Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2000
ReviewState of the science of music interventions. Critical care and perioperative practice.
Music therapy is an easy to administer, relatively inexpensive, noninvasive intervention that can reduce anxiety and pain in critical care and perioperative patients. Libraries of relaxing music selections need to be compiled, reflecting diverse musical tastes. Providing patients with the opportunity to partake in music therapy sessions, selecting their own music, and providing them with quiet, uninterrupted time to listen to the music provides patients with a sense of control and separation from the multiple environmental stressors they are experiencing. ⋯ Further, there are little data with respect to optimal time for implementation of music therapy, length of music therapy sessions, or types of music to use. The effects of cultural diversity have not been addressed. Music therapy can improve the quality of care that critical care and perioperative nurses deliver to their patients.
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Now that heart transplantation is a common therapeutic modality, it has lost much of its earlier mystique. Numerous issues related to donor allocation, immunosuppression, quality-of-life of the recipient, patient selection, cost-effectiveness, and a myriad of ethical considerations remain. ⋯ Current practices and legislation are a part of heart transplantation's evolutionary process. The process can change and advance as rapidly as it did on December 3, 1967, with the announcement of the first successful human-to-human heart transplantation.
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Crit Care Nurs Clin North Am · Dec 1999
Review Case ReportsMaking weaning easier. Pathways and protocols that work.
Clinical pathways and weaning protocols are useful tools for improving the care of patients requiring LTMV. The value of the pathways and protocols rests in large part on the systematic multidisciplinary nature of the tools. ⋯ The success of such care delivery models rests with the quality of those who design, test, and revise them. If developed in a careful and thoughtful manner using the best science available, the pathways and protocols may truly be powerful tools for clinical practice.
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Advances in technology now permit a variety of noninvasive respiratory monitoring options for clinicians. Perhaps a more complex issue is determining how much monitoring is needed as part of routine patient care. Often, practitioners take a "more is better" approach. ⋯ The fact that many aspects of cardiopulmonary assessment can now be determined noninvasively is an important advantage over more invasive technologies and their associated risks. Clearly, monitoring techniques such as pulse oximetry and capnography do not eliminate the need for arterial blood gases and other invasive cardiopulmonary monitoring techniques. Rather, when appropriately applied, noninvasive monitoring has the potential to reduce the frequency of certain invasive procedures and still provide valuable information to nurses and other health care practitioners.