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ICU nursing

Luisa Flohr, Shaylene Beaudry, K Taneille Johnson, Nicholas West, Catherine M Burns, J Mark Ansermino, Guy A Dumont, David Wensley, Peter Skippen, Matthias Gorges
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Saajida Mahomed, A Willem Sturm, Stephen Knight, Prashini Moodley
Background: Appropriate infection control policies and practices are key to reducing the risk of healthcare-associated infections in patients in intensive care units (ICUs). Objective: To evaluate infection control in ICUs using the Infection Control Assessment Tool (ICAT). Methods: Six public and five private adult ICUs were included. Seven modules from the ICAT were administered including ICU, hand hygiene, and isolation and standard precautions...
March 2018: Journal of Infection Prevention
Joseph T Patterson, Kyle Tillinghast, Derek Ward
BACKGROUND: Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. METHODS: Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences...
February 17, 2018: Journal of Arthroplasty
Aleksandra Gutysz-Wojnicka, Dorota Ozga, Danuta Dyk, Wioletta Mędrzycka-Dąbrowska, Marek Wojtaszek, John Albarran
Understanding healthcare professionals perceptions of family presence during resuscitation (FPDR) may help in choosing an effective strategy of implementing this concept in everyday clinical practice. OBJECTIVES: To determine the experiences and views of Polish nurses about family witnessed resuscitation. DESIGN: A cross sectional survey study. SETTING: Delegates (n = 720) attending the Polish Association of Anaesthesia and Intensive Care Nurses conference participated in the study...
March 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Narjeet S Khurmi, Yu-Hui Chang, D Eric Steidley, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Amit K Mathur
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of post-liver transplant death, and variable care patterns may affect outcomes. We aimed to describe epidemiology and outcomes of inpatient CVD care across U.S. hospitals. METHODS: Using a merged dataset from the 2002-2011 Nationwide Inpatient Sample and the American Hospital Association Annual Survey, we evaluated liver transplant patients admitted primarily with myocardial infarction (MI), stroke (CVA), congestive heart failure (CHF), dysrhythmias, cardiac arrest (CA), or malignant hypertension...
March 15, 2018: Liver Transplantation
Sami M Aloush, Faris A Alsaraireh
OBJECTIVE:  To assess nurses' compliance with central line associated bloodstream infection (CLABSI) prevention guidelines related to maintenance of the central line and the predictors of compliance. Method: This was an observational study that used a descriptive cross-sectional design. A sample of 171 intensive care unit (ICU) nurses were observed and their compliance was recorded on a structured observational sheet. The study was conducted in the ICUs of 15 hospitals located in 5 cities in Jordan...
March 2018: Saudi Medical Journal
Hye Jin Yoo, Eunyoung E Suh, Soon Haeng Lee, Jin Hee Hwang, Ji Hye Kwon
PURPOSE: It is difficult to develop a good defense system that can prevent nurses from experiencing physical and verbal violence from patients and families in intensive care units, which are closed spaces. This study aimed to identify intensive care nurses' experience of violence from patients and families and investigate their coping methods, if there are any, in a tertiary hospital in South Korea. METHODS: This study used a mixed methods design utilizing both a survey for collecting quantitative data and individual interviews for a qualitative one...
March 10, 2018: Asian Nursing Research
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
Walter A Boyle, David J Murray, Mary Beth Beyatte, Justin G Knittel, Paul W Kerby, Julie Woodhouse, John R Boulet
OBJECTIVES: Develop a standardized simulation method to assess clinical skills of ICU providers. DESIGN: Simulation assessment. SETTING: Simulation laboratory. SUBJECTS: Residents, Critical Care Medicine fellows, acute care nurse practitioner students. INTERVENTIONS: Performance scoring in scenarios from multiple Critical Care Medicine competency domains. MEASUREMENTS AND MAIN RESULTS: Three-hundred eighty-four performances by 48 participants were scored using checklists (% correct) and holistic "global" ratings (1 [unprepared] to 9 [expert])...
March 7, 2018: Critical Care Medicine
Rambod Amirnovin, Sara Aghamohammadi, Carley Riley, Marlyn S Woo, Sylvia Del Castillo
BACKGROUND: The population of children requiring home mechanical ventilation has evolved over the years and has grown to include a variety of diagnoses and needs that have led to changes in the care of this unique population. The purpose of this study was to provide a descriptive analysis of pediatric patients requiring home mechanical ventilation after hospitalization and how the evolution of this technology has impacted their care. METHODS: A retrospective, observational, longitudinal analysis of 164 children enrolled in a university-affiliated home mechanical ventilation program over 26 years was performed...
March 6, 2018: Respiratory Care
Theodoros Aslanidis, Vasilios Grosomanidis, Konstantinos Karakoulas, Athanasios Chatzisotiriou
Electrodermal activity (EDA) is considered a measure of autonomous nervous system activity. This study performed an exploratory analysis of the EDA changes during blood pooling for arterial blood gas analysis in sedated adult critical care patients and correlated the variations to other monitored parameters. EDA, along with other parameters, were monitored during 4 h routine daytime intensive care nursing and treatment in an adult ICU. 4 h measurements were divided into two groups based upon the sedation level...
