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https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#1
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29775992/from-breaking-point-to-breakthrough-during-the-icu-stay-a-qualitative-study-of-family-members-experiences-of-long-term-intensive-care-patients-pathways-towards-survival
#2
Hege S Haugdahl, Regina Eide, Ingeborg Alexandersen, Tove Engan Paulsby, Berit Stjern, Stine Borgen Lund, Gørill Haugan
AIMS AND OBJECTIVES: To explore family members' experiences of long-term intensive care unit (ICU) patients' pathways towards survival and to highlight family members' efforts to promote the patient's health during the ICU stay. BACKGROUND: Although considerable research has been devoted to the substantial burden of long-term ICU patients, less attention has been paid to health promoting factors that facilitate patients' health and survival during ICU stays. Support from family members can improve patient outcome...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#3
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29742590/a-multicenter-observational-study-of-family-participation-in-icu-rounds
#4
Selena S Au, Amanda L Roze des Ordons, Jeanna Parsons Leigh, Andrea Soo, Simon Guienguere, Sean M Bagshaw, Henry T Stelfox
OBJECTIVES: Guidelines recommend offering family members of critically ill patients the option to attend interdisciplinary team rounds as a way to improve communication and satisfaction. Uncertainty remains around the benefits and risks. DESIGN: We conducted an observational study to describe family participation in ICU rounds and its association with rounding processes. SETTING: Rounds conducted under the leadership of 33 attending physicians in seven hospitals across three Canadian cities...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742551/exploring-research-topics-and-trends-in-nursing-related-communication-in-intensive-care-units-using-social-network-analysis
#5
Youn-Jung Son, Soo-Kyoung Lee, SeJin Nam, Jae Lan Shim
This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses...
May 4, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29736044/improving-the-clinical-pharmacist-handover-process-in-the-intensive-care-unit-with-a-pharmacotherapy-specific-tool-the-i-happy-study
#6
Emma Attfield, Matthew P Swankhuizen, Nicole Bruchet, Richard Slavik, Sean K Gorman
Background: Pharmacists in the intensive care unit (ICU) provide pharmaceutical care to critically ill patients. Identification and resolution of drug therapy problems improves outcomes for these patients. To maintain continuity of care, pharmacotherapy plans should be transferred to a receiving pharmacist upon discharge of patients from the ICU. No previous studies have addressed the development or evaluation of a systematic, standardized clinical handover tool and process for pharmacists...
March 2018: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29730086/implementation-and-evaluation-of-a-follow-up-programme-after-intensive-care-treatment-a-practice-development-project
#7
Margo van Mol, Erwin Ista, Monique van Dijk
OBJECTIVES: This study aimed to measure the effects of a newly developed follow-up programme on intensive care unit patient quality of care, as perceived by their relatives, and the appropriateness of the programme according to nurses. METHODS AND SETTING: This before and after implementation study was conducted in a level III intensive care unit for adult patients and related follow-up wards and included 135 intensive care nurses and 105 general ward nurses. The implemented programme included a personalised poster, a revised discharge protocol and follow-up visits on the ward...
May 2, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29729037/using-focused-ethnography-to-explore-and-describe-the-process-of-nurses-shift-reports-in-a-psychiatric-intensive-care-unit
#8
Martin Salzmann-Erikson
AIMS AND OBJECTIVES: To explore and describe the cultural routine of shift reports among nursing staff in a psychiatric intensive care unit, and further to develop a taxonomic, thematic and theoretical understanding of the process. BACKGROUND: Lack of communication among healthcare staff is associated with risks for medical errors. Thus, handovers and shift reports are an essential and integral routine among nurses in order to pass on information about the patients' health status...
May 5, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29724441/human-factors-in-medical-device-design-methods-principles-and-guidelines
#9
REVIEW
Russell J Branaghan
A total of 400,000 to 500,000 patients die in intensive care units (ICUs) each year, largely because ICUs care for the sickest patients. On the other hand, factors such as workload, shift changes, handoffs, alarm fatigue, inadequate team communication, and difficult-to-use medical devices contribute to the problem. This article focuses on the human factors of those medical devices, a significant cause of adverse events in the ICU.
