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Critical Care Nursing Quarterly

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https://www.readbyqxmd.com/read/27893511/continuous-infusion-antiepileptic-medications-for-refractory-status-epilepticus-a-review-for-nurses
#1
Adam L Wiss, Michael Samarin, Jacob Marler, G Morgan Jones
Status epilepticus requires treatment with emergent initial therapy with a benzodiazepine and urgent control therapy with an additional antiepileptic drug (AED) to terminate clinical and/or electrographic seizure activity. However, nearly one-third of patients will prove refractory to the aforementioned therapies and are prone to a higher degree of neuronal injury, resistance to pharmacotherapy, and death. Current guidelines for refractory status epilepticus (RSE) recommend initiating a continuous intravenous (CIV) anesthetic over bolus dosing with a different AED...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893510/preparing-critical-care-and-medical-surgical-nurses-to-open-a-new-hospital
#2
Odette Y Comeau, Josette Armendariz-Batiste, Jennifer Grant Baer
Building a new hospital is an exciting time. However significant planning is required to prepare staff to assume care of patients in an environment with new workflow changes and new equipment. The challenges of this advanced preparation are compounded when the opening of the new hospital includes the planned move of the inpatient census of patients from an existing hospital to the new hospital. Goals and objectives on the move day include patient and staff safety, with a seamless transition to the new environment...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893509/educating-providers-in-return-to-play-suggested-guidelines-postconcussion
#3
Angela Macci Bires, Amanda L Leonard, Brandon Thurber
As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#4
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893507/case-study-obstetrical-trauma-with-maternal-death-and-fetal-survival
#5
Matthew Mowry
Trauma during pregnancy is the leading cause of non-obstetric-related maternal and fetal death. This article summarizes obstetric physiology and outlines the assessment and treatment of traumatic injuries of the pregnant patient. A case is presented in which a pregnant woman with blunt abdominal trauma was managed efficiently in a trauma center within a hospital that does not have in-house obstetric services.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893506/the-hospital-course-of-a-successfully-treated-patient-with-respiratory-failure-beginning-to-end
#6
T Brian Callister
The successful treatment of a patient with acute respiratory failure is a complex undertaking that requires clinical competence, evidence-based interventions, seamless coordination of care transitions, and transparent open communication among all members of the health care team. Many of the processes of care in these critically ill patients are reassuringly consistent across services, across hospitals, across health systems, and even across the country. Although the clinical course of such complicated patients can be extremely unpredictable, we are fortunate that the professional, technical, and psychosocial aspects of care for these patients can be relatively orderly, evidence-based, and transparent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893505/rib-fracture-protocol-advancing-the-care-of-the-elderly-patient
#7
Susan Leininger
This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893504/accurate-identification-of-infection-source-in-burn-trauma-patients-with-central-line-infection-to-determine-appropriate-treatment-option-as-well-as-proper-public-reporting
#8
Holly M Hampe, Lisa Graper, Kathy Hayes-Leight, Deborah Olszewski, Matthew Moffa, Derek N Bremmer
With the advent of the Patient Safety Movement in the late 1990s and the CMS (Centers for Medicare & Medicaid Services) nonreimbursement program for never events, there has been much focus on the prevention and accurate identification of health care-associated infections such as central line-associated bloodstream infections (CLABSIs). There has certainly been a national effort to decrease the occurrence of these infections. With the implementation of patient safety initiatives such as the central line prevention bundle, there has been a considerable reduction in the number of CLABSIs except for patients with burn trauma...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893503/impacting-care-and-treatment-of-the-burn-patient-conversion-to-electronic-documentation
#9
Holly M Hampe, Terri Keeling, Michelle Fontana, Debbie Balcik
Improving patient care through enhanced electronic communication among health care providers is aimed at reducing the number of medication and medical errors. The American Reinvestment and Recovery Act (ARRA) was signed into law in 2009, supporting the federal government's commitment to the improvement of health care quality, safety, and efficiency through requirements to implement an electronic health record by October 2015 or hospitals and eligible providers potentially realizing penalties or reduced reimbursement rates...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893502/implementing-a-4c-approach-to-quality-improvement
#10
Michelle McGonigal
Designing a quality improvement activity can be labor intensive and intimidating to facilitators who have not been specially trained in process improvement methodologies. To simplify the process, a team was formed with the specific task of developing a basic model that addresses key concepts in change theory. The 2010 Institute of Medicine report stresses the importance of health care professionals working together, collaboratively, to use data to improve patient outcomes and improve care nationally. In addition, as noted in Quality and Safety Education for Nurses (2013), competencies have been developed to promote frontline problem solving including using data for quality improvement, providing safe care, functioning in collaborative teams, respecting and addressing patient and family concerns, applying evidence-based practice, and using informatics to make decisions...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27893501/foreword
#11
Katrina A Pyo, Lori Laux
No abstract text is available yet for this article.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575801/gastric-residual-volume-rethinking-the-threshold
#12
Amir Emami Zeydi, Mohammad Sharafkhani, Mohammad Reza Armat
There are many challenges related to enteral feedings of the mechanically ventilated patient. Among the most often debated issues is the threshold for gastric residual volume before further feeding. This brief article considers the factors to be considered and reviews current thinking on the topic.
