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https://www.readbyqxmd.com/read/28431797/video-education-for-critical-care-nurses-to-assess-pain-with-a-behavioural-pain-assessment-tool-a-descriptive-comparative-study
#1
Annika Björn, Sanna-Mari Pudas-Tähkä, Sanna Salanterä, Anna Axelin
AIM: To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. METHODS: Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments...
April 18, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28410920/potential-drug-interaction-with-opioid-agonist-in-the-setting-of-chronic-low-dose-opioid-antagonist-use
#2
James B Leonard, Vidya Nair, Christopher J Diaz, Jonathan B Penoyar, Penelope A Goode
Low dose naltrexone (LDN) has been evaluated in several small studies for the treatment of inflammatory conditions. It is thought to work through modulation of inflammatory mediators and upregulation of endogenous opioid receptors. This may hypersensitize patients to exogenous opioids. Drug-drug interaction screening tools built into electronic health records and other services identify the interaction as risk of opioid withdrawal rather than hypersensitivity. We present a case of a drug-drug interaction in a patient who was receiving LDN treatment of multiple sclerosis...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#3
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28401613/implementing-augmentative-and-alternative-communication-in-critical-care-settings-perspectives-of-healthcare-professionals
#4
Charlotte Handberg, Anna Katarina Voss
AIM: The aim of the current study was to describe the perspectives of healthcare professionals caring for intubated patients on implementing Augmentative and Alternative Communication (AAC) in critical care settings. BACKGROUND: Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalization and rehabilitation...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28388452/accomplishing-professional-jurisdiction-in-intensive-care-an-ethnographic-study-of-three-units
#5
Andreas Xyrichis, Karen Lowton, Anne Marie Rafferty
This paper reports an ethnographic study examining health professional jurisdictions within three intensive care units (ICUs) in order to draw out the social processes through which ICU clinicians organised and delivered life-saving care to critically ill patients. Data collection consisted of 240 h observation of actual practice and 27 interviews with health professionals. The research was conducted against a backdrop of international political and public pressure for national healthcare systems to deliver safe, quality and efficient healthcare...
March 24, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28388251/being-subject-to-restrictions-limitations-and-disciplining-a-thematic-analysis-of-individuals-experiences-in-psychiatric-intensive-care
#6
Martin Salzmann-Erikson, Cecilia Söderqvist
The aim of this study was to describe individuals' experiences of being hospitalized in psychiatric intensive care units (PICUs). Four participants who had previously been admitted in a PICU were interviewed using open-ended questions. The data were analyzed using thematic analysis. Analysis resulted in a synthesis of the various ways patients experienced limitations: (1) Descriptions of Being Limited in the Environment, (2) Descriptions of being Limited in Interactions with Staff, (3) Descriptions of Being Limited in terms of Access to Information, and (4) Descriptions of Having Limited Freedom and Autonomy...
April 7, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28379510/using-electronic-medical-record-notes-to-measure-icu-telemedicine-utilization
#7
Amy Mj O'Shea, Mary Vaughan Sarrazin, Boulos Nassar, Peter Cram, Lynelle Johnson, Robert Bonello, Ralph J Panos, Heather S Reisinger
Given the complexity of high-acuity health care, designing an effective clinical note template can be beneficial to both document patient care and clarify how telemedicine is used. We characterized documented interactions via a standardized note template between bedside intensive care unit (ICU) providers and teleintensivists in 2 Veterans Health Administration ICU telemedicine support centers. All ICUs linked to support centers and providing care from October 2012 through September 2014 were considered. Interactions were assessed based on initiation site, bedside initiator, contact type, and patient care change...
March 31, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28375992/pain-agitation-and-delirium-guidelines-interprofessional-perspectives-to-translate-the-evidence
#8
Juliane Jablonski, Jaime Gray, Todd Miano, Gretchen Redline, Heather Teufel, Tara Collins, Jose Pascual-Lopez, Martha Sylvia, Niels D Martin
BACKGROUND: Societal guidelines exist for the management of pain, agitation, and delirium (PAD) in critically ill patients. This contemporary practice aims for a more awake and interactive patient. Institutions are challenged to translate the interrelated multivariable concepts of PAD into daily clinical practice and to demonstrate improvement in quality outcomes. An interdisciplinary goal-directed approach shows outcomes in high-acuity surgical critical care during the early stages of implementation...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28369745/inflammasome-gene-profile-is-modulated-in-septic-patients-with-a-greater-magnitude-in-non-survivors
#9
K F Esquerdo, N K Sharma, M K C Brunialti, G L Baggio-Zappia, M Assunção, L C P Azevedo, A T Bafi, R Salomao
Inflammasome signalling induces the processing and secretion of interleukin (IL)-1β and IL-18 which, coupled with pyroptosis, activate further the inflammatory response. In the present study we evaluated the expression of genes involved in inflammasome signalling pathways in septic patients, their interaction networks and the predicted functions modulated in survivors and non-survivors. Twenty-seven patients with sepsis secondary to community-acquired pneumonia admitted to intensive care units from three general hospitals in São Paulo were included into the study...
