The Nursing clinics of North America
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This article provides frontline nurses a tool kit so they can advocate a healthy practice environment. The healthy nurse, healthy work hours, job satisfaction, adequate sleep, power naps at work, and balancing family/work are discussed. ⋯ Case reports with analysis and recommendations are discussed to overcome these barriers. Resources are presented for frontline nurses to develop a tool kit for transforming their environment to a healthy practice environment and to empower them to become healthy nurses.
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Fever is a significant contributor to secondary brain insult and management is a challenge for the neurocritical care team. The absence of standardized guidelines likely contributes to poor surveillance and undertreatment of increased temperature. A need for practice change was identified and this evidence-based practice project was initiated to compile sufficient evidence to develop, implement, and evaluate a treatment guideline to manage fever and maintain normothermia in the neurocritical care population. Ongoing education, inclusion in staff annual competency, and staff update on compliance performance is essential to maintain and sustain the practice change achieved through this project.
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Nurs. Clin. North Am. · Sep 2014
Promoting sleep in the adult surgical intensive care unit patients to prevent delirium.
Ensuring adequate sleep for hospitalized patients is important for reducing stress, improving healing, and decreasing episodes of delirium. The purpose of this project was to implement a Sleep Program for stable patients in the surgical intensive care unit, thereby changing sleep management practices and ensuring quality of care using an evidence-based practice approach. Improving patient satisfaction with sleep by 28 percentage points may be attributed to a standardized process of providing a healing environment for patients to sleep.
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Nurs. Clin. North Am. · Sep 2014
Part II: managing perioperative hyperglycemia in total hip and knee replacement surgeries.
Perioperative hyperglycemia management is an important factor in reducing the risk of surgical site infections (SSIs) in all patients regardless of existing history of diabetes. Reduction of SSIs is one of the quality indicators reported by the National Healthcare Safety Networks of the Centers for Disease Control and Prevention (CDC). In 2009 and 2010, the orthopedic surgical unit had an increased number of SSIs above the CDC benchmark. This article describes the impact of an evidence-based practice standard for perioperative hyperglycemia management in the reduction of SSIs in patients having total hip and knee replacement surgery.
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The objective of this project was to reduce the number of failed extubations in the pediatric intensive care unit. This article describes extubation failures in the pediatric intensive care unit and the development and implementation of an extubation readiness protocol using the Iowa Model for Evidence-based Practice as a guideline. The Iowa Model consists of processes for implementing evidence into practice, such as critiquing and synthesizing the literature, identifying stakeholders, and recognizing triggers. The extubation protocol was developed excluding children with previous lung injury and/or neuromuscular conditions, which contribute to an increased risk and complexity of planned extubations.