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Critical Care Nurse

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https://www.readbyqxmd.com/read/30068727/reducing-use-of-restraints-in-intensive-care-units-a-quality-improvement-project
#1
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
#2
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
#3
(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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/30068719/quiet-time-a-noise-reduction-initiative-in-a-neurosurgical-intensive-care-unit
#9
Danielle Goeren, Sherley John, Katie Meskill, Laura Iacono, Stacy Wahl, Kerri Scanlon
BACKGROUND: High noise levels in intensive care units are common. Increased noise levels can lead to sleep deprivation, increased pain perception, and delirium. The most common cause of reducible noise in intensive care units often is attributed to staff conversations. OBJECTIVES: In January 2015, the neurosurgical intensive care unit staff identified noise as a problem, referencing complaints from other disciplines and family members. Quiet times from 3 am to 5 am and from 3 pm to 5 pm were agreed upon...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068718/the-patient-s-perspective-of-the-intensive-care-unit-diary-in-the-cardiac-intensive-care-unit
#10
Sharon A Levine, Karen M Reilly, Melanie M Nedder, Kathleen Ryan Avery
BACKGROUND: Many patients who survive an intensive care unit admission develop post-intensive care syndrome and face significant long-term physical, cognitive, and mental health impairments. The intensive care unit diary is a reality-sorting tool that is effective in aiding patients to connect their flashbacks and delusional memories to actual events. OBJECTIVES: To describe implementation of an intensive care unit diary in the cardiac intensive care unit and to describe the patient's perspective of the diary...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068717/preventing-surgical-site-infections-related-to-abdominal-drains-in-the-intensive-care-unit
#11
Krystal Orth
Surgical site infections are significant contributors to health care-associated infections. Nursing interventions may help decrease the incidence of surgical site infections, particularly in regards to the management of postsurgical abdominal drains. This comprehensive guide, compiled from evidence-based practice literature, is intended for nurses to use to reduce surgical site infections secondary to postsurgical abdominal drains. This article focuses on drain management in intensive care unit patients, who are at risk for infection because of their immunocompromised state...
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/30068716/implicit-bias-in-patient-care-an-endemic-blight-on-quality-care
#12
EDITORIAL
JoAnn Grif Alspach
No abstract text is available yet for this article.
August 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858202/using-gemba-boards-to-facilitate-evidence-based-practice-in-critical-care
#13
Annette M Bourgault, Michele J Upvall, Alison Graham
BACKGROUND: Tradition-based practices lack supporting research evidence and may be harmful or ineffective. Engagement of key stakeholders is a critical step toward facilitating evidence-based practice change. Gemba , derived from Japanese, refers to the real place where work is done. Gemba boards (visual management tools) appear to be an innovative method to engage stakeholders and facilitate evidence-based practice. OBJECTIVES: To explore the use of gemba boards and gemba huddles to facilitate practice change...
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858201/preventing-venous-thromboembolism-in-adults
#14
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858200/improving-the-precepting-experience-in-a-burn-intensive-care-unit
#15
Amber Thompson, Maria Gonzales, Chelsea Bair, Sarah Ayers, Heather Mountain, Ashley Wrightenberry, Catherine Nevins, Audrey Boyles, Melanie Poe, Loree Kimball, Rayna Gorisek, Linda Long, Chris Turner
No abstract text is available yet for this article.
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858199/discharging-a-patient-after-a-percutaneous-coronary-intervention
#16
REVIEW
Cynthia Webner
No abstract text is available yet for this article.
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858197/supporting-optimal-neurodevelopmental-outcomes-in-infants-and-children-with-congenital-heart-disease
#17
Jennifer K Peterson
Improved survival has led to increased recognition of developmental delays in infants and children with congenital heart disease. Risk factors for developmental delays in congenital heart disease survivors may not be modifiable; therefore, it is important that lifesaving, high-technology critical care interventions be combined with nursing interventions that are also developmentally supportive. Implementing developmental care in a pediatric cardiac intensive care unit requires change implementation strategies and widespread support from all levels of health care professionals...
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858196/nurse-project-consultant-critical-care-nurses-move-beyond-the-bedside-to-affect-quality-and-safety
#18
Lynn G Mackinson, Juliann Corey, Veronica Kelly, Kristin P O'Reilly, Jennifer P Stevens, Susan Desanto-Madeya, Donna Williams, Sharon C O'Donoghue, Jane Foley
A nurse project consultant role empowered 3 critical care nurses to expand their scope of practice beyond the bedside and engage within complex health care delivery systems to reduce harms in the intensive care unit. As members of an interdisciplinary team, the nurse project consultants contributed their clinical expertise and systems knowledge to develop innovations that optimize care provided in the intensive care unit. This article discusses the formal development of and institutional support for the nurse project consultant role...
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858195/new-nutrition-guidelines-promoting-enteral-nutrition-via-a-nutrition-bundle
#19
Ashleigh VanBlarcom, Mary Anne McCoy
Malnutrition in hospitals is often overlooked, underdiagnosed, and untreated. Malnourished patients have increased risk for infection and pressure injuries, longer duration of mechanical ventilation, anemia, depressed cardiac and respiratory functions, and an overall higher risk for mortality. These complications contribute to longer hospital stays and higher health care costs. The benefits of early nutritional support in hospitals may be enhanced by use of a new nutrition care bundle that addresses all aspects of nutrition assessment and intervention...
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29858194/improvement-of-nutritional-intake-in-intensive-care-unit-patients-via-a-nurse-led-enteral-nutrition-feeding-protocol
#20
Ira Orinovsky, Ela Raizman
BACKGROUND: Enteral nutrition in intensive care unit patients has important prognostic clinical value. Feeding protocols are recommended by clinical practice guidelines as a key strategy to maximize the benefits and minimize the risks of enteral feedings. OBJECTIVE: To examine whether enteral nutrition in critically ill patients could be improved by implementation of a nurse-led evidence-based feeding protocol. METHODS: An interprofessional group of intensive care unit nurses, physicians, and a clinical dietitian designed a protocol to address and correct the shortcomings of enteral feeding...
June 2018: Critical Care Nurse
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