Dimensions of critical care nursing : DCCN
-
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.
-
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.
-
Dimens Crit Care Nurs · May 2014
Factors associated with receipt of physical therapy consultation in patients requiring prolonged mechanical ventilation.
Mobilization of critically ill patients in the intensive care unit is associated with improved function at hospital discharge and reduced duration of mechanical ventilation (MV). Few studies, however, focus on physical therapy (PT) in patients on prolonged mechanical ventilation (PMV) despite their high risk of immobility and poor outcomes. ⋯ In our study, we found that PT for PMV patients occurs infrequently and is generally of low intensity. Level of sedation, presence of a tracheostomy, and prehospital nonambulatory status were associated with receipt of PT consultation by day 14 of MV.
-
Dimens Crit Care Nurs · May 2014
The impact of a nurse practitioner rapid response team on systemic inflammatory response syndrome outcomes.
Early recognition of systemic inflammatory response syndrome (SIRS) can significantly alter outcomes such as mortality, unplanned intensive care unit admissions, and cost. ⋯ Improved detection of SIRS and successful implementation of EGDT led to a bridging of the evidence-to-practice gap. Future recommendations on earlier detection of lactic acidosis were rendered as a consequence of this study. The NP-RRT will continue to use the database query to identify SIRS patients in a timely manner and expedite EGDT.