Critical care nurse
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Critical care nurse · Dec 2017
Comparative StudyImplementing a Multicomponent Intervention to Prevent Delirium Among Critically Ill Patients.
Delirium is common among the critically ill. Nonpharmacologic interventions are reportedly effective in reducing incident delirium, but limited data specific to this population exist. ⋯ The strategy was successful in reducing delirium. Self-removals of invasive implements decreased, an observation that has not been previously described. No difference in mortality rate was seen, as has been reported in other studies. Early participation of the whole team, shared leadership, and the provision of concrete tasks were key to the success of this multicomponent intervention.
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Critical care nurse · Dec 2017
Feasibility of a Nurse-Managed Pain, Agitation, and Delirium Protocol in the Surgical Intensive Care Unit.
Society of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed. ⋯ A nurse-managed pain, agitation, and delirium protocol can be feasibly implemented in a surgical intensive care unit.
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Despite improvements in surgical technique and medical management, single-ventricle lesions remain one of the most challenging congenital heart anomalies to treat, and mortality rates are high. Most infants who have single-ventricle palliation undergo a sequence of surgeries to optimize pulmonary and systemic blood flow. The first surgery to separate pulmonary and systemic blood flow is the bidirectional cavopulmonary shunt. ⋯ Although mortality rates are low and decreasing in patients with bidirectional cavopulmonary shunts, morbidity is still a challenge. Nurses must understand the pertinent anatomy and physiology and recognize postoperative complications early in order to reduce morbidity. Postoperative complications, management, outcomes and nursing care are discussed.
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Critical care nurse · Dec 2017
Using SQUIRE 2.0 as a Guide for Planning Your Quality Improvement Project.
This article is the third of a 4-part quality improvement resource series for critical care nurses interested in implementing system process or performance improvement projects. Part 1 defined the differences between research and quality improvement. Part 2 discussed how nurses and managers could identify meaningful quality improvement projects that will make a real difference in their critical care unit while fitting within their time constraints and resources. Part 3 uses the recently revised Standards for Quality Improvement Reporting Excellence guidelines as a basis for designing, implementing, documenting, and publishing quality improvement projects.
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Critical care nurse · Dec 2017
Identifying Information Resources for Patients in the Intensive Care Unit and Their Families.
Providing information to patients in intensive care units and their families is challenging. Patients often are admitted unexpectedly and experience stress and uncertainty. One source of stress has been identified as unclear, uncoordinated, or inconsistent communication and information. Despite the need for information, no centrally located, easily accessible, standardized intensive care unit education content exists. ⋯ Structuring a digital learning center using different stages of the patient's stay in the intensive care unit and placing resources in the context of an information pathway can help coordinate education for these patients and their families, and creates a consistent communication guide for clinicians as well. The optimal digital format should be considered in designing the learning center.