Critical care nurse
-
Critical care nurse · Jun 2024
Simulation Training for Emergency Sternotomy in the Cardiovascular Intensive Care Unit.
Emergency resternotomy in the intensive care unit for a patient who has undergone cardiac surgery can be daunting for surgeons and critical care staff. Clinicians involved are often unfamiliar with the surgical instruments and techniques needed. ⋯ Results of this quality improvement project suggest that simulation training improves staff comfort with and understanding of emergency resternotomy.
-
Critical care nurse · Jun 2024
ReviewRapid Nurse Training to Meet Surge Capacity: An Integrative Review.
The COVID-19 pandemic resulted in unprecedented health care challenges and transformation of nursing practice. A significant challenge faced by health care systems was the rapid identification and training of nurses in various specialties, including critical care, to care for a large influx of critically ill patients. ⋯ Rapidly training registered nurses to care for critically ill patients in a team-based dynamic is a safe and effective course of action to mitigate staff shortages if another pandemic occurs.
-
Critical care nurse · Jun 2024
ReviewA Review of Chlorhexidine Oral Care in Patients Receiving Mechanical Ventilation.
Chlorhexidine gluconate has been considered the criterion standard of oral care for patients receiving mechanical ventilation because of its ability to reduce the incidence of ventilator-associated events. Optimal concentrations and frequencies remain unclear, as do adverse events related to mortality in various intensive care unit populations. ⋯ The evidence regarding the efficacy of chlorhexidine gluconate oral care in reducing ventilator-associated events in specific intensive care unit populations is contradictory. Recently published guidelines recommend de-implementation of chlorhexidine gluconate oral care in all patients receiving mechanical ventilation. Such care may be beneficial only in the cardiac surgical population.
-
Critical care nurse · Jun 2024
Impact of Continuous Renal Replacement Therapy Initiation Time, Kidney Injury, and Hypervolemia in Critically Ill Children.
The mortality rate of pediatric patients who require continuous renal replacement therapy is approximately 42%, and outcomes vary considerably depending on underlying disease, illness severity, and time of dialysis initiation. Delay in the initiation of such therapy may increase mortality risk, prolong intensive care unit stay, and worsen clinical outcomes. ⋯ Future studies are needed to assess real time delays and to evaluate if the implementation of a standardized initiation process decreases initiation time.
-
Critical care nurse · Jun 2024
Increasing the Volume of Delivered Enteral Feeds Using a Volume-Based Feeding Protocol in a Neuroscience Intensive Care Unit.
Iatrogenic malnutrition is a significant burden to patients, clinicians, and health care systems. Compared with well-nourished patients, underfed patients (those who receive less than 80% of their daily energy requirement) have more adverse outcomes related to nutritional status. Volume-based protocols allow for catch-up titrations, are consistently superior to rate-based protocols, and can be implemented in most settings. ⋯ Using a volume-based feeding protocol with supplemental staff education resulted in improved delivery of prescribed enteral feeding.