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29723925/neonatologists-can-impede-or-support-parents-participation-in-decision-making-during-medical-rounds-in-neonatal-intensive-care-units
#10
Anna Axelin, Jyri Outinen, Kirsi Lainema, Liisa Lehtonen, Linda S Franck
AIM: We explored the dynamics of neonatologist-parent communication and decision-making during medical rounds in a level three neonatal intensive care unit. METHODS: This was a qualitative study, with an ethnographic approach, that was conducted at Turku University Hospital, Finland, from 2013-2014. We recruited eight mothers and seven couples, their 11 singletons and four sets of twins and two neonatologists and observed and video recorded 15 medical rounds. The infants were born at 23+5 to 40+1 weeks and the parents were aged 24-47...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29722043/a-taxonomy-and-cultural-analysis-of-intra-hospital-patient-transfers
#11
Alana Rosenberg, Meredith Campbell Britton, Shelli Feder, Karl Minges, Beth Hodshon, Sarwat I Chaudhry, Grace Y Jenq, Beth L Emerson
Existing research on intra-hospital patient transitions focuses chiefly on handoffs, or exchanges of information, between clinicians. Less is known about patient transfers within hospitals, which include but extend beyond the exchange of information. Using participant observations and interviews at a 1,541-bed, academic, tertiary medical center, we explored the ways in which staff define and understand patient transfers between units. We conducted observations of staff (n = 16) working in four hospital departments and interviewed staff (n = 29) involved in transfers to general medicine floors from either the Emergency Department or the Medical Intensive Care Unit between February and September 2015...
May 2, 2018: Research in Nursing & Health
https://www.readbyqxmd.com/read/29721670/non-verbal-communication-in-a-neonatal-intensive-care-unit-a-video-audit-using-non-verbal-immediacy-scale-nis-o
#12
Somashekhar Marutirao Nimbalkar, Himalaya Raval, Satvik Chaitanya Bansal, Utkarsh Pandya, Ajay Pathak
Effective communication with parents is a very important skill for pediatricians especially in a neonatal setup. The authors analyzed non-verbal communication of medical caregivers during counseling sessions. Recorded videos of counseling sessions from the months of March-April 2016 were audited. Counseling episodes were scored using Non-verbal Immediacy Scale Observer Report (NIS-O). A total of 150 videos of counseling sessions were audited. The mean (SD) total score on (NIS-O) was 78.96(7.07). Female counseled sessions had significantly higher proportion of low scores (p < 0...
May 3, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29716911/early-warning-score-communication-bundle-a-pilot-study
#13
EDITORIAL
Cheryl Gagne, Susan Fetzer
BACKGROUND: Unplanned admissions of patients to intensive care units from medical-surgical units often result from failure to recognize clinical deterioration. The early warning score is a clinical decision support tool for nurse surveillance but must be communicated to nurses and implemented appropriately. A communication process including collaboration with experienced intensive care unit nurses may reduce unplanned transfers. OBJECTIVE: To determine the impact of an early warning score communication bundle on medical-surgical transfers to the intensive care unit, rapid response team calls, and morbidity of patients upon intensive care unit transfer...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29716904/identifying-barriers-to-nurse-facilitated-patient-mobility-in-the-intensive-care-unit
#14
Daniel L Young, Jason Seltzer, Mary Glover, Caroline Outten, Annette Lavezza, Earl Mantheiy, Ann M Parker, Dale M Needham
BACKGROUND: Nurse-facilitated mobility of patients in the intensive care unit can improve outcomes. However, a gap exists between research findings and their implementation as part of routine clinical practice. Such a gap is often attributed, in part, to the barrier of lack of time. The Translating Evidence Into Practice model provides a framework for research implementation, including recommendations for identifying barriers to implementation via direct observation of clinical care. OBJECTIVES: To report on design, implementation, and outcomes of an approach to identify and understand lack of time as a barrier to nurse-facilitated mobility in the intensive care unit...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29709466/the-communication-experience-of-tracheostomy-patients-with-nurses-in-the-intensive-care-unit-a-phenomenological-study
#15
Angela Tolotti, Annamaria Bagnasco, Gianluca Catania, Giuseppe Aleo, Nicola Pagnucci, Lucia Cadorin, Milko Zanini, Gennaro Rocco, Alessandro Stievano, Franco A Carnevale, Loredana Sasso
OBJECTIVES: To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. RESEARCH METHODOLOGY/DESIGN: Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. SETTING: The intensive care unit of a hospital in Northern Italy...
