Critical care nurse
-
Critical care nurse · Feb 2012
ReviewDaily interruptions of sedation: a clinical approach to improve outcomes in critically ill patients.
The continuous infusion of sedative agents is often necessary for critically ill patients. However, it has been associated with several disadvantages. Numerous interventions to reduce these risks have been evaluated, including the practice of interrupting sedative infusions on a daily basis. ⋯ The implementation of daily sedation interruptions was suggested to minimize multiple complications associated with continuous sedative infusions and was not associated with intensive care-related complications or long-term psychological effects. Additional studies have revealed perceived barriers to the implementation of daily sedation interruptions. Further randomized controlled trials enrolling larger, more diverse samples are needed to provide more evidence regarding the safety and effectiveness of this intervention.
-
Critical care nurse · Feb 2012
ReviewHospitalized infants who hurt: a sweet solution with oral sucrose.
Pain is harmful to newborn infants. Oral sucrose is safe, inexpensive, and effective at preventing and reducing pain in hospitalized babies who undergo invasive procedures. ⋯ Parents expect nurses to serve as pain advocates for the parents' newborns and to protect the babies from needless suffering. It is incumbent upon nurses to stay abreast of the current evidence and integrate use of oral sucrose into daily pain management practice in emergency, acute, and critical care units.
-
Critical care nurse · Feb 2012
Patients and their families weigh in on evidence-based hospital design.
In 2 landmark publications, the Institute of Medicine reported on significant deficiencies in our current health care system. In response, an area of research examining the role of the physical environment in influencing outcomes for patients and staff gained momentum. The concept of evidence-based design has evolved, and the development of structural guidelines for new hospital construction was instituted by the American Institute of Architects in 2006. ⋯ Critical care nurses must be aware of the current need to recognize how much the physical environment influences care delivery and take steps to maximize patients' safety, satisfaction, and quality of care.
-
Critical care nurse · Feb 2012
Shivering management during therapeutic temperature modulation: nurses' perspective.
Therapeutic temperature modulation, which incorporates mild hypothermia and maintenance of normothermia, is being used to manage patients resuscitated after cardiac arrest. Methods of modulating temperature include intravenous infusion of cold fluids and surface or endovascular cooling. During this therapy, the shiver response is activated as a defense mechanism in response to an altered set-point temperature and causes metabolic and hemodynamic stress for patients. ⋯ Once shivering is detected, treatment is imperative to avoid deleterious effects. The Bedside Shivering Assessment Scale can be used to determine the efficacy of interventions intended to blunt thermoregulatory defenses and can provide continual evaluation of patients' responses to the interventions. Nurses' knowledge and understanding of the harmful effects of shivering are important to effect care and prevent injury associated with uncontrolled shivering.
-
Critical care nurse · Feb 2012
National survey of central venous catheter flushing in the intensive care unit.
Evidence is needed on the best solution for flushing central venous catheters. ⋯ Flushing practices for central venous catheters vary widely. A randomized controlled trial is needed to determine the optimal flushing solution to maintain short-term patency.