Critical care nursing quarterly
-
Axicabtagene ciloleucel and tisagenlecleucel are 2 chimeric antigen receptor (CAR) T-cell immunotherapies targeting CD19 for the treatment of B-cell acute lymphoblastic leukemia and non-Hodgkin lymphoma. Two commonly recognized complications associated with CAR T-cell therapies are cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). ⋯ Presently, the optimum management of ICANS remains elusive, as there lacks consensus guidelines. The objective of this review is to provide a comprehensive summary of ICANS and strategies for prompt identification and management of patients presenting to the intensive care unit with this syndrome.
-
Review
The Impact of Geriatric-Specific Triage Tools Among Older Adults in the Emergency Department.
As the aging population grows, emergency department (ED) service utilization among those 65 years and older is expected to rise. In 2017, it was estimated that approximately 49 million Americans were 65 years and older. ⋯ The aim of this integrative review is to appraise the impact of geriatric-specific triage tolls used in the ED and offer meaningful discussion on how to best address older adults in the ED setting. Findings from this review will help inform the efforts of clinicians, educators, researchers, and public health policy stakeholders charged in the care and advocacy for vulnerable older adults.
-
Burnout and compassion fatigue describe the state of health care professionals' extended stress, emotional states, and prolonged duress after events. In the past few decades, burnout and compassion fatigue have received increased focus and attention. This article summarizes the evolution in moving from viewing burnout as an individual's problem to understanding burnout as an occupational phenomenon, additionally recognizing the powerful role secondary trauma contributes to compassion fatigue. ⋯ The harm from burnout and secondary trauma in health care professionals can be profound, impacting a significant portion of the workforce and manifesting in real suffering, including depression, emotional trauma, and suicide. As health care professionals are daily at risk, the need to recognize, address, and treat burnout is a priority. Both personal resilience building activities for effective stress reduction in clinicians and system-level solutions to address root causes must be utilized to address burnout.
-
First successfully described in 1967, acute respiratory distress syndrome has since garnered much interest and debate. Extensive studies and clinical trials have been carried out in efforts to address the associated high mortality; however, it remains a significant burden on health care. Despite the heterogeneous etiologies that lead to the development of acute respiratory distress syndrome, this rapidly progressing form of respiratory failure, characterized by severe hypoxemia and nonhydrostatic pulmonary edema, has a recognizable pattern of lung injury. In this chapter, we will review the clinical manifestations, definitions, causes, and a brief overview of the pathophysiology of this complex syndrome.
-
Randomized Controlled Trial
Effects of Nurse-Led Intervention on Patients' Anxiety and Sleep Before Coronary Artery Bypass Grafting.
The aim of this study to examine the effects of supportive-educational nurse-led intervention on the patients' anxiety and sleep before the coronary artery bypass grafting. The current clinical trial recruited 160 patients (N = 160) waiting for the coronary artery bypass grafting by random block sampling and divided them into two 80-people experimental and control groups. Spielberger's State Anxiety Inventory was completed on the first day. ⋯ The comparison of the mean quality of sleep the night before the surgery for both groups showed that sleep in the control group compared with sleep in the experimental group had a lower quality, and statistically, it was significant (P < .001). Results showed that nonpharmacological and supportive interventions can reduce patients' anxiety and sleep disturbance before the coronary artery bypass grafting. According to the results, nonpharmacological therapies should be placed at the top of nurses' tasks.