The goal of this study was to explore the factors impacting on the well-being of ICU employees. The objectives of the study were: <ul> <li> To theoretically conceptualise the factors impacting on employees in a hospital ICU.</li> <li> To explore the role of personal factors such as personality, behaviour risks and resilience that impact on the well-being of ICU employees.</li> <li> To explore the organisational and work related factors that impinge on ICU employees and the impact these factors have on their well-being.</li> <li> To make recommendations regarding the implementation of proactive strategies.</li></ul> The research question of the qualitative study is: What are the factors impacting on the well-being of intensive care employees at the Chris Hani Baragwanath Hospital? This is an applied, qualitative research study. The research design used was a collective case study using focus group interviewing. The research study was conducted at Chris Hani Baragwanath Hospital Intensive Care Unit. The sample was selected using non-probability, purposive sampling. The sample consisted of ten doctors, thirteen nursing personnel and seven allied professionals (four physiotherapists and three dieticians). A pilot study was conducted with two doctors, two nurses and a social worker to test the interview schedule. This group did not form part of the sample. The researcher did her best to adhere to ethical considerations. Participants were informed of the nature of the research and completed informed consent forms. Anonymity was ensured through presenting responses collectively. No individual names or responses will be identified. A semi-structured interview schedule was used to collect data during focus group interviewing. The four focus group sessions were tape recorded. After completion of the focus group interviewing, the data was transcribed verbatim and then the data was organised into themes and sub-themes. The findings were released in a mini-dissertation. The report is accurate and reflects the true facts. All sources, references and assistance are acknowledged. The themes and sub-themes identified were: <ul> <li> Theme one: Job Satisfaction and sub-themes-Fulfilment, Meaning to Work, Emotions experienced, Changes healthcare workers would like implemented.</li> <li> Theme two: Stressors and sub-themes- What the stressors are, Control over the Stressors, Self-care techniques utilised, Personal Resources and Ways of de-stressing.</li> <li> Theme three: Trauma</li> <li> Theme four: Interpersonal Relationships and sub-themes- Connectivity amongst team, Impact connectivity has on functioning and Teamwork.</li> <li> Theme five: Role Demands and sub-themes- Job Description, Role Conflict and Balance between work and personal life.</li> <li> Theme six: Job Resources and sub-themes- Adequacy of resources, Resources Lacking and Impact job resources have on functioning.</li> <li> Theme seven: Job Conditions and sub-themes- Work Overload, Job Security and Working Conditions.</li></ul> The findings of the study were as follows: <ul> <li> CHBH employees experience high job satisfaction as they are doing what they want to do. They feel that they make a difference and enjoy trauma work. They are where things happen and where they want to be.</li> <li> The stressors faced by ICU employees can be divided into emotional and physical/resource stressors. The physical stressors were found to be: long working hours, lack of resources, untrained staff, budget, procuring equipment and resources, lack of human resources, equipment and linen shortages. The emotional stressors were related to having to deal with trauma and the impact thereof, dealing with death and dying, decisions regarding the switching off of life support machines, not always knowing if you did the right thing and wondering if you did everything you could for the patient to save their life.</li> <li> Daily, employees are faced with dealing with trauma and the impact thereof. This has an impact on well-being and can lead to compassion fatigue or soul weariness.</li> <li> It is important to examine the interplay of job resources and job demands. If job demands are high and job resources lacking, well-being is impacted. Job resources may buffer the impact of job demands and thus reduce burnout, exhaustion and increase motivation.</li> <li> If job demands are high and job resources low, job demands will exceed the individuals’ capacity to cope and overtax or stretch ability to cope. ICU employees experience being overstretched and overtaxed due to high job demands and being under-resourced. Work overload results in exhaustion.