Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2009
Review Case ReportsThe ten commandments of pain assessment and management in preterm neonates.
Despite advances in pain assessment and management, nonpharmacologic and pharmacologic analgesic therapies continue to be underutilized in managing both acute and procedural pain in preterm neonates. Untreated acute, recurrent, or chronic pain related to disease or medical care may have significant and lifelong physiologic and psychological consequences. Painful procedures in the NICU may be unavoidable, so it is vital that caregivers balance the painful, medically necessary care with evidence-based nonpharmacologic and pharmacologic strategies to relieve pain and stress. We present Ten Commandments of pain assessment and management in preterm neonates to promote the use of best practices and compassionate care in the NICU.
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This article briefly reviews the history of ROP followed by a discussion of the pathogenesis of this complex disorder. We describe the International Classification System for ROP and identify risk factors and screening recommendations. Finally, we discuss some of the measures that have been used in an attempt to both prevent and treat ROP.
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Crit Care Nurs Clin North Am · Jun 2009
ReviewWhen the fetus is alive but the mother is not: critical care somatic support as an accepted model of care in the twenty-first century?
There has been an increase in cases involving the maintenance of brain dead pregnant women on life support to allow for fetal growth toward viability and birth. This article provides an ethical analysis and discusses the critical care nursing needs of the maternal patient.
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Crit Care Nurs Clin North Am · Jun 2009
ReviewPatient safety: effective interdisciplinary teamwork through simulation and debriefing in the neonatal ICU.
According to the Institute of Medicine, team training is necessary to promote a safe and high-quality patient care environment. The complexity of the neonatal ICU requires that interdisciplinary teams collaborate, coordinate, and communicate to achieve common goals and support families. The use of strategies from the aerospace, nuclear power, and national defense industries-simulation, and debriefing-equips health care providers with the knowledge, skills, and behaviors necessary to perform effectively and safely. Families are encouraged to participate in simulation and debriefing so interdisciplinary teams can learn how to approach and support families when disclosing errors and to communicate sensitive information in a safe and nonthreatening environment.
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Crit Care Nurs Clin North Am · Jun 2009
Living with grief following removal of infant life support: parents' perspectives.
Research findings reported in the literature about making life and death decisions for critically ill infants in the neonatal ICU focus primarily on the experiences of health care providers and the ethical dilemmas surrounding these decisions. Fewer studies focus on parents' experiences in making decisions about discontinuing life support for their infant, and even fewer address what life is like for parents following the deaths of their infants. This article expands on the concepts identified by parents as factors in their decision making and on the facilitators and barriers parents faced, and continue to face, in their grieving process.