Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2010
ReviewState of the science: beta-blockers and reduction of perioperative cardiac events.
This article evaluates the current literature concerning the use of perioperative beta-blockade to reduce cardiac events in hopes that it may provide direction to clinicians or demonstrate gaps in medical knowledge, thus revealing areas suitable for future study. The current standard of practice for the use of perioperative beta-blockade in preoperative patients is outlined in the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines. ⋯ Further research is needed to support the ACC/AHA recommendations. It is essential that the decision to use beta-blockade be made on a case-by-case basis with adequate risk stratification as part of the criteria.
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Once considered a benign iatrogenic consequence of intensive care unit (ICU) admission, ICU delirium is now recognized as a prominent disorder that negatively affects patient morbidity and mortality. The primary goal in the detection and treatment of ICU delirium is to ensure the safety of the patient and caregiver(s). Most critically ill patients possess 1 or more risk factors for the development of delirium; therefore, interventions that target delirium assessment and prevention are essential. This article highlights some of the recent data that have emerged regarding ICU delirium, including its definition, incidence, risk factors, diagnostic tools, and treatment.
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Crit Care Nurs Clin North Am · Jun 2010
Case ReportsMedication errors from an emergency room setting: safety solutions for nurses.
Medication errors represent a failure in the medication use process and can increase morbidity and mortality. The National Coordinating Council for Medication Error Reporting and Prevention maintains a taxonomy that assists in standardized reporting, evaluating, and trending of medication error data. Many emergency departments are overcrowded from the increased responsibility of providing emergency and nonurgent medical care. ⋯ As a result, care is fragmented and methods designed to support patient safety are compromised. The most frequently reported error in emergency department care is medication error. This article analyzes methods to reduce medication errors in the emergency department.
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Crit Care Nurs Clin North Am · Jun 2010
Case ReportsVoice of the patient: the essence of patient-centered care.
Health care is being compelled to adopt patient-centered care. Consumers, professionals, and health care and community organizations are partnering to bring the voice of patients to health care reform. ⋯ There are many consumer groups and organizations working to elevate the voice of patients in health care. This article presents the work of just a few who are changing health care.
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Crit Care Nurs Clin North Am · Jun 2010
Defragmenting care: testing an intervention to increase the effectiveness of interdisciplinary health care teams.
Few studies in the literature have examined the outcomes of health care interdisciplinary teams. Most existing studies have measured attributes of health care teams; however, none have implemented and examined outcomes of a team development intervention. This study was conducted to determine whether a development intervention used with an existing interdisciplinary team would reduce the length of stay for patients in an acute care setting. ⋯ LOS may not be the outcome variable that reflects team effectiveness for this population. It is possible that the interdisciplinary team in this study had well-developed collaborative processes before the intervention. Physicians were not included in the team development intervention yet may be the discipline whose participation may have affected LOS.