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Canadian Journal of Critical Care Nursing

Teddie Tanguay, Reagan Bartel
In early 2010, the Royal Alexandra Hospital (RAH) was the only tertiary hospital in Edmonton, Alberta, without a rapid response team (RRT). Once funding was obtained, the RAH RRT was developed with the mission of "Helping you make it happen" with the underlying philosophy that any call is a good call and the team is there to support care on the wards. The RAH RRT is unique, as it uses a registered nurse/respiratory therapist model rather than the physician model used by most tertiary centres. The RAH RRT provides consistent and efficient response to deteriorating patients and visitors to the hospital...
May 2017: Canadian Journal of Critical Care Nursing
Sarah Crowe
ICU care has traditionally focused on curative treatment, but making the decision to withdraw life-sustaining therapies, the there is an increasing awareness of the key role palliative and barriers to providing good end-of-life care, factors that support comfort care play. Through a review of recent literature on end- good end-of-life care, and specific guidelinesfor the withdrawal of-life care and withdrawal of life-sustaining therapies in the of life-sustaining therapies. Using this information, a checklist to intensive care unit, four themes have emerged: the challenges of support end-of-life care by critical care nurses was created...
May 2017: Canadian Journal of Critical Care Nursing
Aalia Shariff, Joanne Olson, Anna Santos Salas, Lisa Cranley
BACKGROUND: Death is a common occurrence in intensive care units (IC Us) and the complexity of care makes it difficult for nurses to find a balance between the patient's physical needs and the family's emotional needs, especially in circumstances of unexpected death. Cumulative or unresolved grief for families can have lasting negative repercussions. Nurses, therefore, need access to bereavement education in order to provide optimal- bereavement support. PURPOSE: The purpose of this review is to identify challenges and facilitators that nurses experience in delivering bereavement support during and after sudden or unexpected death in ICUs...
May 2017: Canadian Journal of Critical Care Nursing
Frances Fothergill Bourbonnais, Sue Malone-Tucker, Debbie Dalton-Kischei
BACKGROUND: Pain is a common experience among patients in intensive care units (ICUs). Many patients in ICUs have difficulty communicating their pain because of mechanical ventilation, and issues can arise when the nurse attempts to interpret the severity of pain,and work towards effective pain management. PURPOSE: The aim of this study was to determine the suitability of the Critical-Care Pain Observation Tool (CPOT) as an assessment tool to be used by ICU nursing staff to assess pain in adult...
October 2016: Canadian Journal of Critical Care Nursing
Marie Edwards
In February 2015, the Supreme Court of Canada released its decision in the Carter v. Canada (Attorney General) case, declaring section 241(b) and section 14 of the Criminal Code invalid, and granting a one-year suspension on that declaration to enable the Parliament of Canada to respond. In June 2016, Bill C-14: An Act to Amend the Criminal Code and Make Related Amendments to Other Acts (Medical Assistance in Dying) was passed after much debate in the House of Commons and Senate of Canada. Brief summaries of the Carter v...
October 2016: Canadian Journal of Critical Care Nursing
Brandi Vanderspank-Wright, Kimberly McMillan
BACKGROUND: There is growing knowledge specif c to remote, rural and northern nursing practice in Canada's north. However, there is limited research that specifically addresses the experiences of critical care nurses working in Canada's northern communities. PURPOSE: The purpose of this pilot study was to begin to explore and better understand the experiences of Canadian nurses providing critical care to patients and families in intensive care units north of the 60th parallel...
October 2016: Canadian Journal of Critical Care Nursing
Renée Chauvin
No abstract text is available yet for this article.
2016: Canadian Journal of Critical Care Nursing
Catherine Villemure, Issam Tanoubi, L Mihai Georgescu, Jean-Nicolas Dubé, Julie Houle
BACKGROUND: In situ simulation (ISS) is an emerging teaching strategy aimed to improve professionals' competencies and collaborative practice to increase patient safety The impact of ISS is still to be demonstrated before expanding the use of this method in our critical care settings. PURPOSE: The objective of this paper is to explore the literature regarding ISS training and present advantages and challenges. DESIGN AND METHOD: An integrative review was conducted, based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement...
2016: Canadian Journal of Critical Care Nursing
Frances Fothergill Bourbonnais, Sharon Slivar, Sue Malone Tucker
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients. Renal replacement therapy is prescribed for as many as 70% of critically ill patients in AKI and may be provided in the form of intermittent or continuous dialysis including intermittent hemodialysis, sustained low-efficiency dialysis, and continuous renal replacement therapy (CR RT). CRRT is commonly used for unstable critically ill patients, as it involves a slow continuous process. The nursing work involved with CR RT is highly complex and the learning requirements are challenging; therefore, it is important to identify nursing practices...
