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https://www.readbyqxmd.com/read/28631532/measuring-sleep-in-the-intensive-care-unit-a-critical-appraisal-of-the-use-of-subjective-methods
#1
Emma L Jeffs, Julie L Darbyshire
OBJECTIVES: To collate and appraise the use of subjective measures to assess sleep in the intensive care unit (ICU). DESIGN: A systematic search and critical review of the published literature. DATA SOURCES: Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature were searched using combinations of the key words "Sleep," "Critical Care," "Intensive Care," and "Sleep Disorders," and this was complemented by hand searching the most recent systematic reviews on related topics...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28630952/estimating-patient-s-health-state-using-latent-structure-inferred-from-clinical-time-series-and-text
#2
Aaron Zalewski, William Long, Alistair E W Johnson, Roger G Mark, Li-Wei H Lehman
Modern intensive care units (ICUs) collect large volumes of data in monitoring critically ill patients. Clinicians in the ICUs face the challenge of interpreting large volumes of high-dimensional data to diagnose and treat patients. In this work, we explore the use of Hierarchical Dirichlet Processes (HDP) as a Bayesian nonparametric framework to infer patients' states of health by combining multiple sources of data. In particular, we employ HDP to combine clinical time series and text from the nursing progress notes in a probabilistic topic modeling framework for patient risk stratification...
February 2017: IEEE-EMBS International Conference on Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28618123/-pain-relieved-but-still-struggling-critically-ill-patients-experiences-of-pain-and-other-discomforts-during-analgosedation
#3
Helene Berntzen, Ida Torunn Bjørk, Hilde Wøien
AIM & OBJECTIVE: To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts, and wakefulness. BACKGROUND: Patients experience both pain and discomfort while in the intensive care unit (ICU). International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favoring pain management, light sedation and early mobilization was implemented in our university hospital medical and surgical ICU in Norway in 2014...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28618038/open-visitation-and-nurse-job-satisfaction-an-integrative-review
#4
Marissa Monroe, Linda Wofford
AIMS AND OBJECTIVES: To explore the effect of open visitation on critical care nurse job satisfaction. BACKGROUND: Open visitation has many benefits for ICU patients and families. However, ICU open visitation affects nurses' work environment too. Because nurse satisfaction is crucial to overall patient satisfaction, nurses' perceptions, experiences, and opinions about open visitation should be considered. DESIGN: A literature search was performed through CINAHL Complete, MEDLINE Complete, PubMed, ScienceDirect, Academic Search Premier and PsychINFO...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#5
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28614432/characteristics-of-nursing-professionals-and-the-practice-of-ecologically-sustainable-actions-in-the-medication-processes
#6
Patricia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira, Patricia Beryl Marck
Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28612365/knowledge-attitude-and-practice-of-intensive-care-unit-nurses-about-physical-restraint
#7
Mohammad Suliman, Sami Aloush, Khitam Al-Awamreh
BACKGROUND: Physical restraint is mainly used in intensive care units (ICUs) to prevent delirious or agitated patients from removing tubes and lines connected to them. However, inappropriate use of physical restraint could have many detrimental physical effects on the patient, such as nerve damage, asphyxiation or even death. AIM: The aim of the study is to investigate nurses' knowledge, attitude and practice of physical restraint in ICUs in Jordanian hospitals, about which little is known...
June 13, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#8
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28611090/a-qualitative-analysis-of-the-three-good-things-intervention-in-healthcare-workers
#9
Karin Rippstein-Leuenberger, Oliver Mauthner, J Bryan Sexton, Rene Schwendimann
BACKGROUND: Intensive care unit (ICU) personnel have an elevated prevalence of job-related burn-out and post-traumatic stress disorder, which can ultimately impact patient care. To strengthen healthcare workers' skills to deal with stressful events, it is important to focus not only on minimising suffering but also on increasing happiness, as this entails many more benefits than simply feeling good. Thus, the purpose of this study was to explore the content of the 'good things' reported by healthcare workers participating in the 'Three Good Things' intervention...
June 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28601795/the-role-of-nurses-clinical-impression-in-the-first-assessment-of-children-at-the-emergency-department
#10
Joany M Zachariasse, Dominique van der Lee, Nienke Seiger, Evelien de Vos-Kerkhof, Rianne Oostenbrink, Henriëtte A Moll
OBJECTIVE: To assess the diagnostic value and determinants of nurses' clinical impression for the recognition of children with a serious illness on presentation to the emergency department (ED). DESIGN: Secondary analysis of a prospective cohort. SETTING AND PATIENTS: 6390 consecutive children <16 years of age presenting to a paediatric ED with a non-surgical chief complaint and complete data available. MAIN OUTCOME MEASURES: Diagnostic accuracy of nurses' clinical impression for the prediction of serious illness, defined by intensive care unit (ICU) and hospital admission...