</li> <li> Relationships are an important aspect of organisational support. Employees value their relationships with colleagues and this provides opportunities for discussing patients, sharing knowledge and obtaining assistance with patient care. By pooling resources the team has additional resources to resolve complex situations.</li> <li> The working conditions of ICU employees are impacted by shortages in human and equipment resources.</li></ul> Recommendations arising from the study are: <ul> <li> A lifestyle and health management program dealing with issues of nutrition, exercise, relaxation, self awareness and disease management.</li> <li> An educative stress management program which is presented at induction and orientation.</li> <li> Preventative programs that enhance knowledge and skills on coping and self-care.</li> <li> Self awareness programs designed to assist employees in understanding their own stressors and reactions, enhance their self-esteem by developing strengths, resilience and coping.</li> <li> Human capital management- developing strategies to attract retain and reduce staff shortages.</li> <li> Facilities for exercise and relaxation- the provision of a gym facility.</li> <li> Program to reduce fatigue and recovery time.</li> <li> Group sessions focussing on catharsis and ventilation of feelings.</li> <li> A comprehensive Employee Wellness Program. </ul> / Dissertation (MSW)--University of Pretoria, 2010. / Social Work and Criminology / Unrestricted

Bakgrund: Intensivvårdssjuksköterskan har en central roll beträffande hantering av centralvenösa infarter och det infektionsförebyggande arbetet som medföljer dem. Nationella riktlinjer för centralvenösa infarter är byggda utifrån evidens och patientsäkerhet. Trots detta så brister följsamheten vilket kan leda till förlängd vårdtid, vårdlidande och ökade samhällskostnader. Vad dessa brister beror på valdes att undersökas, utifrån ett intensivvårdssjuksköterskeperspektiv. Syfte: Syftet med studien var att belysa intensivvårdssjuksköterskans upplevelser av följsamhet till nationella riktlinjer för hantering av centralvenösa infarter. Metod: En kvalitativ empirisk metod med induktiv ansats antogs. Nitton intensivvårdssjuksköterskor intervjuades och datamaterialet analyserades genom en manifest innehållsanalys. Resultat: Datamaterialet resulterade i tre kategorier; Tidens betydelse, Teamets betydelse och Den kliniska erfarenhetens betydelse. Det visar på vikten av intensivvårdssjuksköterskans evidensbaserade kunskap, kliniska blick och ansvarskänsla. Brister förekom när det var en fråga om tid, icke fungerande teamarbete och när intensivvårdssjuksköterskan inte höll sig uppdaterad med ny evidensbaserad kunskap. Slutsats: Organisatorisk förändring krävs för att ge intensivvårdssjuksköterskan tid att se hela patientens behov och möjlighet att uppsöka ny evidens vilket kan ha inflytande på hela teamets arbete kring intensivvårdspatienten. En förbättrad följsamhet till nationella riktlinjer leder till en ökad patientsäkerhet och ett minskat vårdlidande för patienten. / Background: The ICU nurse has a central role when it comes to the management of central venous catheters and the prevention of central line associated blood stream infections. National guidelines for central venous catheters are established from evidence and patient safety. Despite this fact there is a lack of compliance with guidelines which can lead to a prolonged hospital stay, patient suffering and an increased cost societally. To find out the causes of lack of compliance was the basis for this study, from the perspective of the ICU nurse. Aim: The aim of the study was to highlight the ICU nurse’s experiences of compliance to national guidelines for central venous catheters. Method: A qualitative empirical method with an inductive approach was adopted. Nineteen intensive care nurses were interviewed and the data was analyzed through a manifest content analysis. Results: The collected data resulted in three categories; The importance of time, The importance of working as a team and The importance of clinical experience. It presents the significance of the ICU nurse’s evidence-based knowledge, experience and sense of responsibility. Lack of compliance occurred when there was a time pressure, the team did not function properly and when the ICU nurse did not stay up to date with new evidence-based knowledge. Conclusion: Organizational change is required to give the ICU nurse time to be able to see all the needs of the patient and the opportunity to seek new evidence and thereby improve compliance to national guidelines. An increased opportunity for knowledge development for the ICU nurse can have an impact on the entire team working with the intensive care patient. Improved compliance to national guidelines leads to increased patient safety and reduces patient suffering.