April 2, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28365174/which-alternative-communication-methods-are-effective-for-voiceless-patients-in-intensive-care-units-a-systematic-review
#10
REVIEW
Helen Carruthers, Felicity Astin, Wendy Munro
OBJECTIVE: To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. METHODS: A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised...
March 29, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#11
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28347624/efficacy-and-safety-of-normal-saline-instillation-and-paediatric-endotracheal-suction-an-integrative-review
#12
REVIEW
Jessica O'Leary, Marion L Mitchell, Marie Cooke, Andreas Schibler
OBJECTIVE: To synthesise research findings regarding the efficacy and safety of normal saline instillation (NSI) during endotracheal suction in the paediatric intensive care unit. DATA SOURCES: The Cochrane Library, PROSPERO, the National Health Service Centre for Reviews and Dissemination, PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) databases were systematically searched. Subject headings included "suctioning, endotracheal", "suction", "sodium chloride", "normal saline" and "paediatrics"...
March 24, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28335806/effectiveness-of-early-interventions-for-parental-sensitivity-following-preterm-birth-a-systematic-review-protocol
#13
Andréane Lavallée, Marilyn Aita, Anne Bourbonnais, Gwenaëlle De Clifford-Faugère
BACKGROUND: Parental sensitivity is the interaction process by which parents (a) recognize cues from their infant, (b) interpret these cues adequately, (c) identify an appropriate response and (d) apply this response in an appropriate time frame. In the neonatal intensive care unit, parents of preterm infants often encounter factors hampering the establishment of their parental sensitivity. Parents report the need to be in proximity to and to participate in their preterm infant's care in order to develop their sensitivity to their newborn infant...
March 23, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28333788/nursing-interruptions-in-a-trauma-intensive-care-unit-a-prospective-observational-study
#14
Nicole C Craker, Robert A Myers, Jessy Eid, Priti Parikh, Mary C McCarthy, Kathy Zink, Pratik J Parikh
OBJECTIVE: The aims of this study were to identify and analyze elements that affect duration of an interruption and likelihood of activity switch as experienced by nurses in an ICU. BACKGROUND: Although interruptions in the ICU impact patient safety, little is known regarding the complex situations that drive them. METHODS: RNs were observed in a 23-bed surgical ICU. We observed 206 interruptions, and analyzed for duration and activity switch...
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28318973/the-dual-nature-of-early-life-experience-on-somatosensory-processing-in-the-human-infant-brain
#15
Nathalie L Maitre, Alexandra P Key, Olena D Chorna, James C Slaughter, Pawel J Matusz, Mark T Wallace, Micah M Murray
Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) [1]. Although essential for the support and survival of these infants, NICU sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization [2]. Yet the integrity of sensory systems determines effective perception and behavior [3, 4]. In neonates, touch is a cornerstone of interpersonal interactions and sensory-cognitive development [5-7]...
April 3, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#16
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28284292/the-abcdef-bundle-in-critical-care
#17
REVIEW
Annachiara Marra, E Wesley Ely, Pratik P Pandharipande, Mayur B Patel
The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing intensive care unit patient recovery and outcomes. This article reviews the core evidence and features behind the ABCDEF bundle. The bundle has individual components that are clearly defined, flexible to implement, and help empower multidisciplinary clinicians and families in the shared care of the critically ill. The ABCDEF bundle helps guide well-rounded patient care and optimal resource utilization resulting in more interactive intensive care unit patients with better controlled pain, who can safely participate in higher-order physical and cognitive activities at the earliest point in their critical illness...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28279496/outcomes-of-nighttime-refusal-of-admission-to-the-intensive-care-unit-the-role-of-the-intensivist-in-triage
#18
Nicholas Hinds, Amit Borah, Erika J Yoo
PURPOSE: To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. MATERIALS AND METHODS: Retrospective, observational study of patients refused MICU admission at an urban university hospital. RESULTS: Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=...
February 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28273965/emergence-of-carbapenem-resistant-non-fermenting-gram-negative-bacilli-isolated-in-an-icu-of-a-tertiary-care-hospital
#19
Sonika Agarwal, Barnali Kakati, Sushant Khanduri, Shalini Gupta
INTRODUCTION: The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals. The complex interplay of clonal spread, persistence, transmission of resistance elements and cell-cell interaction leads to the difficulty in controlling infections caused by these multi drug-resistant strains...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28270258/the-impact-of-reducing-antibiotics-on-the-transmission-of-multidrug-resistant-organisms
#20
Sean L Barnes, Clare Rock, Anthony D Harris, Sara E Cosgrove, Daniel J Morgan, Kerri A Thom
OBJECTIVE Antibiotic resistance is a major threat to public health. Resistance is largely driven by antibiotic usage, which in many cases is unnecessary and can be improved. The impact of decreasing overall antibiotic usage on resistance is unknown and difficult to assess using standard study designs. The objective of this study was to explore the potential impact of reducing antibiotic usage on the transmission of multidrug-resistant organisms (MDROs). DESIGN We used agent-based modeling to simulate interactions between patients and healthcare workers (HCWs) using model inputs informed by the literature...
March 8, 2017: Infection Control and Hospital Epidemiology
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