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Critical Care Nurse

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https://www.readbyqxmd.com/read/30275070/congenital-cardiac-defects-that-are-borderline-candidates-for-biventricular-repair
#1
Megan Tracey
This article discusses congenital heart defects that are marginal candidates for biventricular repair and highlights the anatomic considerations upon which the surgical decision is based. Specifically, the article reviews the importance of capacitance and compliance of the ventricles and their associated atrioventricular valves. For each of the defects discussed, the imaging modalities used to diagnose a marginal ventricle are reviewed and the surgical decision-making process is outlined. The article also reviews immediate postoperative treatment of these patients and when to consider biventricular repair of a marginal lesion to be a failure...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275069/hyperlactatemia-and-patient-outcomes-after-pediatric-cardiac-surgery
#2
Lether Draben
Elevated serum lactate level, or hyperlactatemia, is often associated with alterations in tissue perfusion, increased risk for complications in the postoperative period, and patient mortality. Measuring lactate levels is a relatively simple and noninvasive method of obtaining useful data about an impending clinical deterioration in a seemingly hemodynamically stable patient. This article evaluates the current practice of measuring lactate levels in pediatric patients after cardiac surgery and the association between these levels and patient outcomes...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275068/accurate-dysrhythmia-monitoring-in-adults
#3
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275067/transitions-in-care-from-acute-care-telemetry-unit-to-home-an-evidence-based-quality-improvement-project
#4
Theresa M Soltis, Kerry A Milner, Denise Buonocore
No abstract text is available yet for this article.
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275066/mechanical-ventilator-modes
#5
REVIEW
John J Gallagher
No abstract text is available yet for this article.
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275065/value-the-journey
#6
Sara Knippa, Carol Ann Rauen, Liana Hochhalter, Ariana Barnes, Mary Kay Bader, Kristin Sollars, Marci Ebberts
No abstract text is available yet for this article.
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275064/automated-audiovisual-feedback-in-cardiopulmonary-resuscitation-training-improving-skills-in-pediatric-intensive-care-nurses
#7
Robert Bishop, Brian Joy, Melissa Moore-Clingenpeel, Tensing Maa
BACKGROUND: High-quality cardiopulmonary resuscitation is associated with improved survival and neurological outcomes after cardiac arrest. Unfortunately, health care professionals frequently do not perform resuscitation within guidelines after life-support training. OBJECTIVES: To determine if brief intermittent training in cardiopulmonary resuscitation could improve nurses' skills to perform high-quality resuscitation 70% or more of the time during 2 minutes of cardiopulmonary resuscitation after 3 training sessions...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275063/caring-for-pediatric-heart-failure-patients-with-long-term-mechanical-circulatory-support
#8
Kari Hyotala
Pediatric cardiac failure is a significant problem that may be caused by cardiomyopathy, myocarditis, or congenital defects that cannot be surgically repaired. Long-term mechanical circulatory support (LTMCS) devices provide hemodynamic support for patients in heart failure as a bridge to heart transplant and, sometimes, cardiac recovery or destination therapy. Critical care nurses must have a comprehensive understanding of LTMCS device function and keen assessment skills to detect signs of impaired perfusion and device failure...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275062/implementation-of-a-clinical-pathway-to-reduce-rates-of-postextubation-stridor
#9
Megan Lange, Neeraj Badjatia, Wan-Tsu Chang
BACKGROUND: Unsuccessful extubation is associated with increased intensive care unit and hospital length of stays, hospital costs, morbidity, and mortality. The most common cause of reintubation is laryngeal edema, often evidenced by postextubation stridor. OBJECTIVE: To reduce the rates of postextubation stridor and reintubation in the neurocritical care unit at a large urban academic medical center. METHODS: A clinical pathway was created to aid in detecting patients expected to experience postextubation stridor and to guide prophylactic treatment...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275061/the-intranasal-route-as-an-alternative-method-of-medication-administration
#10
Calvin Tucker, Lyn Tucker, Kyle Brown
Intranasal drug administration is a less invasive method of drug delivery that is easily accessible for adult and pediatric patients. Medications administered by the intranasal route have efficacy comparable to intravenous administration and typically have superior efficacy to subcutaneous or intramuscular routes. The intranasal route is beneficial in emergent situations when the intravenous route is not available. The intranasal route is safe and effective in various indications, and therapeutic systemic concentrations of medication can be attained via this route...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275060/in-hospital-initiation-of-guideline-directed-heart-failure-pharmacotherapy-to-improve-long-term-patient-adherence-and-outcomes
#11
Nancy M Albert, Marc J Kozinn
Heart failure is a burdensome cardiovascular condition associated with high rates of morbidity and mortality. The 3-month period after hospitalization is a vulnerable phase in which patients are at high risk for mortality and rehospitalization. To reduce risk during this period, patients with heart failure and reduced ejection fraction should receive guideline-directed pharmacological therapies-the right drugs at the right doses-before hospital discharge. Optimal pharmacotherapies for these patients include agents that suppress the renin-angiotensin-aldosterone system, suppress the sympathetic nervous system, enhance vasodilation, slow heart rate when needed, and reduce excess volume...
