within 3 hours hospital arrival; however, EDLOS for ICH spans about 5 a wide variation. To expedite patient admission, we developed standardized triage pathway (NeuroICU-FastTrack). In this study, evaluated...
Introduction Large vessel occlusion (LVO) strokes represent a critical medical emergency requiring prompt intervention to minimize neurological damage and improve patient outcomes. Traditionally, patients with LVO are taken the Emergency Department (ED) via standard Medical Services (EMS) before undergoing endovascular mechanical thrombectomy (MT). However, some Mobile Stroke Treatment Units (MSTUs) introducing an alternative pathway for rapid, pre‐hospital care by taking directly Operating...
Introduction: Stroke is a medical emergency requiring timely intervention to optimize patient outcomes. Intravenous (IV) thrombolytics, the only treatment currently FDA-approved for acute stroke, require pertinent history decisions. Key details are often missed in prehospital setting and during hand-off communication between Emergency Medical Services (EMS) hospital staff, which can delay time treatment. We evaluated if utilization of ‘stroke alert sticker’ by EMS capture standardized...
BACKGROUND AND PURPOSE: Dysphagia can lead to pneumonia and subsequent death following acute stroke. However, no prospective study has demonstrated reduces rates after implementation of a dysphagia screen. METHODS: This was single-center interrupted time series trial screening quality initiative. Subjects included all ischemic or hemorrhagic strokes over 42-month period with 31-month (n=1686) pre-intervention an 11-month (n=648) post intervention period. The multifaceted interdepartmental...
Postdischarge patient calls are an effective intervention to decrease unplanned readmissions. Despite its efficacy, time consuming and compete with other clinical obligations. The purpose of this study was evaluate the viability intern-led quality improvement (QI) on conducting initial postdischarge filter patients who require or nurse follow-up.QI interns from academic medical center's QI program completed within 72 hours discharge a neurosurgery service between June 2018 July 2019....