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Critical Care Nursing Clinics of North America

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https://www.readbyqxmd.com/read/28460706/bundles-guidelines-protocols-and-more-a-pediatric-medley
#1
EDITORIAL
Jerithea Tidwell, Brennan Lewis
No abstract text is available yet for this article.
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460705/massive-transfusion-protocol-simulation-an-innovative-approach-to-team-training
#2
REVIEW
Allison Langston, Dayna Downing, Jennifer Packard, Marion Kopulos, Shelley Burcie, Kay Martin, Brennan Lewis
At a 72-bed pediatric facility, a multidisciplinary team approach was used to prepare for the expansion of services for patients requiring spinal fusion. This preparation included emergency response requiring massive transfusion, necessitating the need for a Massive Transfusion Protocol (MTP) process to be in place. Such instances are low volume/high risk, creating difficulty for staff to gain and maintain proficiency with the equipment and processes related to the MTP in a secure environment. The purpose of this article is to highlight the preparation and education put into place before receiving the first pediatric patient for spinal fusion...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460704/continuous-capnography-in-pediatric-intensive-care
#3
REVIEW
Christine M Riley
Capnography or end-tidal carbon dioxide (Etco2) monitoring has a variety of uses in the pediatric intensive care setting. The ability to continuously measure exhaled carbon dioxide can provide vital information about airway, breathing, and circulation in critically ill pediatric patients. Capnography has diagnosis-specific applications for pediatric patients with congenital heart disease, reactive airway disease, neurologic emergencies, and metabolic derangement. This modality allows for noninvasive monitoring and has become the standard of care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460703/putting-the-family-back-in-the-center-a-teach-back-protocol-to-improve-communication-during-rounds-in-a-pediatric-intensive-care-unit
#4
REVIEW
Terri L Bogue, Lynn Mohr
Patient- and family-centered care is endorsed by leading health care organizations. To incorporate the family in interdisciplinary rounds in the pediatric intensive care unit, it is necessary to prepare the family to be an integral member of the child's health care team. When the family is part of the health care team, interdisciplinary rounds ensure that the family understands the process of interdisciplinary rounds and that it is an integral part of the discussion. An evidence-based protocol to provide understanding and support to families related to interdisciplinary rounds has significant impact on satisfaction, trust, and patient outcomes...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460702/unbundling-the-bundles-using-apparent-and-systemic-cause-analysis-to-prevent-health-care-associated-infection-in-pediatric-intensive-care-units
#5
REVIEW
Terri L Bogue, Robert L Bogue
Today's health care environment emphasizes patient outcomes, although financial incentives and penalties have placed a high priority on elimination of health care-associated infections (HAIs). The use of standardized care bundles is evidence-based; however, implementation of these bundles has not proven effective in eliminating HAIs. Actively learning from HAI events through the use of apparent and systemic cause analysis identifies new barriers to success and opportunities for improvement in further reducing HAIs...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460701/effective-management-of-pain-and-anxiety-for-the-pediatric-patient-in-the-emergency-department
#6
REVIEW
Virginia B Young
Inadequate treatment of pain for children in the emergency department is a persistent problem. Health care professionals are bound by ethical principles to provide adequate pain management; in children, this may be challenging owing to cognitive and developmental differences, lack of knowledge regarding best practices, and other barriers. Studies have concluded that immediate assessment, treatment, and reassessment of pain after an intervention are essential. Self-report and behavioral scales are available...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460700/airways-and-injuries-protecting-our-pediatric-patients-from-respiratory-device-related-pressure-injuries
#7
REVIEW
Laura J Miske, Molly Stetzer, Melissa Garcia, Judith J Stellar
Pressure injury prevention is required in all health care environments. Respiratory technology includes invasive and noninvasive positive pressure ventilation methods of support and life-saving equipment. Pressure injury can occur from tracheostomy tubes and their securement devices, or use of noninvasive positive pressure ventilation interfaces or the head gear. Methods instituted to decrease hospital-acquired pressure injury related to noninvasive positive pressure ventilation and tracheostomy securement devices are discussed...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460699/case-study-of-high-dose-ketamine-for-treatment-of-complex-regional-pain-syndrome-in-the-pediatric-intensive-care-unit
#8
REVIEW
Tracy Ann Pasek, Kelli Crowley, Catherine Campese, Rachel Lauer, Charles Yang
Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460698/when-nursing-assertion-stops-a-qualitative-study-to-examine-the-cultural-barriers-involved-in-escalation-of-care-in-a-pediatric-hospital
#9
REVIEW
Jodi Thrasher, Heidi McNeely, Bonnie Adrian
Pediatric codes outside the ICU are associated with increased morbidity and mortality. This qualitative research highlights results from confidential interviews with 10 pediatric nurses with experience of caring for children who required rapid response, code response, or transfer to intensive care. Detailed examination of nurses' experiences revealed local factors that facilitate and inhibit timely transfer of critical patients. Nurses identified themes including the impact of nurse assertiveness, providers' lack of understanding of nursing, team communication, and other hospital cultural barriers...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460697/pediatric-mild-traumatic-brain-injury-and-population-health-an-introduction-for-nursing-care-providers
#10
REVIEW
Michelle Borzik Goreth