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30275059/have-you-found-your-voice
#12
EDITORIAL
Annette Bourgault
No abstract text is available yet for this article.
October 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068727/reducing-use-of-restraints-in-intensive-care-units-a-quality-improvement-project
#13
Dannette A Mitchell, Teresa Panchisin, Maureen A Seckel
BACKGROUND: Use of physical restrainst is scrutinized in intensive care units today. Usage rates for the 5 intensive care units in the Christiana Care Health Services, Newark, Delaware, were higher than the National Database of Nursing Quality Indicators mean rate of 9.61% to 15.43% for many months during fiscal years 2013 and 2014. OBJECTIVE: To reduce and sustain the restraint rates to less than the national database mean rates for all 5 intensive care units. METHODS: A quality improvement process was used that included forming a multiunit restraint collaborative; reviewing restraint data, including self-extubation rates; surveying staff nurses to examine alignment with evidence-based practice; and selecting a new restraint-alternative product...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068726/pediatric-delirium-in-the-cardiac-intensive-care-unit-identification-and-intervention
#14
Kristen J Bryant
Delirium is characterized by transient behavioral manifestations of acute brain disturbances. Delirium in the intensive care unit has been well researched and documented in the adult population. Pediatric delirium research has lagged, but recent developments in screening tools have shed light on the prevalence of delirium among children. The overall prevalence of delirium in the pediatric intensive care unit is 25%. A recent study showed a prevalence of 49% in the pediatric cardiac intensive care unit; this higher prevalence may be due to factors related to critical illness and the postoperative environment...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068725/ensuring-accurate-st-segment-monitoring
#15
(no author information available yet)
No abstract text is available yet for this article.
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068724/low-molecular-weight-heparin-for-prevention-of-central-venous-catheterization-related-thrombosis-in-children
#16
Sherrie Nameth
No abstract text is available yet for this article.
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068723/nursing-assessment-of-tissue-plasminogen-activator-for-pulmonary-embolism
#17
REVIEW
Melissa McLenon
No abstract text is available yet for this article.
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068722/batter-up
#18
Sara Knippa, Carol Ann Rauen, Tracey A Boyd, Cheryl Rader
No abstract text is available yet for this article.
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068721/overcoming-barriers-to-delirium-screening-in-the-pediatric-intensive-care-unit
#19
Gina M Rohlik, Karen R Fryer, Sandeep Tripathi, Julie M Duncan, Heather L Coon, Dipti R Padhya, Robert J Kahoud
BACKGROUND: Delirium is associated with poor outcomes in adults but is less extensively studied in children. OBJECTIVES: To describe a quality improvement initiative to implement delirium assessment in a pediatric intensive care unit and to identify barriers to delirium screening completion. METHODS: A survey identified perceived barriers to delirium assessment. Failure modes and effects analysis characterized factors likely to impede assessment...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068720/evaluation-of-user-interface-alert-displays-for-clinical-decision-support-systems-for-sepsis
#20
Devida Long, Muge Capan, Susan Mascioli, Danielle Weldon, Ryan Arnold, Kristen Miller
BACKGROUND: Hospitals are increasingly turning to clinical decision support systems for sepsis, a life-threatening illness, to provide patient-specific assessments and recommendations to aid in evidence-based clinical decision-making. Lack of guidelines on how to present alerts has impeded optimization of alerts, specifically, effective ways to differentiate alerts while highlighting important pieces of information to create a universal standard for health care providers. OBJECTIVE: To gain insight into clinical decision support systems-based alerts, specifically targeting nursing interventions for sepsis, with a focus on behaviors associated with and perceptions of alerts, as well as visual preferences...
August 2018: Critical Care Nurse
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