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pediatric ICU nursing

Ahmad Ismail
Providing effective pain management is necessary for all patients in the intensive care unit (ICU). Because of developmental considerations, caring for children may provide additional challenges. The purpose of this literature review is to describe key challenges in providing effective pain management in pediatric intensive care units (PICUs), with the aim of bringing about a better understanding by health care providers caring for children. Challenges of providing effective pain management in the PICU can be categorized into four levels...
October 15, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Kimberly Douglas, Jerry Christopher Collado, Sheila Keller
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations...
October 2016: Critical Care Nursing Quarterly
Marion Mitchell, Maureen Coombs, Krista Wetzig
BACKGROUND: Caring for the bereaved is an intrinsic part of intensive care practice with family bereavement support an important aspect of the nursing role at end of life. However, reporting on provision of intensive care family bereavement support at a national level has not been well reported since an Australian paper published ten years ago. OBJECTIVES: The objective was to investigate provision of family bereavement support in intensive care units (ICU) across New Zealand (NZ) and Australia...
August 25, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Beryl F Yaghmai, Jane L Di Gennaro, Gretchen A Irby, Kristina H Deeter, Jerry J Zimmerman
OBJECTIVES: To reevaluate the effect of a nursing-driven sedation protocol for mechanically ventilated patients on analgesic and sedative medication dosing durations. We hypothesized that lack of continued quality improvement efforts results in increased sedation exposure, as well as mechanical ventilation days, and ICU length of stay. DESIGN: Quasi-experimental, uncontrolled before-after study. SETTING: Forty-five-bed tertiary care, medical-surgical-cardiac PICU in a metropolitan university-affiliated children's hospital...
August 2016: Pediatric Critical Care Medicine
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Lindsey B Justice, David S Cooper, Carla Henderson, James Brown, Katherine Simon, Lindsey Clark, Elizabeth Fleckenstein, Alexis Benscoter, David P Nelson
OBJECTIVES: To improve communication during daily cardiac ICU multidisciplinary rounds. DESIGN: Quality improvement methodology. SETTING: Twenty-five-bed cardiac ICUs in an academic free-standing pediatric hospital. PATIENTS: All patients admitted to the cardiac ICU. INTERVENTIONS: Implementation of visual display of patient daily goals through a write-down and read-back process. MEASUREMENTS AND MAIN RESULTS: The Rounds Effectiveness Assessment and Communication Tool was developed based on the previously validated Patient Knowledge Assessment Tool to evaluate comprehension of patient daily goals...
July 2016: Pediatric Critical Care Medicine
Mauricio A Escobar, Carolynn J Morris
BACKGROUND: The American College of Surgeons Committee on Trauma (ACS-COT) view over- and undertriage rates based on trauma team activation (TTA) criteria as surrogate markers for quality trauma patient care. Undertriage occurs when classifying patients as not needing a TTA when they do. Over-triage occurs when a TTA is unnecessarily activated. ACS-COT recommends undertriage <5% and overtriage 25-35%. We sought to improve the under-triage and over-triage rates at our Level II Pediatric Trauma Center by updating our outdated trauma team activation criteria in an evidence-based fashion to better identify severely injured children and improving adherance to following established trauma team activation criteria...
September 2016: Journal of Pediatric Surgery
Chengsi Ong, Jan Hau Lee, Melvin K S Leow, Zudin A Puthucheary
OBJECTIVE: Although more children are surviving critical illness, little is known about long-term physical impairment. This scoping review aims to critically appraise existing literature on functional outcome measurement tools, prevalence, and risk factors for physical impairments in pediatric critical care survivors. DATA SOURCES: PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature, using a combination of MeSH terms and keywords (critical illness, intensive care, and functional outcomes/status)...
May 2016: Pediatric Critical Care Medicine
Ross E Newman, Michael A Bingler, Paul N Bauer, Brian R Lee, Keith J Mann
OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU. METHODS: A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer)...
April 2016: Hospital Pediatrics
Meghan M Cirulis, Mitchell T Hamele, Chris R Stockmann, Tellen D Bennett, Susan L Bratton
OBJECTIVES: The new Centers for Disease Control and Prevention paradigm for ventilator-associated events is intended to simplify surveillance of infectious and noninfectious complications of mechanical ventilation in adults. We assessed the ventilator-associated events algorithm in pediatric patients. DESIGN: A retrospective observational cohort study. SETTING: This single-center study took place in a PICU at an urban academic medical facility...
February 2016: Pediatric Critical Care Medicine
Orla M Smith, Craig Dale, Sangeeta Mehta, Ruxandra Pinto, Louise Rose
OBJECTIVE: To characterize ICU nurses' research experience, work environments, and attitudes toward clinical research in critically ill adults and children. DESIGN: Cross-sectional survey. SETTING: Eight (seven adult and one pediatric) academic ICUs affiliated with the Canadian Critical Care Trials Group. PARTICIPANTS: Four hundred eighty-two ICU nurses. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Response rate was 56%...
