Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2002
ReviewProactive error prevention in the intensive care unit.
Care provided in the ICU accounts for nearly 30% of acute care hospital costs and, with the aging of Americans, there is an increased demand for critical care services [1]. Critical illness reduces an individual's physical resilience. Minute-to-minute care decisions and interventions mean life or death during this acute disease phase. ⋯ This patient population has the least ability to communicate symptoms to health care providers. The risk of adverse events caused by medications or equipment malfunction is higher because patients in the ICU receive twice as many medications as patients in general care units [2] and often require mechanical support of normal body functions, such as breathing, eating, and eliminating body waste. Consequently, the patient in the ICU has a higher exposure to medical error than patients in other areas of the hospital.
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Crit Care Nurs Clin North Am · Dec 2002
A teamwork model to promote patient safety in critical care.
To create a safe health care system, providers must understand teamwork as a complementary relationship of interdependence. Continuing efforts to adopt the aviation model will enable health care providers to examine the role of human performance factors related to fatigue, leadership, and communication among all providers. ⋯ The growing research base continues to examine the problem of health care safety and to test the most effective team training approaches. What is the most effective pattern and timing of communication among providers? What system level changes are needed in the critical care area to improve communication through teamwork and thus create a safer health care system? What are potential points of error in the daily operation that could be alleviated through effective teamwork? Continuing to test the model will ultimately change patient safety.
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Advances in medical technology during the past 3 decades altered the scenarios of our dying. It is now possible to prolong life, with the frightening reality that we also can extend death. ⋯ These issues include patients' decision-making capacity and right to refuse treatment; withholding and withdrawing life-sustaining treatment, including nutrition and hydration; "no code" decisions; medical futility; and assisted suicide. Implications for critical care practice, education, research and public policy are identified.
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Crit Care Nurs Clin North Am · Jun 2002
The integration of palliative care and critical care: one vision, one voice.
As technological advances transform health care and the American population ages, care at the end of life (EOL) assumes ever-greater significance. Nurses in all practice settings and specialties are challenged to integrate quality palliative care into patient care. Today, this imperative is unifying the nursing profession, with help of the Nursing Leadership Academy for End-of-Life Care.
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Crit Care Nurs Clin North Am · Jun 2002
Case ReportsPediatric palliative care: a family-centered model for critical care.
Melanie's case and the associated concerns are not unique. Children with life-threatening conditions and their families and communities may benefit from a family-centered model of pediatric palliative care. ⋯ An interdisciplinary and collaborative model of pediatric palliative care involves the work of many, including nurses, physicians, social workers, chaplains, child life specialists, pharmacists, ethicists, bereavement counselors, ancillary staff, volunteers, and families themselves. They must incorporate key elements of the model, including clinical services, education and training, support services, and research that address physical, mental, and spiritual needs of families, children, and communities faced with life-threatening conditions.