March 6, 2018: Medical Sciences: Open Access Journal
Tetsu Ohnuma, Daisuke Shinjo, Alan M Brookhart, Kiyohide Fushimi
Background: Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Methods: Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014...
2018: Journal of Intensive Care
D Dante Yeh, Eva Fuentes, Sadeq A Quraishi, Jarone Lee, Haytham M A Kaafarani, Peter Fagenholz, Kathryn Butler, Marc DeMoya, Yuchiao Chang, George Velmahos
BACKGROUND: Failure to provide adequate nutrition in the intensive care unit (ICU) may be particularly harmful for patients with prolonged critical illness. We hypothesized that early nutrition inadequacy is more influential for those requiring a longer ICU stay versus those requiring a shorter stay. METHODS: We enrolled 280 adult patients with prolonged surgical ICU stay who were receiving enteral nutrition for >72 hours. Subjects were divided into 2 groups: shortICU (<14 days) and longICU (≥14 days)...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Michail Zografakis-Sfakianakis, Eelco De Bree, Manolis Linardakis, Argyri Messaritaki, Helen Askitopoulou, Alexandra Papaioannou, Panagiotis Aggouridakis
AIM: To determine the value of the Modified Early Warning Score (MEWS) for general ward patients and its potential use as an alarm tool for ward nurses. METHODS: A combined prospective-retrospective observational study was conducted with 153 patients in a university hospital (2013-2014). All patients were admitted to the intensive care unit (ICU) from general wards. Parameters retrospectively studied were 5 MEWS values at 4 hourly intervals, up to 20 hours before ICU admission...
March 1, 2018: International Journal of Nursing Practice
Yanbin Pan, Zhixia Jiang, Yuan Changrong, Lianhong Wang, Jingjing Zhang, Jing Zhou, Ming Tao, Mingtao Quan, Qiong Wu
AIMS AND OBJECTIVES: To investigate the impact of physical restraint on delirium of adult patients in ICU. BACKGROUND: Delirium is a common clinical syndrome in intensive care unit (ICU), correlated with various adverse clinical outcomes. Physical restraint is a precipitating factor for delirium, however, the effect of physical restraint on delirium, such as duration, number, and appliance, etc., is still unclear. DESIGN: A nested case-control study...
March 1, 2018: Journal of Clinical Nursing
Vincent I Lau, Joyce N H Lam, John Basmaji, Fran A Priestap, Ian M Ball
OBJECTIVES: Evaluate outcomes (mortality, morbidity, unplanned return visits) of patients who are discharged directly to home from the ICU. DESIGN: Prospective cohort study. SETTING: Two tertiary care medical-surgical-trauma ICUs at Canadian hospitals over 1 year (February 2016-2017). SUBJECTS: All adult patients who were either discharged directly to home (Recruited and Nonrecruited cohorts) from ICU or discharged home within 24 hours after ward transfer (Ward Transfer cohort)...
February 28, 2018: Critical Care Medicine
Lauren Breisinger, Angela Macci Bires, Thomas W Cline
The intensive care unit (ICU) can be a place of stress, anxiety, and emotional instability for both patients and families. Medical and nursing care during this acute time is patient focused, and family members are often left in the dark. Unintentional exclusion from information results in high levels of stress, anxiety, and uncertainty for families. Due to the acuity of illness, family members of cardiac surgery patients experience the highest levels of stress. Spouses may experience intense psychosomatic symptoms such as depression, anxiety, and fear for several months after the surgery...
April 2018: Critical Care Nursing Quarterly
Mohammad Bani Younis, Ferial A Hayajneh
Investigating sleep disturbances among intensive care unit (ICU) patients and its serious consequences is considered a crucial issue for nurses. The need of sleep increases during hospitalization time to preserve energy for the healing process. Previous studies have demonstrated that sleep disturbance is one of the most common complaints of patients in the ICUs, with a prevalence of more than 50%. Although the total sleep time might be normal, the patients' sleep is fragmented and light in the intensive care settings...
April 2018: Critical Care Nursing Quarterly
Gérald Chanques, E Wesley Ely, Océane Garnier, Fanny Perrigault, Anaïs Eloi, Julie Carr, Christine M Rowan, Albert Prades, Audrey de Jong, Sylvie Moritz-Gasser, Nicolas Molinari, Samir Jaber
BACKGROUND: One third of patients admitted to an intensive care unit (ICU) will develop delirium. However, delirium is under-recognized by bedside clinicians without the use of delirium screening tools, such as the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU). The CAM-ICU was updated in 2014 to improve its use by clinicians throughout the world. It has never been validated compared to the new reference standard, the Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5)...
March 1, 2018: Annals of Intensive Care
Emily D Browning, Jourdan S Cruz
Health-care workers may experience moral distress when they are unable to act as they believe is ethically appropriate in their clinical work. A social worker-facilitated protocol called Reflective Debriefing was developed and tested for alleviating moral distress through regular debriefings with nursing staff on an intensive care unit (ICU). Forty-two ICU nurses completed a Moral Distress Scale-Revised (MDS-R) at the beginning and end of a 6-month period, during which time regular debriefings were offered...
February 28, 2018: Journal of Social Work in End-of-life & Palliative Care
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