Meng, Lesley and Laudanski, Krzysztof and Restrepo, Mariana and Huffenberger, Ann and Terwiesch, Christian (2021) The Impact of Delayed Symptomatic Treatment Implementation in the Intensive Care Unit. Healthcare, 10 (1). p. 35. ISSN 2227-9032
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Abstract
We estimated the harm related to medication delivery delays across 12,474 medication administration instances in an intensive care unit using retrospective data in a large urban academic medical center between 2012 and 2015. We leveraged an instrumental variables (IV) approach that addresses unobserved confounds in this setting. We focused on nurse shift changes as disruptors of timely medication (vasodilators, antipyretics, and bronchodilators) delivery to estimate the impact of delay. The average delay around a nurse shift change was 60.8 min (p < 0.001) for antipyretics, 39.5 min (p < 0.001) for bronchodilators, and 57.1 min (p < 0.001) for vasodilators. This delay can increase the odds of developing a fever by 32.94%, tachypnea by 79.5%, and hypertension by 134%, respectively. Compared to estimates generated by a naïve regression approach, our IV estimates tend to be higher, suggesting the existence of a bias from providers prioritizing more critical patients.
Item Type: | Article |
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Uncontrolled Keywords: | critical care patient management; intensive care unit operations; medication delay; patient health measurement; quality of health care; empirical analysis; instrumental variables |
Subjects: | Eurolib Press > Medical Science |
Depositing User: | Managing Editor |
Date Deposited: | 10 Nov 2022 05:32 |
Last Modified: | 27 Dec 2023 05:58 |
URI: | http://info.submit4journal.com/id/eprint/87 |