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https://www.readbyqxmd.com/read/28938252/emotional-impact-of-end-of-life-decisions-on-professional-relationships-in-the-icu-an-obstacle-to-collegiality
#1
Alexandra Laurent, Magalie Bonnet, Gilles Capellier, Pierre Aslanian, Paul Hebert
OBJECTIVES: End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. DESIGN: Qualitative study with clinical interviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28936962/-evaluation-of-the-effect-of-a-new-fixation-tape-for-tracheal-catheter-in-intensive-care-patients
#2
Limin Chen, Ruihong Liu, Biyu Shen, Lingling Wang, Zhiming Cui, Guanhua Xu
OBJECTIVE: To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients. METHODS: A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936597/terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#3
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936495/the-accuracy-of-nurses-predictions-for-clinical-outcomes-in-the-chronically-critically-ill
#4
Amy R Lipson, Sarah J Miano, Barbara J Daly, Sara L Douglas
BACKGROUND: Accurately predicting survivorship of patients in the intensive care unit is known to be difficult. Previous research has shown that nurses are more likely to recognize futile medical care than other disciplines. The purpose of this study was to describe the accuracy of nurse's predictions for survival of patients who are chronically critically ill (CCI). METHODS: Using a secondary data analysis from a longitudinal, descriptive study, we evaluated nurses' predictions for survival at admission and until ICU discharge or patient death...
September 2017: Research & Reviews: Journal of Nursing and Health Sciences
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#5
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28931361/patient-family-and-physician-satisfaction-with-planning-for-direct-discharge-to-home-from-intensive-care-units-direct-from-icu-sent-home-study
#6
Joyce Nga Hei Lam, Vincent I Lau, Fran A Priestap, John Basmaji, Ian M Ball
BACKGROUND: In the new era of decreasing hospital bed availability, there is an increasing rate of direct discharge to home (DDH) from intensive care units (ICUs), despite sparse literature informing this practice. OBJECTIVES: To evaluate patient, family, and ICU attending physician satisfaction with planning for DDH from the ICU and intensivists' current DDH practices and perceptions. METHODS: Prospective cohort study, using convenience sampling, of adult patients undergoing DDH from an ICU between February 2016 and February 2017 using a modified FS-ICU 24 satisfaction survey completed by patients, family members, and attending physicians at the time of patient discharge to home from the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28919614/use-of-acute-physiology-and-chronic-health-evaluation-apache-ii-and-red-cell-distribution-width-rdw-for-assessment-of-mortality-of-patients-with-sepsis-in-icu
#7
A Q Huda, M R Karim, M A Mahmud, M S Islam, M F Haque, M R Islam, M A Hossain
Critically ill patients of Intensive Care Unit (ICU) need highest level of monitoring, intense nursing care and integrated management which are very expensive and consume significant part of hospital resources. Prediction of outcome from disease has become an essential component of health science. So, various scoring systems have been developed to predict outcome of critically ill patients in ICU. There is no perfect model of severity score to predict ICU mortality. Search for new system is still remaining as continuous efforts to find the best model to get accurate information about the prognosis and outcome of critically ill patients...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#8
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28902121/critical-care-resources-in-guangdong-province-of-china-three-surveys-from-2005-to-2015
#9
Jian-Feng Wu, Fei Pei, Bin Ouyang, Juan Chen, Yi-Min Li, Yong-Wen Feng, Fa-Liang Guo, Li-Xin Zhou, Zheng Wang, Ying-Jun Guo, Qin-Han Lin, Zhan-Peng Li, Yun Ling, Li Li, Lie-Hua Deng, Ying-Ping Zhao, Jian-Wei Dai, Shu-Yu Luo, Dun-Rong Zhou, Wei-Wen Luo, Ling Zhao, Wei-Ying Chen, Wei-Chuan Wang, Wen-Yang Cai, Qiong-Xiang Luo, Xiang-Dong Guan
OBJECTIVES: Data about the critical care resources in China remain scarce. The purpose of this study was to investigate the variation and distribution of critical care resources in Guangdong province from 2005 to 2015. DESIGN: Data in regard to critical care resources were collected through questionnaires and visits every 5 years from 2005. SETTING: All hospitals in Guangdong province were screened and hospitals that provide critical care services were enrolled...
September 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28899584/evaluating-the-past-to-improve-the-future-a-qualitative-study-of-icu-patients-experiences
#10
Kristin Dahle Olsen, Marit Nester, Britt Sætre Hansen
BACKGROUND: The recovery period for patients who have been in an intensive care unitis often prolonged and suboptimal. Anxiety, depression and post-traumatic stress disorder are common psychological problems. Intensive care staff offer various types of intensive aftercare. Intensive care follow-up aftercare services are not standard clinical practice in Norway. OBJECTIVE: The overall aim of this study is to investigate how adult patients experience theirintensive care stay their recovery period, and the usefulness of an information pamphlet...
September 9, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28890209/nursing-workload-and-adherence-to-non-pharmacological-measures-in-the-prevention-of-ventilator-associated-pneumonia-a-pilot-study
#11
R Jam, O Hernández, J Mesquida, C Turégano, E Carrillo, R Pedragosa, V Gómez, L Martí, J Vallés, P Delgado-Hito
OBJECTIVE: To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS: A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score)...
September 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28881078/the-effects-of-nurse-led-clinical-pathway-in-coronary-artery-bypass-graft-surgery-a-quasi-experimental-study
#12
Ayda Kebapçı, Nevin Kanan
AIMS AND OBJECTIVE: Develop and evaluate the effects of a nurse-led clinical pathway (CP) for patients undergoing CABG (Coronary Artery Bypass Graft Surgery). BACKGROUND: A CP is a multidisciplinary care plan, based on evidence and guidelines to provide consistent, quality care to patients and improve outcomes. DESIGN: Prospective, quasi-experimental design. METHODS: Patients hospitalized for CABG between April 2014 and November 2015 in a hospital in Turkey were studied...
