Critical care nursing clinics of North America
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The health care costs for patients with delirium were estimated to be more than double the costs for patients without delirium and potentially exceeded the costs for falls, diabetes mellitus, and hip fractures; yet the fluctuating nature of the condition makes it a difficult condition for health professionals to recognize and treat. The key, then, is in recognition and prevention.
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Crit Care Nurs Clin North Am · Mar 2012
ReviewStraddling the fence: ICU nurses advocating for hospice care.
A key factor in nurses' experiencing moral distress is their feeling of powerlessness to initiate discussions about code status, EOL issues, or patients' preferences. Moreover, nurses encounter physicians who give patients and their families a false picture of recovery or, worse, block EOL discussions from occurring. Since its release in 1995, the landmark study of almost 10,000 patients in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) reported a widespread gap with physicians' discussions in honest prognosis and EOL issues. ⋯ The ICU nurse should be proficient in communication skills, using evidence-based communication related to functional status, performance scales, disease trajectory, and prognosis. ICU nurses recognize that not every patient survives their ICU stay; yet, for those patients who will not survive, every ICU nurse wants their patient to experience a "good death." Hospice and the palliative care are important aspects of our care continuum and should not be ignored until the last days or hours of a patient's life. Recognizing eligibility for hospice and its alignment with patient EOL preferences can result in optimal EOL care.
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Crit Care Nurs Clin North Am · Sep 2011
ReviewLiver transplantation: issues and nursing care requirements.
Liver transplantation has evolved into an accepted treatment for many suffering from end-stage liver failure. The complex nature of the liver results in every organ system being impacted by either the failing or the transplanted liver. ⋯ Nurses can play an integral role in early identification of graft dysfunction, rejection, or infection. Because of the intimate and large amount of time that the nurse is at the patient’s bedside, he or she is often in a position to monitor for potential risks to the patient and take corrective action.
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Crit Care Nurs Clin North Am · Jun 2011
Practice GuidelineThe 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care: an overview of the changes to pediatric basic and advanced life support.
The American Heart Association (AHA) has a strong commitment to implementing scientific research-based interventions for cardiopulmonary resuscitation and emergency cardiovascular care. This article presents the 2010 AHA major guideline changes to pediatric basic life support (BLS) and pediatric advanced life support (PALS) and the rationale for the changes. The following topics are covered in this article: (1) current understanding of cardiac arrest in the pediatric population, (2) major changes in pediatric BLS, and (3) major changes in PALS.
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Pediatric critical care nurses are exposed to research in the critical care environment on a routine basis and should be knowledgeable about the ethical considerations inherent in this process. The following discussion includes information that centers on the ethical issues of conducting research with children. First, children as a vulnerable population is explored, followed by selected ethical principles that pertain to research, the role of the technological imperative in research, the process of informed consent, and finally, nursing considerations.