Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · May 2015
Conflict management styles among Iranian critical care nursing staff: a cross-sectional study.
Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. ⋯ Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.
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Dimens Crit Care Nurs · Mar 2015
Gastric reflux: association with aspiration and oral secretion pH as marker of reflux: a descriptive correlational study.
Gastric reflux leading to pulmonary aspiration is a frequent event in mechanically ventilated, gastric-fed patients, which can lead to ventilator-associated complications and pneumonia. ⋯ Aspiration events were more frequent than reflux events. Measurement of actual pepsin concentration to detect new reflux and aspiration events is recommended in future studies. Bedside pH measures of oral secretions are not a valid marker of gastric reflux.
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Dimens Crit Care Nurs · Mar 2015
Withdrawal of life-sustaining treatment: patient and proxy agreement: a secondary analysis of "contracts, covenants, and advance care planning".
Families of critically ill patients often make difficult decisions related to end-of-life (EOL) care including the withdrawal of life-sustaining therapies. ⋯ This study highlighted differences in patient and proxy agreement about withdrawal of mechanical ventilation. Critical care nurses provide a key role in supporting EOL decisions. Encouraging ongoing communication about preferences and understanding the role of disease process and prognosis in decision making are paramount. Future research needs to explore factors that may improve patient and proxy agreement in EOL decisions and ways critical care nurses can support patients and proxies in these decisions, ultimately improving EOL care.
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There are evidence-based prevention strategies known to reduce the risk of pulmonary embolism formation. However, pulmonary emboli remain a leading cause of death in critically ill patients with a 3-month mortality of 10% to 15%. This article addresses patients' risk factors, pulmonary embolism prevention strategies, clinical manifestations, and treatment modalities the interdisciplinary team should understand.
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By 2040, there will be 70 million people older than 65 years in the United States. Approximately 50% have pain on a daily basis, and research shows that their pain is often underdiagnosed and undertreated. ⋯ Untreated pain can complicate an ICU stay and delay discharge. This article briefly reviews difficulties in managing pain in ICU patients, suggests creative methods to properly assess pain, and discusses approaches for encouraging elders in ICU to manage their pain effectively.