Critical care nursing quarterly
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Comparative Study Clinical Trial
Sleep monitoring by actigraphy in short-stay ICU patients.
Sleep deprivation is common in intensive care unit (ICU) patients. The criterion standard for sleep monitoring, polysomnography, is impractical in ICU. Actigraphy (a wrist watch indicating amount of sleep) proved to be a good alternative in non-ICU patients, but not in prolonged mechanically ventilated patients, probably due to ICU-acquired weakness. ⋯ The result showed that actigraphy underestimated the amount of wake time and overestimated the amount of sleep. The median specificity for actigraphy was always less than 19% and sensitivity more than 94%. Therefore, actigraphy is not reliable for sleep monitoring in short-stay ICU patients.
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Despite infection-prevention initiatives, hospital-acquired infections (HAIs) are still a common occurrence. Chlorhexidine gluconate (CHG) is an important antibacterial agent. Research indicates that the intervention of bathing with CHG can reduce the number of HAIs. ⋯ The reduction in HAIs was found to be greater as compared to bathing with soap and water. The reduction of these HAIs will allow for a saving of resources, finances and staff time, which may ultimately be passed on to the patient. While further research is indicated, a strong conclusion is drawn that bathing with CHG reduces the number of HAIs.
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Critically ill patients in the intensive care unit (ICU) who require mechanical ventilation often require continuous sedation infusions. These 2 interventions are associated with adverse outcomes such as increased duration of mechanical ventilation, increased length of stay in both the ICU and the hospital, and significant physiological and psychological complications. Daily sedation interruption (DSI) can reduce these adverse effects thereby improving long-term outcomes after critical illness. ⋯ DSI is safe, practical, cost-effective, and results in positive outcomes for patients; however, there are barriers to implementing and incorporating DSI into daily practice. Further research is required to provide additional evidence and promote more widespread utilization.