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Dimensions of Critical Care Nursing: DCCN

Kathleen Ahern Gould
No abstract text is available yet for this article.
September 2018: Dimensions of Critical Care Nursing: DCCN
Hamiyet Kzl, Merdiye Şendir
AIM: This study is a quasi-experimental research that was conducted to evaluate the effects of bathing on vital signs and oxygen saturation in intubated children who are connected to mechanical ventilation. METHODS: The study sample consisted of children who are treated in the pediatric intensive care unit, University of Istanbul Cerrahpasa Faculty of Medicine Hospital. A total of 60 children who met the criteria of the sample group were included in the study. The children were given bed bathing with plain warm water of 32°C to 38°C on 3 different days...
September 2018: Dimensions of Critical Care Nursing: DCCN
Ricardo M Padilla, Linda D Urden, Kathleen M Stacy
BACKGROUND: The rapid response system (RRS) was designed to identify and intervene on patients exhibiting clinical deterioration in the non-critical-care setting but is not always effectively activated by nurses, leading to adverse patient outcomes. OBJECTIVES: The objective of this systematic review was to explore nurses' perceived barriers to RRS activation in the acute adult inpatient setting. METHOD: A systematic review was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist...
September 2018: Dimensions of Critical Care Nursing: DCCN
Renea L Beckstrand, Caitlin Mallory, Janelle L B Macintosh, Karlen E Luthy
BACKGROUND: Critical care nurses (CCNs) frequently provide end-of-life (EOL) care for critically ill patients. Critical care nurses may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care...
September 2018: Dimensions of Critical Care Nursing: DCCN
Michael D Aldridge
In order to gain expertise, intensive care unit nurses must have a good understanding of the pathophysiology and complicated disease processes seen in their units. Nurse educators and critical-care preceptors must be able to explain these complex concepts to a wide variety of audiences including nursing students, graduate nurses, and experienced critical-care nurses. Many times, demonstrations, analogies, visual aids, games, and creative teaching methods can help communicate these complicated ideas. The purpose of this article is to provide ideas for nurse educators and preceptors to use when explaining concepts that may be encountered with patients in a critical-care setting...
September 2018: Dimensions of Critical Care Nursing: DCCN
Susan E Becker, Diane Nickloy
BACKGROUND: Heredity hemochromatosis (HH) is an underdiagnosed genetic disease that can lead to life-threatening multisystem organ failure. Identifying and treating HH early can prevent the progression of the disease. CASE PRESENTATION: For a 60-year-old white patient without obvious symptoms, it was a revelation to discover that he had HH. This patient, although receiving evidence-based care, ultimately required a liver transplant. As his condition deteriorated, the plan for this patient and his family involved working within an interdisciplinary team that included nurse practitioners and intensive care unit nurses...
September 2018: Dimensions of Critical Care Nursing: DCCN
Suzanne Hall Johnson
No abstract text is available yet for this article.
September 2018: Dimensions of Critical Care Nursing: DCCN
Juliann Corey, Sharon C OʼDonoghue, Veronica Kelly, Lynn Mackinson, Donna Williams, Kristin OʼReilly, Susan DeSanto-Madeya
BACKGROUND: Policies, procedures, and guidelines standardize care, meet regulatory requirements, and can promote safety in clinical practice. The existing protocols, policies, guidelines, and directives (PPGDs) at a level 1 trauma academic medical center were underused by the intensive care unit clinicians and did not always clearly represent the supporting evidence. AIMS: The goals of this project were to update the Critical Care Practice Manual (CCPM) and to ensure that clinical practice was aligned with best evidence...
July 2018: Dimensions of Critical Care Nursing: DCCN
Colleen M Halupa, Michael S Halupa, Marty S Warren
BACKGROUND: This 3-year study measured the satisfaction of staff nurses with medical emergency team (MET) nurse services at a 573-bed hospital in the south from 2015 through 2017. Nurse satisfaction is a key management issue. Barriers to effective MET use can negatively impact patient outcomes, staffing, and nurse turnover. OBJECTIVES: The purpose of this study was to assess nurse satisfaction with MET nurses at a large county hospital in the south over a 3-year period...
