Transition to a newly constructed single patient room adult intensive care unit - Clinicians' preparation and work experience.

PURPOSE: To describe how clinicians were prepared for the transition to a novel single patient room (SPR) intensive care unit (ICU) and their work experience during this transition. MATERIALS AND METHODS: In this qualitative descriptive study, four focus groups were conducted six months post-move with a multidisciplinary group of 29 clinicians at a hospital in Montreal, Canada. The interview guide was derived from a readiness for change conceptual framework. Audio recordings were transcribed verbatim and analyzed via thematic analysis. RESULTS: Clinicians described preparation strategies such as educational resources, managerial support and personal initiatives, with some variation across professions. Clinicians felt ready for the transition especially in their adaptation to the new physical environment, yet some challenges related to teamwork dynamics and bedside care persisted after the transition. CONCLUSIONS: The use of preparation strategies that are tailored to clinicians' roles helped build readiness for transition to a novel SPR ICU and facilitated the adaptation process. Challenges related to teamwork dynamics and practices in an isolating environment persisted beyond the adaptation period and must be addressed and overcome to better meet the needs and expectations of ICU clinicians.

Risk Factors and Best Practices for the Prevention of Post-Cardiac Surgery Surgical Site Infections in a Tertiary Care Centre.

BACKGROUND: Post-cardiac surgery surgical site infections (SSIs) pose devastating consequences in terms of morbidity and mortality to patients. OBJECTIVE: To examine current risk factors and best practice perioperative care for prevention of SSI following cardiac surgery through the lens of the demographic/clinical characteristics of patients who developed post-cardiac surgery SSIs at a major tertiary care institution, and to identify where documentation is lacking and could be improved to better serve clinical practice. METHODS: A literature review on post-cardiac surgery SSI prevention and risk factors was performed. These risk factors were examined through a retrospective chart review of the population of patients who developed SSIs during the study period. RESULTS: The study population was characterized by a high prevalence of riskfactors including age, diabetes, obesity, operative time, blood glucose control, surgical re-exploration, blood transfusions, and emergency context, as well as differences from best practice guidelines such as preoperative showering. Compared to other populations in the literature, several ofthese risk factors were more prevalent at the study site than in the other comparable populations. CONCLUSION: The patient population had a relatively high prevalence of riskfactors, and the care received by these patients varied in some ways from best practices. Using best practice guidelines, known risk factors, and the data specific to the institution can provide insightsfor analysis and practice improvement efforts in the form of identifying at-risk patients, improving adherence to best practice guidelines, targeting areas to focus care efforts, and improving clincal documentation.