Critical care nurse
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Critical care nurse · Aug 2020
Exploiting Technology to Popularize Goals-of-Care Conversations and Advance Care Planning.
Goals-of-care conversations are a central component of high-quality patient-centered care. However, clinicians may not engage in such conversations until patients are critically ill. ⋯ Electronic health record platforms can be used to improve the frequency, consistency of documentation, and quality of goals-of-care conversations. A standardized process coupled with effective work tools can foster a culture of advance care planning.
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Critical care nurse · Aug 2020
Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic.
The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. ⋯ Tele-intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.
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Delirium is a complex syndrome prevalent in the intensive care unit. It has been associated with significant morbidity including distress, longer hospital stays, prolonged cognitive impairment, and increased mortality. ⋯ The success of this quality improvement project to enhance recognition of delirium and increase mobility (critical components of the pain assessment, breathing, sedation choice, delirium, early mobility, and family education bundle) was contingent on nursing leaders hip, interdisciplinary team collaboration, and interactive education.
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Critical care nurse · Aug 2020
Holding and Mobility of Pediatric Patients With Transthoracic Intracardiac Catheters.
Nursing care of pediatric patients after cardiac surgery consists of close hemodynamic monitoring, often through transthoracic intracardiac catheters, requiring patients to remain on bed rest and limiting holding and mobility. ⋯ Pediatric patients with transthoracic intracardiac catheters can be safely held and mobilized out of bed.
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Sleep in the intensive care unit can be poorly consolidated and highly fragmented. This review examines the neurobiology of normal and abnormal sleep, with a focus on the changes that occur in the intensive care unit environment. ⋯ The review examines sleep mechanisms, including brain electrical activity, regulatory centers in the brain, and circadian and diurnal patterns of sleep and hemodynamic function. Nursing interventions for specific patient risk factors in the intensive care unit are proposed.