July 2018: Dimensions of Critical Care Nursing: DCCN
Kelly A Powers
BACKGROUND: Education on family presence during resuscitation (FPDR) has been shown to improve critical care nurses' support for FPDR; however, there have been limited studies in this area. Exploring nurses' perceived needs related to FPDR education is important to design educational interventions to promote FPDR in practice. OBJECTIVES: The aim of this study was to explore the FPDR education needs of critical care nurses to provide recommendations for future educational interventions...
July 2018: Dimensions of Critical Care Nursing: DCCN
Rose Bruce, Cheryl Forry
In recent years, early progressive mobilization programs have become mainstays in intensive care units (ICUs). Significant evidence exists that early mobility programs decrease length of stay, reduce time on the ventilator, and decrease the development of delirium in ICU patients. Yet, current literature still describes many barriers to performing early mobility, such as the time required, staffing pressures, and increased workload. Our critical care leaders found that defining and implementing a dedicated mobility champion team member was successful in improving the effectiveness of our early mobility program...
July 2018: Dimensions of Critical Care Nursing: DCCN
(no author information available yet)
No abstract text is available yet for this article.
July 2018: Dimensions of Critical Care Nursing: DCCN
Gian Domenico Giusti, Marco Proietti Righi, Stefano Bambi
No abstract text is available yet for this article.
May 2018: Dimensions of Critical Care Nursing: DCCN
Caitlin Marie McCarroll
BACKGROUND: The Institute of Medicine's report, Dying in America, highlights the critical need for the widespread implementation of palliative care to improve end-of-life care. Approximately 20% of all deaths in America occur during or shortly after an intensive care unit (ICU) admission; therefore, it is important for critical care units to have systems in place to facilitate patient access to palliative care services. OBJECTIVES: The aim of this quality improvement (QI) project was to develop and implement a palliative care screening tool using evidence-based triggers to help increase the proportion of palliative care consultations in the ICU setting...
May 2018: Dimensions of Critical Care Nursing: DCCN
Renee Samples Twibell, Debra Siela, Alexis Neal, Cheryl Riwitis, Heather Beane
BACKGROUND: Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Psychometrically sound measures of physicians' perceptions are needed to create new knowledge and enhance collaboration among critical care nurses and physicians during resuscitation events...
May 2018: Dimensions of Critical Care Nursing: DCCN
Cheryl A Toole, Michele DeGrazia, Jean Anne Connor, Kimberlee Gauvreau, Hillary Bishop Kuzdeba, Patricia A Hickey
BACKGROUND: Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. OBJECTIVES: Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States...
May 2018: Dimensions of Critical Care Nursing: DCCN
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
Angela Nguyen
Acute respiratory distress syndrome (ARDS) is a deadly complication in critically ill patients that causes significant morbidity and mortality. Patients with ARDS are seen across intensive care unit settings, with treatment being largely supportive involving techniques through mechanical ventilation. Using low-tidal-volume ventilation is a standard of practice for patients with ARDS, as a lung protection strategy; however, alveolar decruitment may occur. Recruitment maneuvers can recruit collapsed alveoli and promote oxygenation...
May 2018: Dimensions of Critical Care Nursing: DCCN
Nancy L York, Christy Kane, Carol S Smith
Although incidence is rare, acute cardiac tamponade (CT) is a cardiovascular condition often resulting in a high mortality rate. In acute CT, rapid accumulation of fluid occurs in the pericardial sac and prevents the heart's chambers from adequately filling with blood, leading to reduced diastolic filling, diminished stroke volumes, and subsequent hemodynamic instability. Health care providers should be aware of at-risk patients and the earliest signs and symptoms because an acute CT is considered a medical emergency...
May 2018: Dimensions of Critical Care Nursing: DCCN
Tara L Sacco, Samantha A Delibert
Dangerous, sustained elevation in intracranial pressure (ICP) is a risk for any patient following severe brain injury. Intracranial pressure elevations that do not respond to initial management are considered refractory to treatment, or rICP. Patients are at significant risk of secondary brain injury and permanent loss of function resulting from rICP. Both nonpharmacologic and pharmacologic interventions are utilized to intervene when a patient experiences either elevation in ICP or rICP. In part 1 of this 2-part series, pharmacologic interventions are discussed...
May 2018: Dimensions of Critical Care Nursing: DCCN
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