Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2001
Critical caring. Promoting good end-of-life care in the intensive care unit.
Changing the culture in the ICU to include palliative care interventions along with curative interventions is already underway. Further work is needed, however. This is a role for the critical care nurse. ⋯ Nurses from the hospital palliative care team can consult and be available for follow-up. Promoting good end-of-life care should be a goal for all intensive care nurses and critical care units. This goal is reached one patient at a time.
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Crit Care Nurs Clin North Am · Dec 2001
Translating research into practice. Implications of the Thunder Project II.
The Thunder Project II study described procedural pain in a variety of acute and critical care settings. The procedures studied were turning, tracheal suctioning, wound drain removal, nonburn wound dressing change, femoral sheath removal, and central venous catheter insertion. Turning had the highest mean pain intensity, whereas femoral sheath removal and central venous catheter insertion had the least pain intensity in adults. ⋯ There is a wide range of pain responses to any of these procedures; as a result, standardized and thoughtful pain, and distress assessments are warranted. Planning of care, including the use of preemptive analgesic interventions, needs to be individualized. Future studies are needed to describe patient responses to other commonly performed nursing procedures and to identify effective interventions for reducing procedural pain and distress.
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Crit Care Nurs Clin North Am · Dec 2001
Using nurse-sensitive outcomes to improve clinical practice.
With the many uncertainties in the current health care milieu and continuing movement from general guidelines to ensure an optimal practice approach, it is especially vital that critical care nurses facilitate a research culture in their workplace and strive to improve clinical practice through understanding and evaluating research. Outcomes research helps to identify discipline-specific accountability in patient care. ⋯ Outcomes research continues to be instrumental in defining a base for nursing practice. Although it is not necessary or even desirable that all nurses conduct research, nurses are accountable for providing scientific and appropriate care to ensure the optimal outcome for the patient.