Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2018
ReviewTelemedicine in the Intensive Care Unit: Improved Access to Care at What Cost?
Health systems across the United States are adopting intensive care unit telemedicine programs to improve patient outcomes. Research demonstrates the potential for decreased mortality and length of stay for patients of these remotely monitored units. ⋯ Questions remain as to the true financial implications of these programs and targeted populations that may see the greatest benefit. Despite recent growth, widespread adoption may be limited until these unknowns are answered.
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Crit Care Nurs Clin North Am · Jun 2018
ReviewInformatics Solutions for Application of Decision-Making Skills.
Critical care nurses practice in a challenging environment that requires responses to patients with complex, often unstable health conditions. The electronic health record, access to clinical data, and Clinical Decision Support Systems informed by data from clinical databases are informatics tools designed to work together to facilitate decision-making in nursing practice. The complex decision-making environment of critical care requires informatics tools that support nursing practice through integration of current evidence with clinical data. Recommendations include continuing efforts toward the development of clinical decision support tools based on patient data that include predictive models to support increased patient safety.
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Crit Care Nurs Clin North Am · Jun 2018
Work System Barriers and Strategies Reported by Tele-Intensive Care Unit Nurses: A Case Study.
Tele-intensive care units (ICUs) are an innovation to handle issues such as personnel shortage and improving care. In tele-ICUs, clinical teams monitor ICU patients remotely and support clinicians in multiple ICUs. The tele-ICU and ICU clinicians function as virtual teams. ⋯ We examined the challenges from the perspective of nurses in a tele-ICU. We used a case study design and conducted interviews with 10 tele-ICU nurses. The nurses encounter challenges in interacting with the multiple ICUs that they monitor remotely and have developed strategies to cope with these challenges.
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Crit Care Nurs Clin North Am · Jun 2018
Critical Care Nurses' Cognitive Ergonomics Related to Medical Device Alarms.
This study uniquely gained insight into the intricacy of intensive care nurses' decision-making process when responding to and managing device alarms. Difficulty in responding to alarms included low staffing, multiple job responsibilities, and competing priority tasks. Novice nurses are more tolerant of alarms sounding owing to a lower threshold of comfort with resetting or silencing alarms; more experienced nurses are more comfortable resetting alarm limits to the patient's baseline. Understanding the decision-making process used by nurses can guide the development of policies and learning experiences that are crucial clinical support for alarm management.
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Critically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings. Enteral nutrition has proven to be an important therapeutic strategy for improving the outcomes of critically ill patients and the critical care nurse plays an integral role in their success.