Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Mar 2012
Translating guidelines into practice: ventilator-associated pneumonia prevention strategies in an acute rehabilitation unit.
Ventilator-associated pneumonia has significant mortality (33%-50%). The highest risk of ventilator-associated pneumonia is early in mechanical ventilation with an increase in morbidity and mortality seen with late-onset ventilator-associated pneumonia. Prevention strategies have been recommended for acute care facilities, but there is lack of evidence-based data and recommendations for acute rehabilitation units. ⋯ Education of rehabilitation staff and implementation of the protocol were done. Results showed that the ventilator-associated pneumonia rate decreased from 7.5 to 0 per 1000 patient ventilator days. Translating evidence-based guidelines into practice can be accomplished using a multidisciplinary team.
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Dimens Crit Care Nurs · Jan 2012
Multicenter StudyExploration of the association between professional interactions and emotional distress of intensive care unit nursing personnel.
: Several studies provide evidence for the association between the quality of collaboration among intensive care unit (ICU) professionals and patients' outcomes, as well as nurses' moral distress and professional satisfaction. However, potential associations between collaboration and nurses' mental health indices have not been explored. The aim of this descriptive correlational study was to investigate the degree of satisfaction from interaction among ICU nursing personnel, as well as between ICU nursing personnel and physicians, and potential associations with ICU nursing personnel's anxiety symptoms. ⋯ Nursing personnel in Greek ICUs seem to be satisfied with the quality of relationships among them, as well as with physicians. Despite that anxiety symptoms associate with the degree of satisfaction from professional interaction, the latter may not be a significant indicator of ICU nurses' well-being. Further qualitative research is needed to identify mediating factors.
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Dimens Crit Care Nurs · Jan 2012
ReviewTriggering receptor expressed on myeloid cells type 1 as a potential therapeutic target in sepsis.
Excessive and unregulated inflammation contributes to multiorgan failure and death in sepsis. Triggering receptor expressed on myeloid cells type 1(TREM-1) is expressed on neutrophils and monocytes and is upregulated in the presence of bacterial pathogens. ⋯ Based on these studies, modulation of the TREM-1 signaling pathway has been suggested as a potential therapeutic strategy for the treatment of sepsis, to dampen the inflammatory response without interrupting the ability of the host to clear pathogens. This basic science research may someday lead to other treatments for sepsis and other diseases.
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Dimens Crit Care Nurs · Jan 2012
ReviewFamily presence on rounds: a systematic review of literature.
Family-centered care has become the new trend in the health care field that involves honoring the patient and families' perspectives and choices and supporting them in participating in care and decision making at whatever level they choose. Family presence on rounds is one of the guidelines instituted for evidence-based best practices for support of family in the delivery of patient-centered care in the intensive care unit (ICU) but identified as the least studied among all the other aspects of family-centered care in the ICU. From 1988 to 2010, only 1 research study on family presence was conducted in an adult ICU. The purpose of this article was to review research studies related to family presence on medical rounds; reviews that focus on both adults and pediatric patients in the critical and noncritical care settings are also included.
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Dimens Crit Care Nurs · Jan 2012
Upstream palliative care for the patient with a left ventricular assist device as destination therapy.
Left ventricular assist devices are increasingly being used as destination therapy for heart failure patients who are not candidates for a heart transplant. The palliative care needs of this population will continue to grow as devices become more effective and more left ventricular assist devices are implanted. As part of an integrated multidisciplinary team, nurses are vital to successful outcomes for these patients.