Critical care nurse
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Critical care nurse · Oct 2014
ReviewCarbapenem-resistant enterobacteriaceae: occult threat in the intensive care unit.
Carbapenem-resistant Enterobacteriaceae are a group of virulent, drug-resistant gram-negative bacteria that are increasingly the cause of infection. Such infections are associated with a high morbidity and mortality and increased health care costs. ⋯ Surveillance and infection control measures are paramount in preventing outbreaks of infection caused by carbapenem-resistant Enterobacteriaceae. Critical care nurses are in a vital position to monitor patients at risk for such infections and to promote infection prevention measures.
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Critical care nurse · Oct 2014
Randomized Controlled TrialClosed blood conservation device for reducing catheter-related infections in children after cardiac surgery.
Arterial catheters are potential sources of nosocomial infection. ⋯ Use of a closed blood conservation device could decrease the incidence of catheter-related contamination of intraluminal fluid.
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Critical care nurse · Oct 2014
ReviewIntravenous lipids: antidotal therapy for drug overdose and toxic effects of local anesthetics.
Intravenous lipid emulsion is an accepted therapy for the treatment of severe cardiac toxic effects caused by local anesthetics. Lipid emulsion therapy has also been used successfully to treat cardiac arrest and intractable arrhythmias caused by overdoses of antiepileptic drugs, cardiovascular drugs, and psychotropic medications, but experience with intravenous lipids as antidotal therapy in these clinical situations is limited. ⋯ Patients who have not responded to standard therapies have been quickly revived by administration of intravenous lipids. Use of lipids most likely will increase, and critical care nurses should be familiar with lipid therapy.
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Critical care nurse · Oct 2014
Comparative StudyChlorhexidine Gluconate Bathing to Reduce Methicillin-Resistant Staphylococcus aureus Acquisition.
Methicillin-resistant Staphylococcus aureus (MRSA) is a virulent organism causing substantial morbidity and mortality in intensive care units. Chlorhexidine gluconate, a topical antiseptic solution, is effective against a wide spectrum of gram-positive and gram-negative bacteria, including MRSA. Objectives To examine the impact of a bathing protocol using chlorhexidine gluconate and bath basin management on MRSA acquisition in 5 adult intensive care units and to examine the cost differences between chlorhexidine bathing by using the bath-basin method versus using prepackaged chlorhexidine-impregnated washcloths. ⋯ The chlorhexidine bathing protocol is easy to implement, cost-effective, and led to decreased unit-acquired MRSA rates in a variety of adult intensive care units.
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Critical care nurse · Oct 2014
Comparative StudyActivated partial thromboplastin times from venipuncture versus central venous catheter specimens in adults receiving continuous heparin infusions.
In patients receiving heparin infusions, variations in specimen collection technique may contribute to inaccurate measurements of activated partial thromboplastin time (aPTT). ⋯ Use of this protocol resulted in similar aPTTs when the CVAD specimen was not obtained from the heparin infusion port. However, obtaining the specimen from the heparin infusion port resulted in significantly higher aPTT values.