Critical care nurse
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Critical care nurse · Feb 2024
Insulin Infusion Protocols for Blood Glucose Management in Critically Ill Patients: A Scoping Review.
Continuous insulin infusion is a method for maintaining blood glucose stability in critically ill patients with hyperglycemia. Many insulin infusion protocols have been applied in intensive care units. Understanding the content of these protocols can help clinical staff choose the most appropriate and convenient protocol and promote best practices in managing glucose levels in critically ill adult patients. ⋯ Nurse-led guidelines must be based on the best available evidence and should include other variables related to glucose management (eg, patient disease type, medication, and nutrition) in addition to insulin infusion.
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Critical care nurse · Feb 2024
Screening for Alcohol Use Disorder and Management of Alcohol Withdrawal Syndrome in Critical Care Patients.
Evidence-based research indicates that subjective questionnaires should be eliminated in screening for alcohol use disorder and management of alcohol withdrawal syndrome in critical care patients. However, transitioning clinicians away from these screening tools remains challenging. ⋯ The elimination of previously used tools and the implementation of the Prediction of Alcohol Withdrawal Severity Scale and the new intensive care unit alcohol withdrawal protocol improved alcohol use disorder screening and alcohol withdrawal syndrome management among critical care patients.
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Critical care nurse · Feb 2024
ReviewUse of Biomarkers to Objectively Evaluate Pain in Critically Ill Children: A Scoping Review.
Many studies have been conducted recently to identify biomarkers that could potentially be used to objectively evaluate pain. ⋯ According to this literature review, various biomarkers that are easily obtained and measured in a clinical setting are associated with pain in children. Further investigation of these biomarkers through observational studies is suggested to evaluate their suitability for pain assessment in critically ill children.
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Critical care nurse · Feb 2024
Nurse-Driven Fluid Responsiveness Evaluation in Patients With Septic Shock: A Quality Improvement Initiative.
Fluid responsiveness should be assessed in patients with septic shock because only 50% of patients are fluid responsive. Dynamic measures of fluid responsiveness, like pulse pressure variation measured after a passive leg raise maneuver, are recommended to guide fluid administration in patients with sepsis after initial fluid resuscitation. ⋯ The results indicate that the project had a positive impact on patient outcomes and nurse autonomy.
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Critical care nurse · Feb 2024
Deimplementation of Gastric Residual Volume Monitoring to Enhance Patient Nutrition.
Routine gastric residual volume monitoring remains common in nursing practice. However, current evidence supports using a focused nursing assessment to identify signs and symptoms of enteral feeding intolerance such as abdominal pain, abdominal distension, and vomiting. ⋯ The deimplementation of routine gastric residual volume monitoring is supported by evidence. Use of a focused gastrointestinal nursing assessment to identify enteral feeding intolerance is safe, feasible, and effective and improves nutrition delivery and nurses' workflow.