Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Mar 2009
ReviewCongenital cardiac disease in the newborn infant: past, present, and future.
Congenital heart defects are the most common of all congenital malformations, with a review of the literature reporting the incidence at 6 to 8 per 1000 live births. The Centers for Disease Control reports cyanotic heart defects occurred in 56.9 per 100,000 live births in the United States in 2005, with higher rates noted when maternal age exceeded 40 years. ⋯ Despite advances in detection and treatment, congenital heart disease accounts for 3% of all infant deaths and 46% of death from congenital malformations. This article discusses the embryology, pathogenesis, clinical presentation, incidence, classifications, and management of congenital heart diseases.
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This ethnographic study of the VISICU eICU (VSISCU, Inc., Baltimore, MD) work environment in a large midwestern health care system describes everyday life working in a telemedicine intensive care. Data were gathered through 60 hours of observation and formal interviews of eICU clinician team members. Working in the remote telemedicine center, often referred to as the "Box", is like working in an air traffic control center. Remote oversight and effective communication ensure the best possible outcomes to support the bedside intensive care unit team.
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Crit Care Nurs Clin North Am · Dec 2008
The virtual ICU (vICU): a new dimension for critical care nursing practice.
The virtual or remote intensive care unit is a redesigned model of care that uses state-of-the-art technology to leverage the expertise and knowledge of experienced caregivers over a large group of patients in multiple intensive care units. The registered nurse working in this environment, or eRN, is an expert clinician familiar with evidence-based clinical initiatives that need to occur at the bedside to optimize outcomes for patients. The eRN assists the bedside team by providing a second layer of quality and safety. As the use of this technology continues to grow, a new dimension for critical care nursing practice is emerging that has dramatic implications for the future.
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Crit Care Nurs Clin North Am · Dec 2008
Nurturing innovation in the critical care environment: transforming care at the bedside.
By their sheer nature, critical care nurses are innovative and adaptable problem solvers. The Transforming Care at the Bedside (TCAB) project is a vehicle to create solutions when problems are identified. The TCAB project engages front-line staff to identify areas for improvement and develop solutions. The adoption of TCAB principles into the critical care environment was a natural progression in the development of the innovative culture at the UPMC Shadyside.
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Crit Care Nurs Clin North Am · Dec 2008
ReviewApplication of the Nursing Worklife Model to the ICU setting.
The Nursing Worklife Model explains how work-environment characteristics that affect nursing practice affect nurses' lives in the workplace by contributing to or mitigating burnout. Using the characteristics that are known to be preferred by nurses and consistent with magnet hospital properties will help nurse managers reduce nursing turnover by decreasing burnout and by improving job satisfaction for their staff. This article describes how the five domains of the Nursing Worklife Model can be applied in the critical care setting. Within each of the five domains (nursing leadership, nurses' involvement in hospital affairs, staffing and resource adequacy, nurse-physician collaboration, nursing model of care) are multiple strategies that can be implemented to improve the practice environment for nurses.