Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Jul 2014
ReviewEnhancing critical thinking in clinical practice: implications for critical and acute care nurses.
The complexity of patients in the critical and acute care settings requires that nurses be skilled in early recognition and management of rapid changes in patient condition. The interpretation and response to these events can greatly impact patient outcomes. Nurses caring for these complex patients are expected to use astute critical thinking in their decision making. The purposes of this article were to explore the concept of critical thinking and provide practical strategies to enhance critical thinking in the critical and acute care environment.
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Dimens Crit Care Nurs · Jul 2014
Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.
Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. ⋯ Moral distress scales were elevated, whereas work engagement scales were low. This finding was congruent with Lawrence's study and may reflect ongoing need for greater supports for experienced intensive care unit nurses, from both education and management. Future recommendations for research include examining the interaction of these variables in larger samples to examine additional explanatory factors as well as strategies for self-care, motivation, and behavior change.
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Dimens Crit Care Nurs · Jul 2014
Assessing and addressing moral distress and ethical climate, part 1.
There is minimal research exploring moral distress and its relationship to ethical climate among nurses working in acute care settings. ⋯ Inadequate staffing and perceived incompetent coworkers were the most distressing items. Almost 22% left a previous position because of moral distress and perceived the current climate to be less ethical compared with other participants. Findings may potentially impact nurse retention and recruitment and negatively affect the quality and safety of patient care. Interventions developed focus on the individual nurse, including ethics education and coping skills, intraprofessional/interprofessional approaches, and administrative/policy strategies.
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Dimens Crit Care Nurs · Jul 2014
ReviewOpen intensive care units: a global challenge for patients, relatives, and critical care teams.
The aims of this study were to describe the current status of intensive care unit (ICU) visiting hours policies internationally and to explore the influence of ICUs' open visiting policies on patients', visitors', and staff perceptions, as well as on patients' outcomes. ⋯ The percentages of open ICUs are very different among countries. It can be due to local factors, cultural differences, and lack of legislation or hospital policy. There is a need for more studies about the impact of open ICUs programs on patients' mortality, length of stay, infections' risk, and the mental health of patients and their relatives.
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Dimens Crit Care Nurs · Jul 2014
ReviewMechanical ventilation and the role of saline instillation in suctioning adult intensive care unit patients: an evidence-based practice review.
Saline instillation in suctioning mechanically ventilated patients remains a common practice in the intensive care unit (ICU). Many respiratory therapists and nurses are using saline with suctioning without an adequate knowledge of the current evidence-based research to guide this practice. ⋯ This study does not support the use of saline instillation when suctioning an artificial airway. Further clinical trials are crucial to effectively determine if saline instillation use with suctioning an artificial airway is deemed harmful, which can be strictly enforced as a mandatory clinical guideline for all hospitals to include in their standardized protocol to not use saline instillation with suctioning.