2016: Canadian Journal of Critical Care Nursing
Ruth Trinier, Lori Liske, Vera Nenadovic
Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals...
2016: Canadian Journal of Critical Care Nursing
Catherine Goulding, Mario Bedard
BACKGROUND: Most intravenous medication errors occur during administration. Smart pumps can reduce the incidence of dose or rate errors using soft and hard limits. However, industry standard dose error reduction software misses errors that occur during titration. The dose change alert was developed to detect errors during titration. PURPOSE: To evaluate the safety implications of the dose change alert in the SIGMA Spectrum Infusion System on the administration of high-alert medications at The Ottawa Hospital...
2015: Canadian Journal of Critical Care Nursing
Elena Luk, Lisa Burry, Shaghayegh Rezaie, Sangeeta Mehta, Louise Rose
BACKGROUND: Legislation, guidelines and accreditation standards cal for the minimization of physical restraints, yet their use remains common in intensive care units (ICUs) both in Canada and internationally. In Canada, physical restraints are prescribed by physicians. However, assessment of their need, application, and removal are primarily the responsibility of ICU nurses. OBJECTIVES: We sought to describe Canadian ICU nurses' decision-making and practices of physical restraint application and discontinuation, as well as alternative measures attempted prior to their use for critically ill adults...
2015: Canadian Journal of Critical Care Nursing
Marie Edwards
No abstract text is available yet for this article.
2015: Canadian Journal of Critical Care Nursing
Paula Price
No abstract text is available yet for this article.
2015: Canadian Journal of Critical Care Nursing
Karen Dryden-Palmer
No abstract text is available yet for this article.
2015: Canadian Journal of Critical Care Nursing
Kusum Menon, Belinda Dundon, Betty-Lou Twolan, Salman AlShammari
UNLABELLED: An unplanned extubation is defined as an extubation that occurs at a time other than that planned for the procedure. It may result in life-threatening complications such as laryngospasm, pulmonary or cardiac failure. Quality improvement initiatives have targeted an unplanned extubation rate of 0% in pediatric intensive care units. OBJECTIVE: To determine if a targeted approach specific to local practices and unit culture could decrease the incidence of and, ultimately, eliminate unplanned extubations in our tertiary care PICU...
2015: Canadian Journal of Critical Care Nursing
Andrew B Cooper, Paula Chidwick, Pamela Cybulski, Robert Sibbald
Ethical or legal errors related to the consent pathway for incapable patients are an everyday reality. Quality improvements in communication or palliative care have been attempted, but little attention has been given to meeting basic legal and ethical obligations. In this paper, the authors share lessons learned during two years of implementing the Checklist for meeting Ethical and Legal Obligations (ChELO) in the intensive care unit of a large community hospital in Ontario. We use a case-based approach to demonstrate the need for our intervention, our use of positive deviance in a change strategy, and the effectiveness of the checklist itself...
2015: Canadian Journal of Critical Care Nursing
Geraldine S Whittaker
Patients frequently are readmitted to the intensive care unit because of a lack of lifestyle change that puts them at risk for cardiac issues. Nurses view this as non-compliance, however, use of the term "non-compliance" has negative connotations. The factors contributing to non-compliance include nursing's views, and patients' perceptions of health risk and lack of motivation. In this article, the author proposes an educational approach and strategies for intensive care nurses to use when teaching patients about changes required to address lifestyle behaviours, such as increasing exercise, smoking cessation, and healthy diets...
2015: Canadian Journal of Critical Care Nursing
Brandi Vanderspank-Wright, Frances Fothergill Bourbonnais, Cynthia Toman, Christine McPherson
BACKGROUND: The early 1960s marked the opening of intensive care units (ICUs) in several hospitals across Canada. From the beginning, registered nurses constituted the largest body of health care providers in the ICU environment and they were the central provider of hands-on care to patients and families. From a historical perspective, however, a limited body of knowledge exists specific to the development of ICU nursing in Canada. PURPOSE: In this study we explored the development of ICU nursing in Canada from 1960 to 2002 using a social history approach that emphasized the creation of an historical account from the perspective of the everyday experiences of ICU nurses...
2015: Canadian Journal of Critical Care Nursing
Julie L Preston, Judy Currey, Julie Considine
BACKGROUND: To avoid adverse patient outcomes from inappropriate treatment, it is recommended that an atrial electrogram (AEG) be recorded whenever atrial arrhythmias develop in patients after cardiac surgery. However, AEGs are not commonly performed because nurses lack knowledge about differentiating atrial rhythms on AEGs. OBJECTIVE: To investigate whether completing a novel online evidence-based education program on interpreting AEGs would improve critical care nurses' AEG interpretation...
2015: Canadian Journal of Critical Care Nursing
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