September 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28875782/improving-communication-with-families-in-the-intensive-care-unit
#13
Deborah Briggs
Families ('family' will be used in this article to refer to anyone the patient considers significant, whether they are an actual family member or not) of patients who are critically ill have heightened communication needs. Nurses are an important source of information, particularly about day-to-day patient events and progress. Intensive care unit (ICU) nurses are valued by families because they provide clear, jargon-free information about the patient and their condition. However, they have sometimes been criticised for focusing on short-term issues while avoiding potentially difficult conversations about long-term outcomes and prognosis...
September 6, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28875617/clinical-considerations-when-applying-vital-signs-in-pediatric-korean-triage-and-acuity-scale
#14
Bongjin Lee, Do Kyun Kim, June Dong Park, Young Ho Kwak
Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the 'real practice (RP)-level,' while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the 'simulation (S)-level...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28865340/is-patient-length-of-stay-associated-with-intensive-care-unit-characteristics
#15
Ilona W M Verburg, Rebecca Holman, Dave Dongelmans, Evert de Jonge, Nicolette F de Keizer
PURPOSE: We described the association between Intensive care units (ICU) characteristics and ICU Length of stay (LoS), after correcting for patient characteristics. We also compared the predictive performances of models including either patient and ICU characteristics or only patient characteristics. MATERIALS AND METHODS: We included all admissions of 38 ICUs participating in the Dutch National Intensive Care Evaluation registry (NICE) between 2014 and 2016. We performed mixed effect regression including, one ICU characteristic in each model and a random intercept per ICU...
August 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28864431/palliative-care-professional-development-for-critical-care-nurses-a-multicenter-program
#16
Wendy G Anderson, Kathleen Puntillo, Jenica Cimino, Janice Noort, Diana Pearson, Deborah Boyle, Michelle Grywalski, Jeannette Meyer, Edith O'Neil-Page, Julia Cain, Heather Herman, Susan Barbour, Kathleen Turner, Eric Moore, Solomon Liao, Bruce Ferrell, William Mitchell, Kyle Edmonds, Nathan Fairman, Denah Joseph, John MacMillan, Michelle M Milic, Monica Miller, Laura Nakagawa, David L O'Riordan, Christopher Pietras, Kathryn Thornberry, Steven Z Pantilat
BACKGROUND: Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care. OBJECTIVE: To implement and evaluate a palliative care professional development program for ICU bedside nurses. METHODS: From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28859648/engaging-patients-and-families-to-create-a-feasible-clinical-trial-integrating-palliative-and-heart-failure-care-results-of-the-enable-chf-pc-pilot-clinical-trial
#17
Marie Bakitas, J Nicholas Dionne-Odom, Salpy V Pamboukian, Jose Tallaj, Elizabeth Kvale, Keith M Swetz, Jennifer Frost, Rachel Wells, Andres Azuero, Konda Keebler, Imatullah Akyar, Deborah Ejem, Karen Steinhauser, Tasha Smith, Raegan Durant, Alan T Kono
BACKGROUND: Early palliative care (EPC) is recommended but rarely integrated with advanced heart failure (HF) care. We engaged patients and family caregivers to study the feasibility and site differences in a two-site EPC trial, ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers). METHODS: We conducted an EPC feasibility study (4/1/14-8/31/15) for patients with NYHA Class III/IV HF and their caregivers in academic medical centers in the northeast and southeast U...
August 31, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28858150/effort-reward-imbalance-and-burnout-among-icu-nursing-staff-a-cross-sectional-study
#18
COMPARATIVE STUDY
Cristobal Padilla Fortunatti, Yasna K Palmeiro-Silva
BACKGROUND: Occupational stress is commonly observed among staff in intensive care units (ICUs). Sociodemographic, organizational, and job-related factors may lead to burnout among ICU health workers. In addition, these factors could modify the balance between efforts done and rewards perceived by workers; consequently, this imbalance could increase levels of emotional exhaustion and depersonalization and decrease a sense of personal accomplishment. OBJECTIVE: The purpose of this study was to analyze the relationship between effort-reward imbalance and burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment) among ICU nursing staff in a university hospital in Santiago, Chile...
September 2017: Nursing Research
https://www.readbyqxmd.com/read/28858143/facilitated-nurse-medication-related-event-reporting-to-improve-medication-management-quality-and-safety-in-intensive-care-units
#19
Jie Xu, Carrie Reale, Jason M Slagle, Shilo Anders, Matthew S Shotwell, Timothy Dresselhaus, Matthew B Weinger
BACKGROUND: Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. OBJECTIVES: The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs...
September 2017: Nursing Research
https://www.readbyqxmd.com/read/28853187/time-motion-analysis-of-nursing-work-in-icu-telemetry-and-medical-surgical-units
#20
Elizabeth Schenk, Ruth Schleyer, Cami R Jones, Sarah Fincham, Kenn B Daratha, Karen A Monsen
AIM: This study examined nurses' work, comparing nursing interventions and locations across three units in a United States hospital using Omaha System standardized terminology as the organizing framework. BACKGROUND: The differences in nurses' acute-care work across unit types are not well understood. Prior investigators have used time-motion methodologies; few have compared differences across units, nor used standardized terminology. METHODS: Nurse-observers recorded locations and interventions of nurses on three acute-care units using hand-held devices and web-based TimeCaT(™) software...
August 29, 2017: Journal of Nursing Management
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