Journal of critical care
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Journal of critical care · Apr 2017
What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians.
To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. ⋯ Key barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system-related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation.
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Journal of critical care · Apr 2017
Increased incidence of clinical hypotension with etomidate compared to ketamine for intubation in septic patients: A propensity matched analysis.
This study compared the incidence of clinical hypotension between ketamine and etomidate within a 24 hour period following endotracheal intubation. ⋯ Ketamine was associated with a lower incidence of clinical hypotension within the 24 hour period following endotracheal intubation in septic patients.
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Journal of critical care · Apr 2017
Opportunities for interprofessional input into nurse and physician hand-off communication.
Hand-offs are vulnerable times for hospitalized patients. Nurses and physicians routinely engage in hand-off communication but their communications remains siloed. Our objectives were to identify key information from each profession that would be of use to the other's hand-off process, and to identify facilitators and barriers to obtaining that input. ⋯ There are key areas of content that both physicians and nurses would like from the other profession to enhance intensive care unit hand-off communication. Interventions designed to increase interdisciplinary communication should focus on these key areas of content.
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Journal of critical care · Apr 2017
Case ReportsMaking a case for controlled organ donation after cardiac death: the story of Italy's first experience.
Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. ⋯ By making donation possible, the medical team was able to fulfill the family's last request on behalf of the patient. This case should stimulate deliberation regarding the potential to shorten the 20-minute no-touch period currently in place in Italy. Such an action would not have injured this patient and would certainly have increased the quality of the procured organs.
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Journal of critical care · Apr 2017
Perspectives of patients and family members regarding psychological support using intensive care diaries: An exploratory mixed methods study.
Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what information delivery method is preferred. ⋯ Patient and relative preferences of receiving a diary are not related to psychological distress. Diverse opinions around common themes suggest the need for a range of interventions to aid psychological recovery.