Bakgrund: Varje år vårdas en mängd barn på allmänna intensivvårdsavdelningar i Sverige, där den allra största delen av patienterna är vuxna. Intensivvårdssjuksköterskan ska kunna vårda alla patienter med svikt i ett eller flera organ oavsett ålder och diagnos, samt vara beredd på snabba förändringar i patientens tillstånd. Det kan vara en ovan situation för intensivvårdssjuksköterskan att vårda barn. Vården av barn och vuxna skiljer sig åt på många sätt, vilket kan orsaka känslor av osäkerhet och stress hos intensivvårdssjuksköterskan. Barn som intensivvårdas har alltid familjen i sin närhet. Samspelet med barn och familj är en förutsättning för att vården ska fungera på bästa sätt.  Syfte: Syftet med studien var att beskriva intensivvårdssjuksköterskors upplevelser av att vårda barn och deras familjer på allmän intensivvårdsavdelning. Metod: En kvalitativ intervjustudie. Semistrukturerade intervjuer genomfördes med 12 intensivvårdssjuksköterskor. Kvalitativ innehållsanalys användes för att analysera data.  Resultat: Analysen resulterade i fyra generiska kategorier: Att vårda barn är en ovan situation för intensivvårdssjuksköterskor, Familjen ses som en resurs, Att arbeta tillsammans med familjen mot samma mål samt Kunskap och erfarenhet har betydelse för intensivvårdssjuksköterskors upplevelse av att vårda barn. Tillsammans bildade de en huvudkategori: Kunskap och erfarenhet hos intensivvårdssjuksköterskan kan bidra till ökat fokus på familjen Slutsats: Resultatet visar en osäkerhet och rädsla hos intensivvårdssjuksköterskor som vårdar barn och deras familjer på allmän intensivvårdsavdelning. Osäkerheten grundar sig i en känsla av brist på kunskap och erfarenhet. Resultatet visar också att intensivvårdssjuksköterskor ser barnets familj som en viktig resurs i vården av barnet. Intensivvårdssjuksköterskans osäkerhet brist på kunskap kan ta den tid i anspråk som kunde ha lagts på samspelet med barnet och dess familj. Utbildning och praktisk träning efterfrågas. / Background: In Sweden, a lot of children every year are cared for in general intensive care units where the most part of the patients are adults. The intensive care nurses are supposed to be able to care for every patient with failure of one or several organs regardless of age or diagnosis, as well as be prepared for rapid change in the patient’s condition. It can be an anusual situation for the intensive care nurse to care for children. Caring for children and adults differs in many different ways, which can lead to the intensive care nurse feeling insecure and stressed. A child in need of intensive care has always got their family nearby. The interplay with the child and its family is important to achieve the best possible care.  Aim: The aim of the study was to describe intensive care nurses' experiences of caring for children and their families in the general intensive care unit. Method: A qualitative interview study. Semi-structured interviews with 12 intensive care nurses were conducted. Qualitative content analysis was used to analyse data.  Results: The analysis resulted in four generic categories: Caring for children is an unusual situation for intensive care nurses, Family is seen as a resource, To work with the family towards the same goal and Knowledge and experience are important for intensive care nurses´ experience of caring for children. Together they formed a main category: Knowledge and experience can contribute to increased family focus.  Conclusions: The result shows insecurity and fear among intensive care nurses who care for children and their families in a general intensive care unit. The insecurity is based on a feeling of lack of knowledge and experience. The result also shows that intensive care nurses sees the family of the child as an important resource in the child's care. The insecurity of the intensive care nurse and the lack of knowledge can take time that could have been spent on interaction with the child and their family. Education and practical training are requested.