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575800/an-exploration-of-nursing-assistants-perceptions-about-job-satisfaction
#13
Darcie M Brady
High levels of staff turnover of certified nursing assistants (CNAs) are costly and disruptive to patient care. A variety of factors contribute to a 36% turnover rate of CNAs nationwide (2015 Staffing Report, 2015). According to Stone and Wiener, high rates of turnover and staff vacancies have multilayered consequences; patient care suffers, cost of constantly replacing workers soars, and worker job dissatisfaction increases. This study examined the CNAs' beliefs about job satisfaction as an approach to prevent job turnover and retain high achieving staff in one acute care hospital in a south eastern region...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575799/implementation-of-a-pediatric-early-warning-scoring-system-at-an-academic-medical-center
#14
Kimberly Douglas, Jerry Christopher Collado, Sheila Keller
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575798/nurse-driven-catheter-associated-urinary-tract-infection-reduction-process-and-protocol-development-through-an-academic-practice-partnership
#15
Pamela Johnson, Anna Gilman, Alicia Lintner, Ellen Buckner
Translating evidence-based practices to the bedside can be facilitated by an active academic-practice partnership between nursing faculty and frontline nursing staff. A collaborative effort between the university's academic nurses and the medical center's clinical nurses explored, created, implemented, and evaluated an evidence-based nurse-driven protocol for decreasing the rate of catheter-associated urinary tract infections. The nurse-driven protocol was piloted in 4 intensive care units and included nurse-driven orders for catheter discontinuation, utilization of smaller bore urinary catheters, addition of silver-based cleansing products for urinary catheter care, and education of staff on routine catheter care and maintenance...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575797/point-of-care-testing-of-troponin-levels-compared-with-automated-laboratory-evaluation-a-reliability-study
#16
Adacilis Ramirez Sardi, Julie A Lamoureux, Tanya M Cohn, Shirley G Phillip-Samuel
Traditionally, troponin levels are measured in the blood using an automated laboratory protocol, but the use of a faster technology, the point-of-care (POC) testing of troponin levels, has shown promise in the effective differential diagnosis of cardiac injury. The purpose of this study was to compare the 2 methods. A total of 1567 patients were seen in the emergency department who were tested with both the POC iSTAT troponin and laboratory troponin from a secondary analysis of retrospective data collected between June 2012 and December 2012...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575796/improving-heart-failure-outcomes-the-role-of-the-clinical-nurse-specialist
#17
Jennifer Coen, Kimberly Curry
This article identifies and explains barriers to optimal outcomes of heart failure and the role of the clinical nurse specialist in overcoming these obstacles, improving patient outcomes and quality of life. In recent years, advances in heart failure management have increased survival rates, and as a result, the number of patients requiring services to manage disease progression and the complex array of symptoms associated with end-stage heart disease. Management of the heart failure patient is dependent on the severity of the disease and wide range of available treatment regimens...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575795/physical-and-visual-accessibilities-in-intensive-care-units-a-comparative-study-of-open-plan-and-racetrack-units
#18
Mahbub Rashid, Nayma Khan, Belinda Jones
This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques...
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27575794/foreword
#19
Carmen G Warner
No abstract text is available yet for this article.
October 2016: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27254646/letter-to-the-editor
#20
Jason Chertoff
No abstract text is available yet for this article.
July 2016: Critical Care Nursing Quarterly
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