Critical care nurse
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Critical care nurse · Apr 2020
Relationship Between Delirium and Ventilatory Outcomes in the Medical Intensive Care Unit.
Delirium is a common neuropsychiatric diagnosis in intensive care units and often leads to extended hospital stays and an increased rate of complications. Delirium can be classified as hypoactive, hyperactive, or mixed. Hyperactive delirium is often accompanied by agitation, which is a predictive factor for unplanned extubation. Hypoactive delirium does not include outward agitation; its incidence and relationship to ventilatory outcomes, specifically unplanned extubation and duration of mechanical ventilation, are relatively unexplored. ⋯ Hypoactive delirium is common among intensive care unit patients and may precede unplanned extubation. Patient history and comorbidities remain the strongest predictors of unplanned extubation.
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Critical care nurse · Apr 2020
Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians.
Professional burnout is a widespread phenomenon in health care. The health of patients and organizations begins with the well-being of health care professionals. Identifying and understanding self-care strategies that professionals perceive to be helpful is crucial to combat burnout. ⋯ Developing effective self-care strategies helps promote health care professionals' physical and psychological well-being and reduce burnout. It is vital for health care professionals to care for themselves so that they can best care for others.
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Critical care nurse · Apr 2020
ReviewCommunication in Pediatric Critical Care Units: A Review of the Literature.
Current communication styles in pediatric critical care units do not often consider the needs of providers, patients, or family members. ⋯ Twenty-eight articles met inclusion criteria and were analyzed according to study focus (provider, parent/caregiver, patient, or tool). This review links communication to outcomes related to providers, parents, and patients. Current tools are reviewed to evaluate their effectiveness in addressing communication barriers and to guide future research in communication. Findings indicate that effective communication is challenging in intensive care units despite robust evidence that effective communication improves patient outcomes and quality metrics. Repeated and varied forms of communication, especially written reinforced with verbal communication, seem to have the strongest effect and show promising results. Common barriers nurses face on their units are identified, and solutions are suggested. This review adds to current knowledge by linking communication to measurable outcomes and examining communication barriers and needs specific to pediatric critical care populations from the provider, parent, and patient perspectives.
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Critical care nurse · Apr 2020
Early Identification of Delirium in Intensive Care Unit Patients: Improving the Quality of Care.
Delirium has long-term consequences for intensive care unit patients. The project site, an urban academic hospital, did not previously use a validated delirium screening tool, and patients commonly received sedative medications to treat agitation. ⋯ The variation of high-risk medication use was significantly controlled with the implementation of CAM-ICU and education. Nurses felt that hands-on training with the CAM-ICU increased their comfort in identifying patients at risk for delirium. Future work will focus on assessment accuracy.
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Patients with both true and false arrhythmia alarms pose a challenge because true alarms might be buried among a large number of false alarms, leading to missed true events. ⋯ An awareness of factors associated with arrhythmia alarms might aid in developing solutions to decrease alarm fatigue. To improve detection of true alarms, further research is needed to build and test electrocardiographic algorithms that adjust for clinical and electrocardiographic characteristics associated with false alarms.