Bakgrund: En intensivvårdsavdelning vårdar de allra sjukaste patienterna, som på grund av sjukdomens svårighetsgrad inte kan vårdas på en vårdavdelning. Den avancerade och högteknologiska miljön är för många människor främmande och skrämmande och kan i kombination med att behöva bekanta sig med tanken på att patienten kan avlida kan upplevas påfrestande för närstående. Med närstående menas de personer som patienten uppger som sina närmaste. I Sverige tillämpas nationellt vårdprogram utvecklat av Socialstyrelsen, där närståendestöd utgör en viktig del.  I och med covid19-pandemin har ett behov uppstått att vårda i livets slut, särskilt inom intensivvård där många svårt sjuka i Covid-19 vårdas. Intensivvårdssjuksköterskan ska kunna bemöta sorg, ge stöd samt delge närstående information om vård i livets slut. Syfte: Att beskriva närståendes upplevelser av vård i livets slut på en intensivvårdsavdelning. Metod: Systematisk litteraturstudie med induktiv ansats. Den insamlade datan har analyserats med hjälp av kvalitativ innehållsanalys. Resultat: Studiens resultat genererade fyra kategorier: Kommunikation, Viljan att få vara delaktig, Att få rätt stöd i en svår situation samt En vårdmiljö som påverkar. Slutsats: Närståendes upplevelser av vård i livets slut handlar om den högteknologiska miljön som deras närstående vårdas i, men också om kommunikation och stöd från vårdpersonal samt sin egen delaktighet. Närstående önskar tydlig och ärlig kommunikation, erbjudas att vara delaktiga i beslut och omvårdnad, förstå den högteknologiska miljön samt erbjudas stöttning både andligt och emotionellt. / Background: An intensive care unit cares for the most ill patients, who due to the severity of the disease cannot be cared for in a regular hospital ward. The advanced and high-tech environment is foreign and sometimes frightening to many people and in combination with getting aware of the fact that the patient may die can be experienced as stressful for the next of kin. By next of kin means the persons whom the patient states as their nearest and dearest. In Sweden, a national care program developed by the National Board of Health and Welfare is applied, where support for the next of kin is an important part. Due to the Covid-19 pandemic, a need to provide care at the end-of-life has increased, especially in intensive care units where many seriously ill people in Covid-19 are cared for. The intensive care nurse must be able to respond to grief, provide support and provide next of kin with information about care at the end of life. Aim: To describe next of kin’s experiences of end-of-life care in an intensive care unit.  Method: Systematic literature review with an inductive approach. The collected data of this study has been analyzed using qualitative content analysis. Results: This study generated four categories: Communication, willingly to participate, To get support in a demanding situation and A caring environment that effects. Conclusion: Relatives' experiences of end-of-life care are about the high-tech environment in which their relatives are cared for, but also about communication, support from caring staff and family members own participation. Relatives want clear and honest communication. Family members wants to be offered to be involved in decisions and care, understand the high-tech environment and are offered support both spiritually and emotionally.