Despite increasing injury prevalence of traumatic brain injury (TBI) in children, most injuries in children are mild in severity. Even mild injuries can result in long-term or chronic effects not apparent until the child ages, resulting in increased economic burden and overall lifetime costs related to injury. Early recognition of TBI is essential for ongoing evaluation and management of acute symptoms and reduction of chronic health effects. Providing early interventions to manage acute and postconcussive symptoms and reducing health disparities in children with mild TBI can minimize adverse events that impact health-related quality of life for the injured child and their family and increase overall population health...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460696/caring-for-kids-bridging-gaps-in-pediatric-emergency-care-through-community-education-and-outreach
#11
REVIEW
Ann Luckstead-Gosdin, Lori Vinson, Cynthia Greenwell, Jefferson Tweed
The Pediatric Emergency Services Network (PESN) was developed to provide ongoing continuing education on pediatric guidelines and pediatric emergency care to rural and nonpediatric hospitals, physicians, nurses, and emergency personnel. A survey was developed and given to participants attending PESN educational events to determine the perceived benefit and application to practice of the PESN outreach program. Overall, 91% of participants surveyed reported agreement that PESN educational events were beneficial to their clinical practice, provided them with new knowledge, and made them more knowledgeable about pediatric emergency care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460695/reducing-fresh-tracheostomy-decannulations-following-implementation-of-a-fresh-tracheostomy-guideline
#12
REVIEW
Kristen Hood, Brennan Lewis, Cindy Darnell Bowens
Pediatric patients undergoing tracheostomy placement are often medically fragile with multiple comorbidities. The complexity of these patients partnered with the risks of a newly placed tracheostomy necessitates a clear understanding of patient management and clinical competence. At our institution, a quality improvement initiative was formed with a focus on increasing the safety of these patients by developing a postoperative care guideline.
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160961/preface
#13
EDITORIAL
Todd M Tartavoulle, Jennifer Manning
No abstract text is available yet for this article.
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160960/infections-in-the-intensive-care-unit-posttransplant-infections
#14
REVIEW
Fiona Winterbottom, Misty Jenkins
Solid organ transplantation has become a well-established standard of care for end-organ failure, and the nurse in the intensive care unit may be exposed to these patients at any stage in the care continuum of pretransplant or posttransplant care. Knowledge of risk factors, timing, and treatments for infections may help to enhance clinical practices and optimize patient safety and clinical outcomes.
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160959/wound-infections-in-critical-care
#15
REVIEW
Jean E Cefalu, Kendra M Barrier, Alison H Davis
Patients admitted to critical care units are at high risk for increased morbidity and mortality from skin and deep wound infections. Despite considerable progress, wound healing remains a challenge to many clinicians. Nurses working in critical care environments need to understand the anatomic and physiologic basis for wound healing, distinguish wound inflammation from wound infection, recognize the presence of biofilms, and implement evidence-based wound care in order to promote successful outcomes in this patient population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160958/opportunistic-fungal-infections-in-critical-care-units
#16
REVIEW
Deborah D Garbee, Stephanie S Pierce, Jennifer Manning
Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients. Fatigue and fever are common symptoms that require critical care nurses to remain vigilant in assessment to identify at-risk patients and promote use of timely cultures and appropriate treatments for fungal infections...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160957/hospital-acquired-infections-current-trends-and-prevention
#17
REVIEW
Christine Boev, Elizabeth Kiss
Health care-associated infections (HAIs) are the primary cause of preventable death and disability among hospitalized patients. According to the Centers for Disease Control and Prevention (CDC), complications or infections secondary to either device implantation or surgery are referred to as HAIs. Specifically, the CDC monitors surgical site infections, central-line-associated bloodstream infection, catheter-associated urinary tract infections, and ventilator-associated pneumonias. This article explores HAIs specific to pathophysiology, epidemiology, and prevention, and how nurses can work together with other health care providers to decrease the incidence of these preventable complications...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160956/the-role-of-liver-function-in-the-setting-of-cirrhosis-with-chronic-infection-and-critical-illness
#18
REVIEW
Susan Lee, Latanja Divens, Leanne H Fowler
The patient with sepsis in the setting of hepatitis C virus (HCV)-related cirrhosis can have a more rapid decline in other organ dysfunction during critical illness and faces further increase in the risk for death. This article discusses the role of liver function in the patient with a systemic critical illness in contrast to the worsened pathophysiology of the patient with cirrhosis secondary to chronic HCV infection and critical illness, inpatient and posthospitalization management of the critically ill patient with chronic HCV-related cirrhosis, and the nursing implications and recommendations for future research for this population...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160955/infection-in-the-critically-ill-older-adult
#19
REVIEW
Jennifer Manning, Jean E Cefalu
Many challenges exist in caring for older adults with infection in critical care environments. Older adults are at high risk due to diminished reserve, age-related changes, comorbidities, subtle clinical presentations, and institutionalization. Additional risks include infections, such as pneumonia, influenza, and nosocomial infections. Age-related changes contribute to the increased risk of infection in older adults. Nursing assessments should be tailored to the needs of the older patient. To improve health care outcomes in this population, nursing care of the critically ill older adult with infection should include comprehensive assessment, surveillance for risks, and strategies aimed to aggressively treat infection...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160954/management-of-sepsis-in-patients-with-pulmonary-arterial-hypertension-in-the-intensive-care-unit
#20
REVIEW
Todd M Tartavoulle
Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment...
March 2017: Critical Care Nursing Clinics of North America
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