Critical care nursing quarterly
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The leading cause of death due to health care-associated infections is ventilator-associated pneumonia (VAP). The lack of clarity in the definition of VAP has made it difficult to execute and evaluate the effectiveness of prevention strategies. ⋯ This article outlines the results of a quality improvement project that was conducted to address this recommendation, improve current staff knowledge, identify gaps in practice, and determine the rate of compliance with prevention strategies. The major findings of this project also exposed limitations of the electronic medical record system, and suggested enhancements, which would promote the VAP Bundle initiatives, facilitate documentation, and permit straightforward data collection.
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Therapeutic hypothermia (TH) reduces neurologic injury and mortality in out-of-hospital cardiac arrest survivors. Myocardial infarction (MI) is one of the main causes of cardiac arrest and primary percutaneous coronary intervention (PCI) is recommended as initial treatment for patients who present with acute ST-segment elevated MI (STEMI). Cape Fear Valley Medical Center (CFVMC) was the only designated PCI center in the state of North Carolina without a TH protocol. ⋯ The development of a postarrest STEMI TH protocol involved multiple disciplines and required approval from several committees. Lack of physician and nursing knowledge of the protocol proved to be the greatest challenge. The TH protocol is a step forward in implementing evidence-based practice and improving the quality of postresuscitation care provided to postcardiac arrest STEMI patients.
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Health care professionals have begun to view family members as an integral part of the healing process and the well-being of patients in the intensive care unit. The needs of family members may be varied, and nurses must become attuned to the family members' needs and acquire skills to direct interventions toward identifying and meeting those needs. ⋯ The hypothesis proposed that a gap exists between identified needs of family members visiting intensive care patients and their perceptions of needs as being met or unmet. Data analysis included quantitative and qualitative methods.