Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2007
ReviewEmerging nurse-sensitive outcomes and evidence-based practice in postoperative cardiac patients.
Outcomes continue to be one of the most powerful measures of quality care in all health care settings for all caregivers. Nurse-sensitive outcome measurement is one of the most promising strategies that can enhance patient care and satisfaction of patients, families, and caregivers. The purpose of this article is to assist intensive care unit nurses with identification and implementation of current evidence-based nursing interventions for the critically ill patients undergoing cardiac surgery.
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Crit Care Nurs Clin North Am · Jun 2007
ReviewJustification for a minimal lift program in critical care.
This chapter reviews literature pertaining to patient-handling tasks spanning the areas of epidemiology, biomechanics, perceived stresses, education and training programs, and introduction of mechanical patient lifting devices. All findings agree that patient handling is inherently dangerous and has been attributed to the majority of injuries incurred by nursing personnel; however, most studies have been performed in hospitals or long term care settings, but have not been specific to the area of critical care. The critical care environment poses unique challenges for nursing personnel and therefore, to ergonomists.
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Crit Care Nurs Clin North Am · Jun 2007
ReviewWorkload and patient safety among critical care nurses.
Several dimensions of workload experienced by nurses working in ICUs are described in this article, including the physical workload related to patient handling. The effects of workload on various outcomes, such as the health, safety, and quality of working life of nurses, and the safety of care provided by ICU nurses are discussed. A systemic approach to the assessment of workload is proposed that is aimed at identifying the work system factors that contribute to the different facets of workload and the interdependencies among the various dimensions of workload.
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Sepsis is a syndrome produced by the accelerated activity of the inflammatory immune response, the clotting cascade, and endothelial damage. It is a systematic process that can progress easily into septic shock and MODS. The chemical mediators or cytokines produce a complex self-perpetuating process that impacts all body systems. ⋯ The challenge for nurses caring for septic patients is to support the treatment goals, to prevent added complications including stress ulcers, DVTs, aspiration pneumonia, and the progression to MODS, and to address the patient's and the family's psychosocial needs. As complex as the pathophysiology of sepsis is, the nursing care is equally complex but also rewarding. Patients who previously might have died now recover as vigilant nursing care combines forces with new drug therapies and evidence-based practice guidelines.
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Crit Care Nurs Clin North Am · Dec 2006
ReviewImplementing best practice strategies to prevent infection in the ICU.
Critically ill patients are at high risk for infection because of many factors. Quality and regulatory groups have published guidelines regarding infection prevention in the ICU. ⋯ Bundles of intervention along with daily rounds an assessment are essential program components. Ongoing surveillance and re- education and reinforcement are also part of a strong infection prevention program.