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Critical care nursing

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https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#1
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29791310/ways-of-knowing-as-a-framework-for-developing-reflective-practice-among-nursing-students
#2
T Diane Campbell, Kelly Penz, Marie Dietrich-Leurer, Karen Juckes, Kathy Rodger
Abstract Background:Nursing students face the challenge of developing a comprehensive understanding of the complex role of the registered nurse across various clinical settings. Frameworks such as the "ways of knowing", help students conceptualize and critically reflect upon important processes in their professional learning. However, the academic language used to describe frameworks can be challenging. PURPOSE: This manuscript has two purposes. First, to briefly describe the historical climate influencing the development of nursing as a discipline...
May 23, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29790324/-interruptions-during-nursing-handover-observational-study-in-an-italian-intensive-care-unit
#3
Vincenzo Damico, Liana Murano, Flavia Cazzaniga
AIM: the purpose of this study is to investigate interruptions as they occur during the nursing handover in an Italian Intensive Care Unit. METHOD: prospective observational study carried out in the Lecco hospital's Department of Anaesthesiology and Critical Care Service (formerly A. Manzoni Hospital) from 15th July 2016 to 30th December 2016. To capture and understand the causes and occurences of interruptions, data were collected through participating observa- tion...
January 2018: Professioni Infermieristiche
https://www.readbyqxmd.com/read/29790137/-diabetic-foot-neuropathy-and-related-factors-in-patients-with-type-2-diabetes-mellitus
#4
Tzu-Yu Chen, Chia-Huei Lin, Yue-Cune Chang, Chih-Hsin Wang, Yi-Jen Hung, Wen-Chii Tzeng
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality. PURPOSE: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29788908/perceptions-of-insulin-use-in-type-2-diabetes-in-primary-care-a-thematic-synthesis
#5
Kathy Ellis, Henrietta Mulnier, Angus Forbes
BACKGROUND: Increasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29787309/predicting-intensive-care-unit-readmission-with-machine-learning-using-electronic-health-record-data
#6
Juan C Rojas, Kyle A Carey, Dana P Edelson, Laura R Venable, Michael D Howell, Matthew M Churpek
RATIONALE: Patients transferred from the intensive care unit (ICU) to the wards who are later readmitted to the ICU have increased length of stay, healthcare expenditure, and mortality compared to those who are never readmitted. Improving risk-stratification for patients transferred to the wards could have important benefits for critically ill hospitalized patients. OBJECTIVE: We aimed to use a machine-learning technique to derive and validate an ICU readmission prediction model with variables available in the electronic health record (EHR) in real-time and compare it to previously published algorithms...
May 22, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#7
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29783090/inter-and-intra-disciplinary-collaboration-and-patient-safety-outcomes-in-u-s-acute-care-hospital-units-a-cross-sectional-study
#8
Chenjuan Ma, Shin Hye Park, Jingjing Shang
BACKGROUND: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. OBJECTIVES: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes...
May 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29781847/identification-of-the-critical-nontechnical-skills-for-surgeons-needed-for-high-performance-in-a-variable-resource-context-notss-vrc
#9
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta Mutabazi, William A Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVE: To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). BACKGROUND: As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29781257/providing-nutritional-support-for-patients-in-critical-care
#10
Lorraine Mutrie, Barry Hill
The provision of nutritional support for patients who are critically ill is complex and multifaceted, in part because of the variety and complexity of potential clinical presentations. This article explores the importance of providing nutritional support for patients who are critically ill and explains the pathophysiology of nutrition in altered health states. It discusses nutritional screening and assessment, the various routes of nutrition administration and the nursing considerations involved in providing nutritional support in critical care...
May 21, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29780789/a-fundamentals-train-the-trainer-approach-to-building-pediatric-critical-care-expertise-in-the-developing-world
#11
Sheri S Crow, Beth A Ballinger, Mariela Rivera, David Tsibadze, Nino Gakhokidze, Nino Zavrashvili, Matthew J Ritter, Grace M Arteaga
Pediatric Fundamental Critical Care Support (PFCCS) is an educational tool for training non-intensivists, nurses, and critical care practitioners in diverse health-care settings to deal with the acute deterioration of pediatric patients. Our objective was to evaluate the PFCCS course as a tool for developing a uniform, reproducible, and sustainable model for educating local health-care workers in the optimal management of critically ill children in the Republic of Georgia. Over a period of 18 months and four visits to the country, we worked with Georgian pediatric critical care leadership to complete the following tasks: (1) survey health-care needs within the Republic of Georgia, (2) present representative PFCCS lectures and simulation scenarios to evaluate interest and obtain "buy-in" from key stakeholders throughout the Georgian educational infrastructure, and (3) identify PFCCS instructor candidates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#12
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29779794/understanding-pain-and-pain-management-in-elderly-nursing-home-patients-applying-an-interprofessional-learning-activity-in-health-care-students-a-norwegian-pilot-study
#13
Elin Damsgård, Hege Solgård, Karin Johannessen, Katrine Wennevold, Gunnvald Kvarstein, Gunn Pettersen, Beate Garcia
Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans...
May 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#14
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#15
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29776706/gaps-in-pain-agitation-and-delirium-management-in-intensive-care-outputs-from-a-nurse-workshop
#16
REVIEW
Carsten Hermes, Maria Acevedo-Nuevo, Andrea Berry, Thomas Kjellgren, Alessandra Negro, Paola Massarotto
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29776002/the-chaos-of-hospitalisation-for-patients-with-critical-limb-ischaemia-approaching-major-amputation
#17
Susan Monaro, Sandra West, Jana Pinkova, Janice Gullick
AIMS AND OBJECTIVES: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI). BACKGROUND: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775993/postnatal-psychosocial-assessment-and-clinical-decision-making-a-descriptive-study
#18
Deborah Sims, Cathrine Fowler
AIM: The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. BACKGROUND: Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775991/redefining-perinatal-experience-a-philosophical-exploration-of-a-hypothetical-case-of-gender-diversity-in-labour-and-birth
#19
Brianna Richardson, Sheri Price, Marsha Campbell-Yeo
OBJECTIVE AND AIMS: Using a queer phenomenological approach, the objective of this philosophical analysis is to explore the transgender experience in highly gendered clinical areas, such as the birth unit, and make recommendations on how to provide perinatal care that is inclusive of gender diversity within these areas. This paper aims to describes a hypothetical clinical experience to provide insight on the institutional barriers that currently exist and to provide nurses and midwives with pragmatic strategies to enhance gender-diverse care in general and gendered clinical areas...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775512/improving-post-hospital-medication-management-in-a-danish-municipality-a-process-evaluation
#20
Mette Geil Kollerup, Tine Curtis, Birgitte Schantz Laursen
AIMS AND OBJECTIVES: This study evaluates an intervention developed to improve patient safety in post-hospital medication management carried out by visiting nurses working in a municipality in Denmark. The intervention consisted of three elements: an initial inter-disciplinary home visit by nurses, two subsequent scheduled visits, and the use of an organising tool. BACKGROUND: As a consequence of specialised treatment plans and new treatment possibilities, patients with complex care needs can now be discharged from hospital more rapidly - and in greater numbers - than previously...
May 18, 2018: Journal of Clinical Nursing
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