Critical care nurse
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Critical care nurse · Dec 2011
Nurse-led implementation of a safe and effective intravenous insulin protocol in a medical intensive care unit.
Recent evidence has linked tight glucose control to worsened clinical outcomes among adults in intensive care units. ⋯ Implementation of a nurse-led, conservative intravenous insulin protocol in the medical intensive care unit is effective and safe and markedly reduces the rate of hypoglycemia.
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Critical care nurse · Dec 2011
Optimal management of shivering during therapeutic hypothermia after cardiac arrest.
Both pharmacological and nonpharmacological methods are used to control shivering in therapeutic hypothermia. An evidence-based protocol based on the most current research has been developed for the management of shivering during therapeutic hypothermia. ⋯ In addition, skin counterwarming techniques, such as use of an air-circulating blanket, are effective nonpharmacological methods for reducing shivering when used in conjunction with medication. As a last resort, neuromuscular blocking agents are considered appropriate therapy for management of refractory shivering.
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Critical care nurse · Dec 2011
Comparative StudyCritical care staff nurses: empowerment, certification, and intent to leave.
Certification is a voluntary process that is used to recognize specialized knowledge and skills. Little research has been focused on staff nurses with specialty certification. ⋯ The differences between nurses who were certified and those who were not may be related to variables other than certification. Further research and theoretical model testing is needed to determine the value of certification.
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Critical care nurse · Dec 2011
Postoperative nausea and vomiting in adults: implications for critical care.
Postoperative nausea and vomiting is a dreaded, uncomfortable, and unpleasant patient experience that is also a factor contributing to adverse outcomes in postoperative recovery. The key to management of this concern is to identify high-risk patients and to develop a systematic method of assessment, intervention, and evaluation within the perianesthesia care continuum. This discussion outlines the wide range of pharmacological and alternative therapies that are available in clinical practice with a case study to illustrate incorporation of these interventions in critically ill patients.
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Critical care nurse · Dec 2011
Achieving quality patient-ventilator management: advancing evidence-based nursing care.
This article presents suggestions for nurses to gain skill, competence, and comfort in caring for critically ill patients receiving mechanical ventilatory support, with a specific focus on education strategies and building communication skills with these challenging nonverbal patients. Engaging in evidence-based practice projects at the unit level and participating in or leading research studies are key ways nurses can contribute to improving outcomes for patients receiving mechanical ventilation. Suggestions are offered for evidence-based practice projects and possible research studies to improve outcomes and advance the science in an effort to achieve quality patient-ventilator management in intensive care units.