June 10, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#11
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
June 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28599662/a-randomized-controlled-pilot-study-to-evaluate-the-effect-of-an-enteral-formulation-designed-to-improve-gastrointestinal-tolerance-in-the-critically-ill-patient-the-spirit-trial
#12
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28598947/moral-distress-in-picu-and-neonatal-icu-practitioners-a-cross-sectional-evaluation
#13
Charles Philip Larson, Karen D Dryden-Palmer, Cathy Gibbons, Christopher S Parshuram
OBJECTIVES: To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. DESIGN: Cross-sectional survey. SETTING: A large pediatric tertiary care center. SUBJECTS: Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. INTERVENTIONS: A 41-item questionnaire examining moral distress, burnout, and uncertainty...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28598014/ward-nurses-experience-of-the-transfer-of-icu-patients-a-great-responsibility-and-a-huge-challenge
#14
Ronny Enger, Birgitta Andershed
AIMS AND OBJECTIVES: The aim of the study was to describe nurses' experiences of patients' transition from ICUs to general wards and their suggestions for improvements. BACKGROUND: In the ICU, the most seriously ill patients with life-threatening conditions and multiple organ dysfunction syndromes are cared for and carefully monitored by specially trained professionals using advanced techniques for the prevention of failure of vital functions. The transfer of ICU patients to general wards means a change from a high to a lower level, including the loss of one-to-one nursing and a reduction of visible monitoring equipment and general close attention...
June 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28595826/-what-happens-behind-the-curtains-an-exploration-of-icu-nurses-experiences-of-post-mortem-care-on-patients-who-have-died-in-intensive-care
#15
Carien de Swardt, Nicola Fouché
THE AIM OF THE STUDY: The aim of this study was to explore the experiences of intensive care nurses performing post mortem care on patients who had died in an intensive care unit at a private hospital in Cape Town. The study further sets out to identify educational needs and to offer recommendations that may address these needs for this sample of nurses. METHODOLOGY AND SETTING: A qualitative research design using a descriptive method was used to explore the experiences of a purposive heterogeneous sample of six nurses who were working in an intensive care unit in a private hospital in Cape Town...
June 5, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28595825/nursing-staff-s-experiences-of-working-in-an-evidence-based-designed-icu-patient-room-an-interview-study
#16
Fredrika Sundberg, Sepideh Olausson, Isabell Fridh, Berit Lindahl
INTRODUCTION: It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. OBJECTIVE: The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room...
June 5, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#17
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
June 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28587503/sense-of-responsibility-in-icu-end-of-life-decision-making-relatives-experiences
#18
Ranveig Lind
BACKGROUND: Relatives of intensive care unit patients who lack or have reduced capacity to consent are entitled to information and participation in decision-making together with the patient. Practice varies with legislation in different countries. In Norway, crucial decisions such as withdrawing treatment are made by clinicians, usually morally justified to relatives with reference to the principle of non-maleficence. The relatives should, however, be consulted about whether they know what the patient would have wished in the situation...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28579349/electromagnetic-guided-placement-of-nasoduodenal-feeding-tubes-versus-endoscopic-placement-a-randomized-multicenter-trial
#19
Wouter F W Kappelle, Daisy Walter, Paul Stadhouders, Hendrik J A Jebbink, Frank P Vleggaar, Peter van der Schaar, Jan Willem Kappelle, Ingeborg van der Tweel, Medard F M Van den Broek, Frank J Wessels, Peter D Siersema, Jan F Monkelbaan
BACKGROUND AND AIMS: Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to esophagogastroduodenoscopy guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. METHODS: In 3 centers with no prior experience in EMP, patients were randomized to placement of a single lumen nasoduodenal feeding tube either with EGDP or EMP...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28577478/association-between-advanced-practice-nursing-and-30-day-mortality-in-mechanically-ventilated-critically-ill-patients-a-retrospective-cohort-study
#20
Kojiro Morita, Hiroki Matsui, Hayato Yamana, Kiyohide Fushimi, Tomoaki Imamura, Hideo Yasunaga
PURPOSE: Little is known about the association between advanced practice nursing and mortality. The aim of this study was to evaluate whether the presence of advanced practice nurses (APN), that is, certified nurse (CN) and certified nurse specialist (CNS) in intensive care, is associated with 30-day mortality for mechanically ventilated critically ill patients. MATERIALS AND METHODS: Using a Japanese national in-patient database, we identified 45,620 patients who were admitted to an intensive care unit (ICU) and received mechanical ventilation within 2 days of hospital admission between 1 April 2014 and 31 March 2015...
May 24, 2017: Journal of Critical Care
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