Bakgrund: COVID-19 är ett coronavirus som identifierades hos patienter med oförklarlig lunginflammation i Kina i december 2019. Sedan början av pandemin har operationsavdelningar i Sverige stängts till förmån för särskilda COVID-IVA. Anestesisjuksköterskor har flyttats från sina ordinarie arbetsplatser för att hjälpa till och stötta arbetet. Inga tidigare studier finns om anestesisjuksköterskors upplevelse av att vårda patienter med COVID-19. Syfte: Att undersöka anestesisjuksköterskors upplevelser av att vårda patienter med COVID-19 på COVID-IVA. Metod: Semistrukturerade intervjuer genomfördes med 10 anestesisjuksköterskor på ett mellanstort sjukhus i södra Sverige. Datamaterialet analyserades utifrån en kvalitativ innehållsanalys. Resultat: Anestesisjuksköterskorna kände oro inför första arbetsdagen på COVID-IVA. De kom dock snabbt in i arbetsuppgifterna och det skapade trygghet. Att inte få använda sin erfarenhet till fullo var negativt men att slippa patientansvar upplevdes positivt. Arbetet på COVID-IVA var påfrestande gällande både arbetsmiljön och privatlivet. Slutsats: Anestesisjuksköterskorna upplevde blandade känslor inför arbetet på COVID-IVA. Det fanns en oro över tillgången till skyddsutrustning. Flera trivdes ej med arbetsuppgifterna och ville inte arbeta på COVID-IVA ”för alltid”. Arbetet på COVID-IVA utvecklade dem personligen men inte inom yrkesprofessionen. Man var beroende av sina kollegor i teamet för att klara av att ta hand om patienterna. Känslan av att vara behjälplig, att känna sig uppskattad och värdefull bidrog till upplevelsen av att känna sig behövd. Arbetsmiljön på COVID-IVA upplevdes dålig då den var påfrestande gällande både arbetstempo och arbetsbelastning. De flesta anestesisjuksköterskor var ej nöjda över att behöva arbeta på COVID-IVA men flera uppgav att stämningen på COVID-IVA ändå var god. / Background: COVID-19 is a coronavirus that was identified in patients with unexplained pneumonia in China in December 2019. Since the beginning of the pandemic, operating wards in Sweden have been closed in favor of special COVID-ICU’s. Nurse anesthetists have been moved from their regular workplaces to help and support the work. There are no previous studies on nurse anesthetists’ experience of caring for patients with COVID-19. Aim: To explore nurse anesthetists’ experiences of caring for patients with COVID-19 at COVID-ICU. Method: Semi-structured interviews were conducted with 10 nurse anesthetists at a medium-sized hospital in southern Sweden. The data material was analyzed on the basis of a qualitative content analysis. Results: The nurse anesthetists felt anxious before their first working day at COVID-ICU. However, they quickly got into the tasks and it created safety. Not being able to use their experience to the full was negative but avoiding patient responsibility was experienced as positive. The work at COVID-ICU was stressful regarding both the work environment and private life. Conclusion: The nurse anesthetists experienced mixed feelings before working in COVID-ICU. There was concern about the availability of personal protective equipment. Many did not like the tasks and did not want to work at COVID-ICU "forever". The work at COVID-ICU developed them personally but not in their professional profession. They were dependent on their colleagues in the team to be able to care for the patients. Feeling appreciated and valuable contributed to the experience of feeling needed. The work environment in COVID-ICU was perceived as poor as it was stressful in terms of both work pace and workload. Despite the fact that most nurse anesthetists were not satisfied with having to work at COVID-ICU, several stated that the atmosphere in COVID-ICU was still good.

Bakgrund: Utvecklingen av intensivvården har under de senaste åren lett till att antalet personer som överlever intensivvården har ökat. Över hälften av alla överlevare drabbas av olika komplikationer i efterförloppet som kräver behandling och rehabilitering. Kunskapen om detta är av betydelse för sjuksköterskan för att förstå vikten av personcentrerad vård efter intensivvårdsbehandling. Syfte: Syftet med litteraturstudien var att sammanställa intensivvårdsbehandlade patienters upplevelser av efterförloppet. Metod: En kvalitativ litteraturstudie med induktivt förhållningssätt. Databaserna PubMed, Cinahl och SveMed+ användes för att ta fram material för studien. En kvalitetsgranskning av studierna utfördes med SBU:s granskningsmall för kvalitativa studier. Resultat: Resultatet redovisas utifrån sex kategorier: fysisk, psykisk och kognitiv påverkan, en lång återhämtningsprocess, behov av stöd från närstående, behov av omvårdnad, behov av hanteringsstrategier och förändringar av livet. Konklusion: Studiens resultat skildrar de intensivvårdsbehandlade patienternas olika upplevelser i