Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Jul 2013
Case ReportsUsing ABGs to optimize mechanical ventilation: three case studies illustrate how arterial blood gas analyses can guide appropriate ventilator strategy.
This article focuses on translating arterial blood gas information into clinical benefits, with 3 case scenarios that focus on using arterial blood gases to manage mechanical ventilation.
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Dimens Crit Care Nurs · Jul 2013
Neuro/Trauma intensive care unit nurses' perception of the use of the full outline of unresponsiveness score versus the Glasgow Coma Scale when assessing the neurological status of intensive care unit patients.
: This study compares the Full Outline of Unresponsiveness (FOUR) Score scale with the Glasgow Coma Scale (GCS) when evaluating a patient's level of responsiveness in the neuro/trauma intensive care unit of a large medical center. This new scoring tool evaluates 4 functional categories: eye response, motor response, brainstem reflexes, and respiratory pattern. ⋯ : The FOUR Score scale provides a reliable neurological assessment of intubated patients where the GCS does not differentiate patient status once intubated.
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Dimens Crit Care Nurs · Jul 2013
Using evidence-based leadership initiatives to create a healthy nursing work environment.
In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing. Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.
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Dimens Crit Care Nurs · Jul 2013
PCA by proxy: taking the patient out of patient-controlled analgesia: this controversial practice can be done safely in carefully controlled circumstances.
Among the questions raised about patient-controlled analgesia (PCA) by proxy are as follows: What are the safety issues related to PCA by proxy? Should another type of pain management be used for patients who can not activate the PCA button? This article focuses on safe PCA use and authorized agent-controlled analgesia (AACA).
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Dimens Crit Care Nurs · Jul 2013
Critical care nurses' perceptions of preparedness and ability to care for the dying and their professional quality of life.
A study was undertaken to explore whether critical care nurses perceive that they have been adequately prepared during basic nursing education to care for the dying and their loved ones and to identify if there is a relation between their perceptions of preparedness and ability to provide end of life care and professional quality of life (PQOL). Findings indicate that there is a relationship between critical care nurse perceptions of preparedness and ability to care for the dying and their PQOL, with higher compassion satisfaction scores, lower compassion fatigue scores, and lower burnout scores for those who perceive themselves more prepared and better able to provide end of life care (N = 473). Thus, pedagogic interventions to enhance perceptions of preparedness and ability to care for the dying can potentially improved PQOL for nurses working in critical care areas, possibly diminishing the incidence of compassion fatigue and burnout.