January 2016: Critical Care Medicine
Gitte Y Larsen, Michelle Schober, Anthony Fabio, Stephen R Wisniewski, Mary Jo C Grant, Nadeem Shafi, Tellen D Bennett, Deborah Hirtz, Michael J Bell
BACKGROUND: Traumatic brain injury (TBI) is an important worldwide cause of death and disability for children. The Approaches and Decisions for Acute Pediatric TBI (ADAPT) Trial is an observational, cohort study to compare the effectiveness of six aspects of TBI care. Understanding the differences between clinical sites-including their structure, clinical processes, and culture differences-will be necessary to assess differences in outcome from the study and can inform the overall community regarding differences across academic centers...
June 2016: Neurocritical Care
Anita Patel, Eunice Clark, Chani Traube, Katherine Biagas
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Angela Hui Ping Kirk, Brenda Sok Peng Ng, Ang Noi Lee, Bixia Ang, Jan Hau Lee
BACKGROUND: Critically ill children frequently receive inadequate nutritional support. Feeding protocols have been shown to facilitate optimal nutritional care. PURPOSE: We aim to determine the perceptions of critical care nurses with regard to the implementation of a feeding protocol as well as to their preferred teaching methods before introducing this protocol in our pediatric intensive care unit (PICU). We hypothesize that nursing experience and educational level are factors that predict readiness to adopt this protocol...
December 2015: Journal of Nursing Research: JNR
Christiana M Russ, Michael Agus
BACKGROUND: Hospitalized children have a wide range of acuity and risk of decompensation. The objective of this study was to determine where pediatric patients are triaged when they present to pediatric hospitals needing intense monitoring and nursing care, but do not require invasive monitoring or technology. METHODS: We completed a telephone survey of pediatric hospitals in the United States with at least 2 non-neonatal pediatric wards and at least 50 acute inpatient beds...
October 2015: Hospital Pediatrics
Melanie Cooper Flaigle, Judy Ascenzi, Sapna R Kudchadkar
Delirium in the pediatric intensive care unit (PICU) setting is often unrecognized and undertreated. The importance of screening and identification of ICU delirium has been identified in both adult and pediatric literature. Delirium increases ICU morbidity, length of mechanical ventilation and length of stay. The objective of this study was to determine the current knowledge level about delirium and its risk factors among pediatric critical care nurses through a short questionnaire. We hypothesized that before a targeted educational intervention, PICU care providers do not have an adequate knowledge base for accurate screening and diagnosis of delirium in critically ill children...
January 2016: Journal of Pediatric Nursing
J'ai Watson, Angela Kinstler, William P Vidonish, Michael Wagner, Li Lin, Kermit G Davis, Susan E Kotowski, Nancy M Daraiseh
BACKGROUND: Excessive exposure to noise places nurses at risk for safety events, near-misses, decreased job performance, and fatigue. Noise is particularly a concern in pediatric intensive care units, where highly skilled providers and vulnerable patients require a quiet environment to promote healing. OBJECTIVE: To measure noise levels and noise duration on specialty pediatric intensive care units to explore sources of noise and its effects on the health of registered nurses...
September 2015: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Jeannette A Rogowski, Douglas O Staiger, Thelma E Patrick, Jeffrey D Horbar, Michael J Kenny, Eileen T Lake
The neonatal intensive care unit (NICU) is a setting with high nurse-to-patient ratios. Little is known about the factors that determine nurse workload and assignment. The goals of this study were to (1) develop a measure of NICU infant acuity; (2) describe the acuity distribution of NICU infants; (3) describe the nurse/infant ratio at each acuity level, and examine the factors other than acuity, including nurse qualifications and the availability of physicians and other providers, that determined staffing ratios; and (4) explore whether nurse qualifications were related to the acuity of assigned infants...
October 2015: Research in Nursing & Health
Juan Qian, Ying Wang, Yucai Zhang, Xiaodong Zhu, Qunfang Rong, Hongxia Wei
BACKGROUND: Application of the sepsis resuscitation bundle is limited by clinician knowledge, skills, and experience. We used the adjusted first-hour basic care tasks in pediatric patients in three tertiary hospitals in Shanghai, China. OBJECTIVE: The aim of this study is to survey the compliance of the adjusted tasks and to evaluate in situ simulation team training on improving the compliance. METHODS: A prospective observational study was performed with the survey checklists from May 2011 to January 2012 in three pediatric intensive care units...
February 2016: Journal of Emergency Medicine
Lisa M Korst, Daniele S Feldman, D Lisa Bollman, Moshe Fridman, Samia El Haj Ibrahim, Arlene Fink, Lacey Wyatt, Kimberly D Gregory
OBJECTIVE: The objective of the study was to describe the resources and activities associated with childbirth services. STUDY DESIGN: We adapted models for assessing the quality of healthcare to generate a conceptual framework hypothesizing that childbirth hospital resources and activities contributed to maternal and neonatal outcomes. We used this framework to guide development of a survey, which we administered by telephone to hospital labor and delivery nurse managers in California...
October 2015: American Journal of Obstetrics and Gynecology
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