efterförloppet. Patienterna upplevde att deras behov inte blev tillgodosedda samt att tillgången till och kvaliteten på den uppföljande vården var begränsad. De upplevde även en brist på information om vad tiden efter intensivvårdsbehandlingen skulle innebära. Den uppföljande vården har utvecklats under den senaste tiden, men behöver fortsatt utveckling för att kunna tillgodose behoven hos denna patientgrupp. / Background: The development of intensive care during the latest years have led to increasing numbers of ICU survivors. More than half of all survivors are affected by different complications after intensive care treatment that needs treatment and rehabilitation. This knowledge is of meaning for the nurse to understand the importance of person-centred care after intensive care treatment. Aim: The aim of the study was to compile patients’ experiences of recovery after intensive care treatment. Method: A literature review with a qualitative approach was used. Literature searches were performed in the databases PubMed, Cinahl and SveMed+. The quality of the selected studies was assessed using SBU’s review tamplet for qualitative studies. Results: The results are reported based on six categories: physical, mental, and cognitive impact, a long recovery-process, need for support from family and friends, need for care, need for coping strategies and changes in life. Conclusion: The results of the study describes the patients´ different experiences during the recovery from intensive care treatment. The patients experienced that their needs weren´t fullfilled and that the availability and quality of the follow-up care was limited. They also experienced that there was a lack of information about the recovery. The follow-up care has developed during the recent years, but it needs further development to be able to meet the needs of this group of patients.

Contexte: L’utilisation efficiente des ressources en soins intensifs représente un défi potentiellement surmontable dans un contexte de régionalisation des services. Conséquemment, il importe de convenir de critères homogènes et transparents permettant de trier et de transporter les patients là où ils peuvent recevoir les soins nécessaires à leur condition. Objectif: L’objectif principal de cette étude est d’identifier et d’évaluer les publications définissant les critères utilisés pour prioriser ou refuser une admission aux soins intensifs. Méthodes: Nous avons entrepris une revue systématique en accord avec les lignes directrices PRISMA. Nous avons identifié tous les articles pertinents publiés jusqu’au 8 novembre 2016 au moyen des bases de données PubMed, Embase, Medline, EBM Reviews, CINAHL Complete, les bases de données recensant la littérature grise ainsi qu’en effectuant une revue manuelle d’articles supplémentaires. Nous avons ensuite évalué la qualité des articles retenus selon une échelle d’appréciation que nous avons développée. Finalement, nous avons extrait puis évalué chaque critère individuel en plus de les regrouper par thème. Résultats: L’étude nous a permis d’identifier 5818 abrégés. Nous avons révisé 416 articles exhaustivement pour en retenir 129 qui correspondent aux critères d’inclusion. Il s’agit d’articles de recherche originale (34%), de lignes directrices (26 %) ou de revues de la littérature (21 %). Nous avons extrait 200 critères de triage et de transport au sein des 129 articles. Ceux-ci proviennent surtout des États-Unis (43 %) et privilégient un mécanisme d’exclusion (71 %) plutôt que de priorisation (17 %) des clientèles. Peu d’articles abordent les critères de transport (4 %). Nous avons classifié les critères selon qu’ils soient reliés à l’un ou l’autre des quatre thèmes qui ont émergé de notre analyse : au patient; à la condition clinique; au médecin qui évalue le cas; ou au contexte. Le critère le plus fréquemment cité est celui de la préférence du patient suivi de l’évaluation du médecin. Conclusion: Une revue systématique a permis de générer une liste de 200 critères utilisés pour prioriser ou exclure certains types de patients dans un état critique. Malgré les limites de notre étude, celle-ci peut permettre aux cliniciens et aux preneurs de décision de concevoir des politiques de triage et d’admission au niveau local, régional ou national. De plus, l’étude identifie des champs de recherche potentiels où le développement de critères spécifiques et mesurables pourrait contribuer au développement de lignes directrices diminuant la variabilité dans les pratiques et améliorant le processus d’admission aux soins intensifs. / Context: Intensive care bed unavailability negatively affects patients' outcomes. Strategies that reduce inefficient use of resources and reduce unavailability may increase quality and accessibility of critical care. As advocacy for regionalization of critical care resources