Critical care nurse
-
Critical care nurse · Jun 2018
Review Case ReportsFrailty in Critical Care: Examining Implications for Clinical Practices.
Frailty is an aging-related, multisystem clinical state characterized by loss of physiological reserves and diminished capacity to withstand exposure to stressors. Frailty increases the risk of serious adverse outcomes, compared with that of nonfrail people of the same age. Adverse outcomes can be severe and may include procedural complications, delirium, significant functional decline and disability, prolonged hospital length of stay, extended recovery periods, and death. ⋯ Such knowledge underpins effective organization and delivery of care strategies aimed at minimizing harm and maximizing positive outcomes for frail older adults. Drawing from recent literature, this article explores frailty and critical illness by discussing 2 dominant models of the concept. Using a clinical case study, links between frailty and critical care nursing practices are highlighted and clinical considerations are explored.
-
Critical care nurse · Jun 2018
Review Case ReportsNew Nutrition Guidelines: Promoting Enteral Nutrition via a Nutrition Bundle.
Malnutrition in hospitals is often overlooked, underdiagnosed, and untreated. Malnourished patients have increased risk for infection and pressure injuries, longer duration of mechanical ventilation, anemia, depressed cardiac and respiratory functions, and an overall higher risk for mortality. ⋯ The bundle has 6 main components: assessment of malnutrition, initiation and maintenance of enteral nutrition, reduction of aspiration, implementation of enteral feeding protocols, avoiding the use of gastric residual volumes, and early initiation of parenteral nutrition when enteral feedings cannot be initiated. Implementing the nutrition bundle can help ensure that patients receive adequate nutrition during their hospital stay, thereby reducing adverse outcomes.
-
Critical care nurse · Jun 2018
ReviewSupporting Optimal Neurodevelopmental Outcomes in Infants and Children With Congenital Heart Disease.
Improved survival has led to increased recognition of developmental delays in infants and children with congenital heart disease. Risk factors for developmental delays in congenital heart disease survivors may not be modifiable; therefore, it is important that lifesaving, high-technology critical care interventions be combined with nursing interventions that are also developmentally supportive. ⋯ This manuscript reviews developmentally supportive interventions such as massage, developmentally supportive positioning, kangaroo care, cue-based feeding, effective pain/anxiety management, and procedural preparation and identifies strategies to implement developmentally supportive interventions in the care of infants and children with congenital heart disease. Improving developmental support for these infants and children at high risk for developmental delay may improve their outcomes and help promote family-centered care.
-
Critical care nurse · Jun 2018
ReviewNurse Project Consultant: Critical Care Nurses Move Beyond the Bedside to Affect Quality and Safety.
A nurse project consultant role empowered 3 critical care nurses to expand their scope of practice beyond the bedside and engage within complex health care delivery systems to reduce harms in the intensive care unit. As members of an interdisciplinary team, the nurse project consultants contributed their clinical expertise and systems knowledge to develop innovations that optimize care provided in the intensive care unit. ⋯ The nurse project consultants' responsibilities within a group of quality improvement initiatives are described and their challenges and lessons learned discussed. The nurse project consultant role is a new model of engaging critical care nurses as leaders in health care redesign.