Critical care nurse
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Despite improvements in surgical technique and medical management, single-ventricle lesions remain one of the most challenging congenital heart anomalies to treat, and mortality rates are high. Most infants who have single-ventricle palliation undergo a sequence of surgeries to optimize pulmonary and systemic blood flow. The first surgery to separate pulmonary and systemic blood flow is the bidirectional cavopulmonary shunt. ⋯ Although mortality rates are low and decreasing in patients with bidirectional cavopulmonary shunts, morbidity is still a challenge. Nurses must understand the pertinent anatomy and physiology and recognize postoperative complications early in order to reduce morbidity. Postoperative complications, management, outcomes and nursing care are discussed.
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Critical care nurse · Dec 2017
Using SQUIRE 2.0 as a Guide for Planning Your Quality Improvement Project.
This article is the third of a 4-part quality improvement resource series for critical care nurses interested in implementing system process or performance improvement projects. Part 1 defined the differences between research and quality improvement. Part 2 discussed how nurses and managers could identify meaningful quality improvement projects that will make a real difference in their critical care unit while fitting within their time constraints and resources. Part 3 uses the recently revised Standards for Quality Improvement Reporting Excellence guidelines as a basis for designing, implementing, documenting, and publishing quality improvement projects.
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Critical care nurse · Dec 2017
Identifying Information Resources for Patients in the Intensive Care Unit and Their Families.
Providing information to patients in intensive care units and their families is challenging. Patients often are admitted unexpectedly and experience stress and uncertainty. One source of stress has been identified as unclear, uncoordinated, or inconsistent communication and information. Despite the need for information, no centrally located, easily accessible, standardized intensive care unit education content exists. ⋯ Structuring a digital learning center using different stages of the patient's stay in the intensive care unit and placing resources in the context of an information pathway can help coordinate education for these patients and their families, and creates a consistent communication guide for clinicians as well. The optimal digital format should be considered in designing the learning center.
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Critical care nurse · Dec 2017
Perceptions of Families of Intensive Care Unit Patients Regarding Involvement in Delirium-Prevention Activities: A Qualitative Study.
Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. ⋯ Family members want to be involved with care and delirium prevention; however, many times they do not know what to do without the direction of a health care provider. Family members would benefit from open dialogue with the bedside nurse to increase family comfort and involvement in care.
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Critical care nurse · Dec 2017
Perceptions of Family Members, Nurses, and Physicians on Involving Patients' Families in Delirium Prevention.
Delirium occurs in up to 80% of patients admitted to an intensive care unit. Nonpharmacologic delirium-prevention strategies, which are commonly used by the bedside nurse, have reduced the incidence and duration of delirium in patients in the intensive care unit. With increasing demands on the nurse, strategies such as including the patient's family in delirium prevention activities should be investigated. OBJECTIVE To determine opinions and willingness of health care providers to involve patients' families in nonpharmacologic delirium-prevention activities in the intensive care unit, and of patients' families to be involved. ⋯ Health care providers and family members are supportive of the latter performing delirium-prevention activities. Family of patients in the intensive care unit may work collaboratively with nurses to reduce the incidence and duration of delirium in these patients.