increases, there is a need for agreed triage and transport criteria. However, outside of the trauma population, such agreed criteria and recommendations are lacking. Objective: We aimed to identify and appraise articles defining criteria used to prioritize or withhold a critical care admission. Methods: We undertook a systematic review according to PRISMA guidelines. Relevant articles were identified through searches of PubMed, Embase, Medline, EBM Reviews, CINAHL Complete from inception until November 8th, 2016. We also undertook searches through gray literature as well as a manual review of references. We then assessed the quality of identified articles through an appraisal scale we developed. Finally, we extracted and evaluated all criteria within the articles and grouped them by theme. Results: A total of 5818 abstracts were identified. After screening, we reviewed 416 articles in full and 129 articles met study criteria. These articles were mainly original research (34%), guidelines (26%) and reviews (21%). Amongst them, we identified 200 unique triage and transport criteria. Most articles were published in the United States (43%) and highlighted exclusion criteria (71%) rather than a prioritization mechanism (17%). Very few articles pertained to transport of critically ill patients (4%). We classified criteria as they related to one of four emerging themes: patient, condition, physician and context. The most commonly found triage criteria was patient preference followed by physician’s assessment that the patient was too well to benefit from ICU admission. Conclusion: A systematic review aimed at identifying triage and transport criteria used to prioritize or exclude certain patient populations under different settings helped to generate a list of 200 criteria classified within 4 themes. Despite its limitations, this study may help clinicians and decision makers devise local, regional or national ICU triage criteria. It also identifies gaps in knowledge where future clinical research yielding specific and measurable criteria tailored to clearly defined patient populations may help to decrease ICU triage variability.

No description available.

The purpose of this review of literature is to explore the effects of interventional and environmental auditory stimuli on the adult critical care population. Current research has yet to compare and contrast the effectiveness of various interventional auditory stimuli on stress relief, an oversight this thesis aims to remedy. Modern day critical care settings demand the identification of the most therapeutic interventional auditory stimulus and the most stress-inducing environmental stimuli, so that interventions can be made to optimize patient stress levels and improve outcomes. Suggestions will be made on how to simultaneously reduce harmful or stress inducing auditory stimuli in the critical care setting and implement the optimal stress-relieving interventional auditory stimuli.

The purpose of this review of literature is to investigate the various roles of video surveillance (VS) in the hospital's intensive care unit (ICU) as well as its legal and ethical implications. Today, hospitals spend more money on the ICU than on any other unit. By 2030, the population of those 65 and over is expected to double. 80% of older adults have at least one chronic diseases (Centers for Disease Control and Prevention, 2013). As a consequence, the demand for ICU services will likely increase, which may burden hospital with additional costs. Because of increasing economic pressures, more hospitals are using video surveillance to enhance quality care and reduce ICU costs (Goran, 2012). Research shows that VS enhances positive outcomes among patients and best practice compliance among hospital staff. The results are fewer reports of patient complications and days spent in the ICU, and an increase in reported hospital savings. In addition, VS is becoming an important tool for the families of newborns in the neonatal ICU (NICU). The belief is that the VS can facilitate parent-baby bonding. In the United States of America, privacy rights impose legal restrictions on VS. These rights come from the U.S. Constitution, Statutory law, Regulatory law, and State law. HIPPA authorizes the patient to control the use and disclosure of his or her health information. Accordingly, hospitals are under obligation to inform patients on their right to protected health information. It is appropriate that hospitals use VS for diagnostic purposes as long as they have obtained patient consent. According to modern day privacy experts Charles Fried and Alan Westin, a violation of a person's privacy equates a violation on their liberty and morality. However, if a physician suspects that a third party person is causing harm to the patient, than the use of covert VS is justifiable.