Clinical nurse specialist CNS
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The purpose of this article is to delineate what we know about adherence with sedation withdrawal protocols and guidelines. Reasons for lack of adherence and associated outcomes are explored in addition to potential solutions. ⋯ The findings described in this article suggest that adherence to sedation withdrawal protocols and guidelines is not good despite perceptions to the contrary. The article delineates potential solutions as suggested by the authors of the reviewed articles and those of the author of this article.
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The aims of this study were to determine whether bowel sounds auscultation is necessary in critically ill patients and to forecast the prospect of bowel sounds as a monitoring measurement in the intensive care unit (ICU). ⋯ Bowel sounds auscultation is necessary in the ICU. Effective application in critically ill patients requires reasonable practice and precise instrumentation.
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The purpose of this study was to determine the impact of implementation of evidence-based alcohol withdrawal syndrome (AWS) guideline using the Clinical Institute Withdrawal Assessment of Alcohol Scale--Revised scale on care and outcomes of burn patients with comorbid alcohol use and on physician and nurse documentation of alcohol screening, education, and referral. ⋯ Greater efforts should be directed at managing alcohol withdrawal. An advance practice nurse can make an important contribution.
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Delirium is the most frequent complication associated with hospitalization of older adults, responsible for 17.5 million additional hospital days in the United States each year; yet, nurses fail to recognize it more than 30% of the time. ⋯ Findings provide further support for the significance of nurses' underrecognition of delirium in the hospitalized older adult when using the CAM. Additional research is warranted regarding the clinical decision-making processes that nurses use in assessing acute cognitive changes and in identifying strategies to improve delirium recognition.