Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2020
ReviewIntensive Care Unit Patient Diaries: A Review Evaluating Implementation and Feasibility.
Post-intensive care syndrome is a detrimental cluster of symptoms that can have a negative impact on life after discharge from the intensive care unit (ICU). The use of patient diaries while hospitalized in the ICU has been reported to help survivors and families create memories and fill in gaps from their hospitalization. A review of the literature revealed that patient selection, diary content, family involvement, and staff perceptions are essential to the implementation of a diary program. Understanding the importance and impact diaries can have on survivors increases compliance and sustainability of this program.
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Crit Care Nurs Clin North Am · Jun 2020
ReviewSleep in the Intensive Care Unit: Biological, Environmental, and Pharmacologic Implications for Nurses.
There is a clear relationship between lack of sleep, poor health outcomes, and delayed recovery from illness in the intensive care unit. Several factors can contribute to poor quality sleep in the intensive care unit, including (1) environmental disruptions such as light and sound, (2) physiologic disruptions such as discomfort, nausea, and pain, (3) psychological disruptions such as anxiety and a lack of privacy, and (4) health care provider-related disruptions, such as medication administration and nursing care. Nursing implications include increased attention to the role of sleep to promote intensive care unit patient's health outcomes and using multicomponent sleep-promoting protocols.
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Crit Care Nurs Clin North Am · Jun 2020
ReviewBereavement Care in the Adult Intensive Care Unit: Directions for Practice.
Bereavement support is recommended as part of family-centered care in critical care settings. This literature review describes the impact on a family after the death of a loved one in the intensive care unit (ICU) and how bereavement services could help. ⋯ A bereavement risk assessment tool is also described to more optimally meet families' needs. Finally, the goal of this review is to guide ICUs in planning and developing of a successful and sustainable bereavement program.
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Patients admitted to the intensive care unit (ICU) are at an extremely high risk for developing intensive care syndrome. Increased illness severity often result in prolonged immobility, altered cognition, and the development of psychotic manifestations. Any constellation of these problems can result in prolonged patient impairment long after transfer from the ICU. Quick recognition of these symptoms leads to the development of a targeted rehabilitation to minimize long-term sequelae and optimize functional recovery.
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Opioid analgesics are the historical mainstay for postoperative cardiothoracic surgery pain relief. Although opioids are efficacious, they are linked with adverse effects, including sedation and respiratory depression. ⋯ Preoperatively educating patients and families on expected nociception and treatment options decreases postprocedural pain. Discussing use of nonopioid analgesics for mild pain and instructions on tapering opioid medications at discharge may prevent future misuse.