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Critical Care Nursing Clinics of North America

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https://www.readbyqxmd.com/read/30098747/sepsis-special-considerations-management-and-treatment-for-diverse-patient-populations
#1
EDITORIAL
Jennifer B Martin, Jennifer E Badeaux
No abstract text is available yet for this article.
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098746/sepsis-in-the-burn-patient
#2
REVIEW
Jennifer Manning
Sepsis is the leading cause of death in burn patients. Interventions are challenging owing to a lack of specific guidelines. All burn types involve a risk for complications. Interventions should include care of the burn, medication administration, continuous monitoring for infection development, infection prevention measures, and (if necessary) treatment of sepsis. Sepsis in burn patients is different from the unburned population. Efforts are needed to develop more accurate diagnostic strategies and guidelines to trigger rapid treatment via specific sepsis bundles...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098745/sepsis-in-the-obstetric-client
#3
REVIEW
Marie Adorno
Maternal sepsis is the third most common direct cause of maternal mortality following maternal hemorrhage and maternal hypertension. Undetected and poorly managed maternal infections can lead to sepsis, death, or disability for the mother and an increased likelihood of early neonatal infection and other adverse outcomes. When caring for obstetric patients, it is important to identify the stages of antepartum, intrapartum, and postpartum care. Sepsis occurs at any stage of obstetric care.
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098744/early-identification-and-management-of-the-septic-patient-in-the-emergency-department
#4
REVIEW
Jessica Landry, Leanne H Fowler
Sepsis and septic shock affect millions of people around the globe and kills more than 1 in 4 patients worldwide. Emergency departments (EDs) nationwide have implemented evidence-based protocols to facilitate the early detection and treatment of patients with sepsis. Despite these efforts, patients present to the ED undifferentiated and can often have an unclear source of infection. The latest literature provides refined definitions and clinical criteria for sepsis identification and indicates that early detection combined with the appropriate early management improves the septic patients' morbidity and mortality rates...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098743/special-considerations-for-the-septic-patient-going-to-the-operating-room
#5
REVIEW
Juanita L Derouen
Perioperative care of the septic patient presents unique challenges for the nurse. Understanding the physiology of sepsis is important for the nurse to anticipate the physiologic changes associated with the disorder and to prioritize the patient's needs. Ensuring adequate intravenous access by peripheral or central venous access as well as anticipating potential invasive monitoring lines allows the nurse to quickly administer antibiotic therapy, initiate fluid resuscitation, and prepare for potential vasopressor use...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098742/hospital-costs-associated-with-sepsis-compared-with-other-medical-conditions
#6
REVIEW
Denise M Danna
Sepsis is a condition that has become a main focus for health care organizations owing to the alarming cost of caring for patients, as well as the disturbing mortality rates, that accompany this condition. Sepsis is one of the costliest conditions billed to all payer groups: Medicare, Medicaid, private insurance, and uninsured patients. Health care organizations have implemented multiple strategies and best practices to improve the outcomes of patients with a diagnosis of sepsis.
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098741/cardiogenic-shock-in-the-septic-patient-early-identification-and-evidence-based-management
#7
REVIEW
Todd Tartavoulle, Leanne Fowler
Sepsis-induced cardiogenic shock is a lethal condition and the management of it is challenging. Cardiogenic shock in the septic patient involves myocardial systolic and diastolic dysfunction. The limited ability of the ventricles to contract effectively results in a decrease in oxygen delivery to the organs and tissues. Supportive therapy is provided to patients with sepsis and no specific drug can reverse the myocardial dysfunction. Rapid diagnosis, prompt antibiotic therapy, cautious protocol-driven fluid resuscitation and vasoactive agents, control of infectious source, and expeditious coronary artery revascularization is recommended to achieve a positive outcome...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098740/simulation-to-manage-the-septic-patient-in-the-intensive-care-unit
#8
REVIEW
Alison H Davis, Sherri P Hayes
Sepsis and septic shock are complex, clinical conditions associated with high morbidity and mortality rates. There are evidence-based guidelines outlining priority care areas for sepsis, including early screening outside the intensive care unit. Nurses are directly involved with patient care and must be able to provide safe, competent care after graduation. High-fidelity human patient simulation is an educational tool that provides access to a safe learning environment where the care of a septic patient can be experienced...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098739/hit-or-miss-a-review-of-early-onset-sepsis-in-the-neonate
#9
REVIEW
Monica Scheel, Shannon Perkins
For the bedside nurse identifying at-risk neonates for development of early-onset sepsis is a challenge. The ambiguity of clinical presentation can easily be overlooked, resulting in delayed treatment of this vulnerable population. Adding to this dilemma is inconsistent implementation of screening criteria used by health providers to identify at-risk neonates, resulting in lost opportunities of early identification and treatment. This article discusses the current approach to and the nurse's role in early-onset sepsis...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098738/emerging-adjunctive-approach-for-the-treatment-of-sepsis-vitamin-c-and-thiamine
#10
REVIEW
Jennifer E Badeaux, Jennifer B Martin
Evidence is emerging that parenteral administration of high-dose vitamin C and thiamine may be a beneficial adjuvant therapy of severe sepsis and septic shock. Despite modern practices in critical care medicine, sepsis and severe sepsis remain a leading cause of morbidity and mortality in the critical care unit.