April 27, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29707650/using-an-audience-response-system-smartphone-app-to-improve-resident-education-in-the-pediatric-intensive-care-unit
#16
Hoyoung Chung, Tom Kallay, Nick Anas, Diana Bruno, Jose Decamps, Darci Evans, Niveditha Vilasagar, Richard B Mink
In the Pediatric Intensive Care Unit (PICU), most teaching occurs during bedside rounds, but technology now provides new opportunities to enhance education. Specifically, smartphone apps allow rapid communication between instructor and student. We hypothesized that using an audience response system (ARS) app can identify resident knowledge gaps, guide teaching, and enhance education in the PICU. Third-year pediatric residents rotating through the PICU participated in ARS-based education or received traditional teaching...
January 2018: Journal of Medical Education and Curricular Development
https://www.readbyqxmd.com/read/29706412/handover-from-operating-theatre-to-the-intensive-care-unit-a-quality-improvement-study
#17
Andrea P Marshall, Georgia Tobiano, Niki Murphy, Greg Comadira, Nicola Willis, Therese Gardiner, Lucy Hervey, Wendy Simpson, Brigid M Gillespie
BACKGROUND: Transitioning a patient from the operating theatre (OT) to the intensive care unit (ICU) is a dynamic and complex process. Handover of the critically ill postoperative patient can contribute to procedural and communication errors. Standardised protocols are means for structuring and improving handover content. Both have been shown to be effective in reducing information omission and improve communication during this transition period. OBJECTIVES: The aim of this uncontrolled before and after study was to improve handover processes and communication about the care for critically ill patients transferred from OT to ICU...
April 26, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29701418/traumatic-carotid-jugular-av-fistula-in-a-child
#18
Pedro Lima, Anabela Gonçalves, Manuel Fonseca, Carolina Mendes, Óscar Gonçalves
INTRODUCTION: Traumatic Arteriovenous fistulae of the neck vessels are a rare condition, comprising less than 4% of traumatic fistulae found anywhere else in the body. METHODS: The authors propose to report a clinical case of such a condition in a 10-year-old boy who sustained a gunshot wound in the left side of the neck. RESULTS: Shortly after the event, the patient was admitted to paediatric ICU and intubated for airway protection. A palpable thrill in the left side of the neck was noticed, giving rise to the need of imaging study...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29682768/combining-conversation-analysis-and-event-sequencing-to-study-health-communication
#19
Kristen E Pecanac
Good communication is essential in patient-centered care. The purpose of this paper is to describe conversation analysis and event sequencing and explain how integrating these methods strengthened the analysis in a study of communication between clinicians and surrogate decision makers in an intensive care unit. Conversation analysis was first used to determine how clinicians introduced the need for decision-making regarding life-sustaining treatment and how surrogate decision makers responded. Event sequence analysis then was used to determine the transitional probability (probability of one event leading to another in the interaction) that a given type of clinician introduction would lead to surrogate resistance or alignment...
April 23, 2018: Research in Nursing & Health
https://www.readbyqxmd.com/read/29681432/a-systematic-review-evaluating-the-role-of-nurses-and-processes-for-delivering-early-mobility-interventions-in-the-intensive-care-unit
#20
REVIEW
Anna Krupp, Linsey Steege, Barbara King
OBJECTIVES: To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. METHODS: A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure...
April 19, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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