Heart & lung : the journal of critical care
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Comparative Study
Relationship of age, sex, and procedure type to extubation outcome after heart surgery.
To identify the relationship of age, sex, and type of procedure to extubation outcome (< or = 8 hours or > 8 hours), and to identify barriers to extubation after heart surgery. ⋯ Age is a powerful predictor of delayed extubation after heart surgery. Only postoperative somnolence distinguished barriers to extubation in younger and older patients.
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Comparative Study
A comparison of patients' communication-related responses during intubation and after extubation.
The purpose of this exploratory pilot study was to examine patients' communication-related responses during intubation and after extubation, and to determine whether differences in patients' report of responses at these two points in time, if present, were associated with demographic and situational variables. ⋯ Results provide direction for larger longitudinal prospective and retrospective studies with larger samples that examine patients' recall of their responses during intubation, especially related to communication.
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To describe the grief experience of pediatric intensive care nurses when their patients die. ⋯ These results demonstrate that pediatric intensive care nurses' grief is different from that of surviving family member grief. Further research is required to document in further depth the experiential learning process to coping with multiple, accumulated losses for these professional caregivers. The findings of this study also could encourage further research that examines interventions designed to enhance the type of education and support needed in relation to the grief experience of nurses.
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Patients with prolonged intensive care unit (ICU) length of stay, though few in number, consume as much as 50% of ICU resources. With increasing pressures for cost containment in health care, the availability of ICU beds may be jeopardized. To improve the efficiency of care for patients requiring a surgical intensive care unit (SICU) stay of 3 or more days, a multidisciplinary, highly "protocolized," Progressive Care Area was developed within the existing SICU environment. ⋯ In designing the Progressive Care Area, we drew on a number of published management strategies-including total quality management concepts and our prior experience in establishing ventilator management teams. The Progressive Care Area has resulted in a reduction in both the frequency and variation of resources used. A Progressive Care Area within an existing ICU is a viable alternative for the care of the patients who have prolonged lengths of stay and are less acutely ill, and it significantly improves ICU efficiency.
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To describe how nurses assess and manage pain in critically ill children. ⋯ Pain assessment of critically ill children includes unique indicators, as compared to less sick children, and must take into account the child's decreased ability to communicate pain.