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098737/beyond-the-intensive-care-unit-posttraumatic-stress-disorder-in-critically-ill-patients
#11
REVIEW
Jennifer B Martin, Jennifer E Badeaux
Medical care progress has enabled more patients in the intensive care unit to survive critical illnesses and return to daily living. This shift in survival rates has shed new light on the emotional consequences this experience. For patients surviving an ICU stay, posttraumatic stress disorder has been identified in approximately 9% to 27% compared with 7% of the general US population. Practitioners have an important role to play in early identification of patients experiencing signs and symptoms of this disorder...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098736/early-administration-of-intravenous-fluids-in-sepsis-pros-and-cons
#12
REVIEW
Laura S Bonanno
Fluid resuscitation in the management of patients with sepsis and severe sepsis has been considered the standard of care for almost 2 decades. The rationale for fluid resuscitation is related to improvement in cardiac output and organ perfusion. Recent research evidence challenges the use of fluid resuscitation in patients diagnosed with sepsis. Research is needed to determine the timing of fluid administration, as well as the volume and type of fluid to achieve positive patient outcomes. This article discusses the pros and cons of early fluid administration in the management of patients with sepsis...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/30098735/summary-of-the-2016-international-surviving-sepsis-campaign-a-clinician-s-guide
#13
REVIEW
Kendra M Barrier
The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 provides updated recommendations, rationales, and evidence tables for best care of patients with sepsis. "Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock (sepsis-3) is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality than with sepsis alone." Sepsis and septic shock are major health care problems, affecting millions of people around the world each year...
September 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724447/using-heuristic-evaluation-to-improve-sepsis-alert-usability
#14
REVIEW
Ariani Arista Putri Pertiwi, Dan Fraczkowski, Sheryl L Stogis, Karen Dunn Lopez
Sepsis, life-threatening organ dysfunction in response to infection, is an alarmingly common and aggressive illness in US hospitals, especially for intensive care patients. Preventing sepsis deaths rests on the clinicians' ability to promptly recognize and treat sepsis. To aid early recognition, many organizations have employed clinician-facing electronic sepsis alert systems. However, the effectiveness of the alert relies on heavily on the visual interface, textual information, and overall usability. This article reports a usability inspection of a sepsis alert system...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724446/telemedicine-in-the-intensive-care-unit-improved-access-to-care-at-what-cost
#15
REVIEW
William J Binder, Jennifer L Cook, Nickalaus Gramze, Sophia Airhart
Health systems across the United States are adopting intensive care unit telemedicine programs to improve patient outcomes. Research demonstrates the potential for decreased mortality and length of stay for patients of these remotely monitored units. Financial models and studies point to cost-effectiveness and the possibility of cost savings in the face of abundant startup costs. Questions remain as to the true financial implications of these programs and targeted populations that may see the greatest benefit...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724445/advancing-continuous-predictive-analytics-monitoring-moving-from-implementation-to-clinical-action-in-a-learning-health-system
#16
Jessica Keim-Malpass, Rebecca R Kitzmiller, Angela Skeeles-Worley, Curt Lindberg, Matthew T Clark, Robert Tai, James Forrest Calland, Kevin Sullivan, J Randall Moorman, Ruth A Anderson
In the intensive care unit, clinicians monitor a diverse array of data inputs to detect early signs of impending clinical demise or improvement. Continuous predictive analytics monitoring synthesizes data from a variety of inputs into a risk estimate that clinicians can observe in a streaming environment. For this to be useful, clinicians must engage with the data in a way that makes sense for their clinical workflow in the context of a learning health system (LHS). This article describes the processes needed to evoke clinical action after initiation of continuous predictive analytics monitoring in an LHS...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724444/work-system-barriers-and-strategies-reported-by-tele-intensive-care-unit-nurses-a-case-study
#17
Peter L T Hoonakker, Pascale Carayon
Tele-intensive care units (ICUs) are an innovation to handle issues such as personnel shortage and improving care. In tele-ICUs, clinical teams monitor ICU patients remotely and support clinicians in multiple ICUs. The tele-ICU and ICU clinicians function as virtual teams. Little is known how these teams function and what challenges they encounter. We examined the challenges from the perspective of nurses in a tele-ICU. We used a case study design and conducted interviews with 10 tele-ICU nurses. The nurses encounter challenges in interacting with the multiple ICUs that they monitor remotely and have developed strategies to cope with these challenges...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724443/advocating-for-greater-usability-in-clinical-technologies-the-role-of-the-practicing-nurse
#18
REVIEW
Karen Dunn Lopez, Linda Fahey
Health care, especially ICUs, rely on multiple types of technology to promote the best patient outcomes. Unfortunately, too often these technologies are poorly designed, causing errors, additional workload, and unnecessary frustration. The purpose of this article is to (1) empower nurses with the needed usability and usability testing vocabulary to identify and articulate clinical technology usability problems and (2) provide ideas on ways nurses can advocate to have an impact on positive change related to technology usability within a health care organization...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724442/informatics-solutions-for-application-of-decision-making-skills
#19
REVIEW
Christine W Nibbelink, Janay R Young, Jane M Carrington, Barbara B Brewer
Critical care nurses practice in a challenging environment that requires responses to patients with complex, often unstable health conditions. The electronic health record, access to clinical data, and Clinical Decision Support Systems informed by data from clinical databases are informatics tools designed to work together to facilitate decision-making in nursing practice. The complex decision-making environment of critical care requires informatics tools that support nursing practice through integration of current evidence with clinical data...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29724441/human-factors-in-medical-device-design-methods-principles-and-guidelines
#20
REVIEW
Russell J Branaghan
A total of 400,000 to 500,000 patients die in intensive care units (ICUs) each year, largely because ICUs care for the sickest patients. On the other hand, factors such as workload, shift changes, handoffs, alarm fatigue, inadequate team communication, and difficult-to-use medical devices contribute to the problem. This article focuses on the human factors of those medical devices, a significant cause of adverse events in the ICU.
June 2018: Critical Care Nursing Clinics of North America
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