Dimensions of critical care nursing : DCCN
-
Dimens Crit Care Nurs · Nov 2013
ReviewPrevention of unplanned intensive care unit admissions and hospital mortality by early warning systems.
Researchers have found that patients exhibit physiological changes up to 8 hours prior to an arrest event. Deaths have been attributed to a lack of observation, lack of documentation of observations, inability of a caregiver to recognize early signs of deterioration, and lack of communication between healthcare providers. This integrative review examines early warning scoring systems and their effectiveness in predicting a patient's potential for deterioration and considers whether these scoring systems prevent unplanned intensive care unit admissions and/or death. ⋯ Nine studies fitting the search criteria were included in this review. Early warning scoring systems that interface with electronic medical records and are supplemented with decision aides (algorithms) and clinical support systems produce an effective screening system for early identification of deteriorating patients. This multifaceted approach decreases unplanned intensive care unit admissions and hospital mortality.
-
Dimens Crit Care Nurs · Nov 2013
Using the synergy model of patient care in understanding the lived emergency department experiences of patients, family members and their nurses during critical illness: a phenomenological study.
Despite many studies conducted aimed to understand and improve emergency care, research on the triad of nurses, patients, and family members looking at the lived emergency department experiences and their perspective of each from the other is notably absent. In a hermeneutic phenomenological study using van Manen's method, a sample of 10 patients, 5 family members, and 8 nurses of a nonprofit community hospital was recruited and interviewed in 2010 to 2011 to explore, understand, and describe their lived experiences during critical illness in the emergency department. ⋯ The American Association of Critical-Care Nurses' Synergy Model for Patient Care was applied in conceptualizing the findings and served as a framework in recommending practices and interventions geared toward improving competencies required in caring for critically ill patients and their families in the emergency department. The study supports recognizing the patient and family as active participants in the patient's medical care; encouraging family-member presence and creating institutional policies for patient- and family-centered care, as well as encouraging the development of ongoing programs that will recognize, enhance, and support the psychological and emotional well-being of emergency department nurses.
-
The purpose of the study was to explore the satisfaction of patients' families and nurses with visitation guidelines in the 5 critical care units at a 435-bed acute care hospital in the southeastern part of the United States. ⋯ Family member visitation in the intensive care unit setting should be flexible and open. This may include tailoring a plan on admission with the family to allow open access to the patient during times when they are most available; thus, each family has a plan that suits its unique dynamics.