Over the past 15 years, an increasing number of elderly patients were admitted to our ICU. The incidence of nosocomial bloodstream infection is lower among very old ICU patients when compared to middle-aged and old patients. Yet, the adverse impact of this infection is higher in very old patients.

The Intensive Care Unit is a data intensive environment where large volumes of patient monitoring and observational data are daily generated. Today, there is a lack of an integrated clinical platform for automated decision support and analysis. Despite the potential of electronic records for infection surveillance and antibiotic management, different parts of the clinical data are stored across databases in their own formats with specific parameters, making access to all data a complex and time-consuming challenge. Moreover, the motivation behind physicians' therapy decisions is currently not captured in existing information systems. The COSARA research project offers automated data integration and services for infection control and antibiotic management for Ghent University Hospital. The platform not only gathers and integrates all relevant data, it also presents the information visually at the point of care. In this paper, we describe the design and value of COSARA for clinical treatment and infectious diseases monitoring. On the one hand, this platform can facilitate daily bedside follow-up of infections, antibiotic therapies and clinical decisions for the individual patient, while on the other hand, the platform serves as management view for infection surveillance and care quality improvement within the complete ICU ward. It is shown that COSARA is valuable for registration, real-time presentation and management of infection-related and antibiotics data.

This retrospective study suggests that serum urea concentration and serum urea concentration cut-offs at time of initiation of RRT have no predictive value for in-hospital mortality in ICU patients with AKI.

BackgroundInformation technology (IT) may improve the quality, safety and efficiency of medicine, and is especially useful in intensive Care Units (ICUs) as these are extremely data-rich environments with round-the-clock changing parameters. However, data regarding the implementation rates of IT in ICUs are scarce, and restricted to non-European countries. The current paper aims to provide relevant information regarding implementation of IT in Flemish ICU's (Flanders, Belgium).MethodsThe current study is based on two separate but complementary surveys conducted in the region of Flanders (Belgium): a written questionnaire in 2005 followed by a telephone survey in October 2008. We have evaluated the actual health IT adoption rate, as well as its evolution over a 3-year time frame. In addition, we documented the main benefits and obstacles for taking the decision to implement an Intensive Care Information System (ICIS).ResultsCurrently, the computerized display of laboratory and radiology results is almost omnipresent in Flemish ICUs, (100% and 93.5%, respectively), but the computerized physician order entry (CPOE) of these examinations is rarely used. Sixty-five % of Flemish ICUs use an electronic patient record, 41.3% use CPOE for medication prescriptions, and 27% use computerized medication administration recording. The implementation rate of a dedicated ICIS has doubled over the last 3 years from 9.3% to 19%, and another 31.7% have plans to implement an ICIS within the next 3 years. Half of the tertiary non-academic hospitals and all university hospitals have implemented an ICIS, general hospitals are lagging behind with 8% implementation, however. The main reasons for postponing ICIS implementation are: (i) the substantial initial investment costs, (ii) integration problems with the hospital information system, (iii) concerns about user-friendly interfaces, (iv) the need for dedicated personnel and (v) the questionable cost-benefit ratio.ConclusionsMost ICUs in Flanders use hospital IT systems such as computerized laboratory and radiology displays. The adoption rate of ICISs has doubled over the last 3 years but is still surprisingly low, especially in general hospitals. The major reason for not implementing an ICIS is the substantial financial cost, together with the lack of arguments to ensure the cost/benefit.

No abstract

No abstract

No abstract

No abstract