Critical care nurse
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Critical care nurse · Feb 2014
Sedation and its association with posttraumatic stress disorder after intensive care.
Overuse of sedation in patients treated with mechanical ventilation can increase duration of ventilation, duration of delirium, and time to discharge. Although current principles of care include implementation of sedation protocols and/or daily interruptions in sedation to improve patients' outcomes, these strategies remain underused. ⋯ Published studies on posttraumatic stress disorder and sedation are limited by small sample size, heterogeneous sedation practices, and inadequate follow-up. Despite limitations, current data suggest contemporary sedation practices to keep patients calm and comfortable but awake, as appropriate, are not associated with increased rates or severity of posttraumatic stress disorder.
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Critical care nurse · Feb 2014
Case ReportsAddition of acute care nurse practitioners to medical and surgical rapid response teams: a pilot project.
Background Vanderbilt University Hospital's original rapid response team included a critical care charge nurse and a respiratory therapist. A frequently identified barrier to care was the time delay between arrival of the rapid response team and arrival of the primary health care team. Objective To assess the impact of adding an acute care nurse practitioner to the rapid response team. ⋯ Opportunities for process improvement were identified on 18% of the calls. After implementation, charge nurses were surveyed, with 96% expressing high satisfaction associated with enhanced service and quality. Conclusions Teams led by nurse practitioners provide diagnostic expertise and treatment, facilitation of transfers, team communication, and education.