Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2010
Safe practices for enteral nutrition in critically ill patients.
Promoting patient safety in the enterally fed critically ill patient is dependent on nursing surveillance and recognition of potential areas of patient harm and medical errors. Identifying areas for potential human error, administrative and organizational conditions that are conducive to error, and the patient's own tolerance to EN need to be recognized by the critical care nurse if the risk for EN complications is to be minimized.
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Crit Care Nurs Clin North Am · Jun 2010
Neonatal intensive care unit and emergency department nurses' descriptions of working together: building team relationships to improve safety.
Teamwork is considered a critical factor in delivering high-quality, safe patient care although research on the evidence base of the effectiveness of teamwork and communication across disciplines is scarce. Health care providers have limited educational preparation for the communication and complex care coordination across disciplines required by today's complex patients. Complex work environments are affected by little understood human factors including the intricacies of human communication and behavior. ⋯ Results from 4 focus groups of 18 nurses from a neonatal intensive care unit and emergency department trauma resuscitation teams, revealed 3 themes with descriptive meanings to help understand the complexities of teamwork. These findings illustrate the rewards and challenges for teams working together in the current health care environment. Continuing to investigate teamwork can add to our understanding of what nurses and health professionals need to know about teamwork to help develop evidence-based team training in prelicensure education and in practice settings.
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Adequate nurse staffing is inextricably linked to patient outcomes and, although optimal staffing levels for inpatient hospital units are widely debated, staffing standards for critical care areas such as intensive care units may be less variable. Even established staffing levels cannot guarantee adequate staffing. ⋯ There are times when staffing fails to meet desired levels and nurses are challenged to meet their duty to the patient for safety. The purpose of this article is to identify the safety challenges posed when staffing levels are less than planned in critical care settings and discuss individual, organizational, and policy-oriented strategies for protecting patient safety.
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Crit Care Nurs Clin North Am · Jun 2010
Human factors: should your medical devices require intensive care?
The design of a medical device should include active consideration of the way in which real users will actually use the device in the real environment of use. This consideration must include making the way in which the user interfaces with the device, for example, the buttons, the displays, the connections, such that the user can complete their tasks without error and without undue burden. This consideration of realistic user needs is addressed by the discipline of human factors.
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Although bronchoscopies have been performed for over a century and are relatively safe when practice guidelines are followed, they are invasive and a real source of anxiety and fear for the patient. The role of the critical care nurse is essential to a successful outcome. This article provides an overview of the main diagnostic and therapeutic indications, contraindications, and possible complications. Also discussed are patient education; patient and staff safety; and considerations before, during, and after the procedure.