Critical care nurse
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Pain is a common and distressing symptom in critically ill patients. Uncontrolled pain places patients at risk for numerous adverse psychological and physiological consequences, some of which may be life-threatening. ⋯ Several tools have been developed to identify objective measures of pain, but the best tool has yet to be identified. A comprehensive search on the reliability and validity of observational pain scales indicated that although the Critical-Care Pain Observation Tool was superior to other tools in reliably detecting pain, pain assessment in individuals incapable of spontaneous neuromuscular movements or in patients with concurrent conditions, such as chronic pain or delirium, remains an enigma.
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Critical care nurse · Jun 2013
Effectiveness of critical care discharge information in supporting early recovery from critical illness.
Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. ⋯ Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users' needs are discussed. Results should inform the design of future studies on this topic.
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Critical care nurse · Jun 2013
Preventing ventilator-associated pneumonia in children: an evidence-based protocol.
Ventilator-associated pneumonia, the second most common hospital-acquired infection in pediatric intensive care units, is linked to increased morbidity, mortality, and lengths of stay in the hospital and intensive care unit, adding tremendously to health care costs. Prevention is the most appropriate intervention, but little research has been done in children to identify necessary skills and strategies. ⋯ Following the recommendations of the Centers for Disease Control and Prevention and adapting an adult model also can support this endeavor. Ultimately, the bedside nurse directs care, using best evidence to prevent this important health care problem.