Critical care nurse
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Critical care nurse · Jun 2021
Reducing Intubation Time in Adult Cardiothoracic Surgery Patients With a Fast-track Extubation Protocol.
Prolonged intubation after cardiac surgery increases the risk of morbidity and mortality and lengthens hospital stays. Factors that influence the ability to extubate patients with speed and efficiency include the operation, the patient's baseline physiological condition, workflow processes, and provider practice patterns. ⋯ The number of early extubations following cardiac surgery was successfully increased. Faster progression to extubation did not increase risk of reintubation or other adverse events. Using a framework that integrated personal, social, and environmental influences helped increase the impact of this project.
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Critical care nurse · Jun 2021
Magnetic Resonance Imaging-Guided Cardiac Catheterization Evacuation Drills.
The interventional cardiac magnetic resonance imaging suite combines a cardiac catheterization x-ray laboratory with a magnetic resonance imaging suite. At the study institution, interventional cardiac magnetic resonance imaging procedures (ie, magnetic resonance imaging-guided cardiac catheterizations) have been performed under institutional review board-approved research protocols since 2015. Because the workplace incorporates x-ray and magnetic resonance imaging in a highly technical environment, education about the importance of magnet safety is crucial to ensure the safety of patients and staff. ⋯ Magnetic resonance imaging-guided cardiac catheterization evacuation drills promote preparedness, ensure patient and staff safety, and improve evacuation time in the interventional cardiac magnetic resonance imaging environment.
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Critical care nurse · Jun 2021
Case ReportsOff Target: Case Report of Heparin Resistance in a Neurosurgical Intensive Care Unit Patient.
Heparin resistance was discovered in a patient in the surgical intensive care unit who underwent emergency endovascular coiling and later an anterior communicating artery clipping procedure to treat subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm. ⋯ Risk factors for heparin resistance include antithrombin deficiency, elevation of factor VIII or fibrinogen level, elevation in heparin-binding proteins, increased heparin clearance, sepsis, trauma, and burns. The astute critical care nurse may be the first to recognize this condition in a patient, preventing a potentially fatal complication.
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Critical care nurse · May 2021
Situational Awareness Huddles in a Pediatric Cardiac Intensive Care Unit During the COVID-19 Pandemic.
The COVID-19 pandemic has created challenges for provider teams working in intensive care units, including rapidly changing patient care regulations, staffing considerations, and preservation of personal protective equipment. The need for enhanced respiratory precautions for infected patients and patients under investigation has necessitated a new process for interventions and resuscitation. ⋯ A novel huddle process created situational awareness among staff caring for patients requiring enhanced respiratory isolation because of COVID-19. Multidisciplinary huddles allowed staff from various disciplines to apply a process map for interventions and resuscitations among critically ill children with heart disease.
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Critical care nurse · Apr 2021
A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit.
Catheter-associated urinary tract infections are the second most common health care-associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs. ⋯ This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care-associated infections.