Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Jan 2003
Review Case ReportsNew thoughts on sepsis: the unifier of critical care.
In the United States, more than $16 billion annually is spent managing patients with severe sepsis and its sequelae. Insight into the inflammatory response, endothelial tissue, and the coagulation cascade suggest promising new treatment regimens that limit morbidity and mortality due to sepsis and multisystem organ failure. This article will discuss new information regarding the pathophysiology of the inflammatory response and sepsis. Current thoughts on clinical management and a promising new agent, Activated Protein C, will be presented.
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Dimens Crit Care Nurs · Jan 2003
Decreased cardiac output: validation with postoperative heart surgery patients.
This study was done to analyze the association between defining characteristics of decreased cardiac output (DCO) identified by noninvasive methods and the cardiac index (CI) estimated by thermodilution. Two defining characteristics were associated with DCO: decreased peripheral pulse and decreased peripheral perfusion. This study points out the relevance of peripheral circulation assessment in postoperative cardiac surgery patients.
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Dimens Crit Care Nurs · Sep 2002
Randomized Controlled Trial Clinical TrialUsing evidence-based practice to develop a protocol for postoperative surgical intensive care unit patients.
Sixty adult postoperative patients from the surgical intensive care unit with core temperatures <35.4 degrees C, as measured by a pulmonary artery catheter, were randomly assigned to one of three treatment options for hypothermia. Results of this study confirmed findings in the literature that forced warm air generated quickest rewarming times. A rewarming protocol for hypothermic patients was developed and implemented. Performance improvement activity demonstrated high compliance rates with nurses using the rewarming protocol.
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Dimens Crit Care Nurs · Sep 2002
Organizational considerations in the development of a new cardiovascular recovery unit.
The focus of dialogue surrounding healthcare institutions is frequently economic in nature. The business climate is one of intense competition to secure market domination. ⋯ However, there are several noneconomic factors an organization must consider before undertaking such an endeavor. This paper will discuss the organizational theories of vision, leadership, job design, and team development in relationship to the development of a new cardiovascular recovery unit.