Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
-
This paper reports the findings of a study which aimed to identify the barriers to evidence-based practice in an acute National Health Service (NHS) trust. The study was carried out as part of an action research project designed to promote evidence-based practice. ⋯ The results of this study demonstrate that structures and cultures within organizations can be important barriers to evidence-based practice. Factors which are external to individual trusts are also important. Existing hierarchical structures both in the NHS and within and between the different professional groups, are manifest in the existence of a largely deferential culture which emphasizes the routine in practice decision making. Given this reality, organizations will have to adopt multiple strategies to facilitate and promote the use of evidence in practice decision making.
-
Intensive Crit Care Nurs · Oct 1998
ReviewIntensive nursing care of patients with a microvascular free flap after maxillofacial surgery.
This article provides an introduction to the care of patients following maxillofacial surgery, many of whom undergo the complexities of microvascular flap surgery and need careful nursing assessment in the postoperative period. A brief introduction to this surgery illustrates some of the potential reasons for admission to the intensive care unit. The nursing care is vital to maintain the survival of the flap, the details of which are discussed along with factors which potentially contribute to flap failure. Other considerations such as haemodynamic stability, postoperative complications, the importance of education and other options for postoperative management also form further points for discussion.
-
Intensive Crit Care Nurs · Oct 1998
ReviewTo bag or not to bag? Manual hyperinflation in intensive care.
Manual hyperinflation or bagging is a physiotherapy technique commonly used on mechanically ventilated patients on intensive care. The way it is performed appears to vary widely, and in the past there has been little or no monitoring of what is actually happening during the technique in terms of what airway pressures and tidal volumes are being delivered to the patient. Conclusive evidence from large scientific studies of the benefits and side effects of manual hyperinflation are to date still lacking.
-
Intensive Crit Care Nurs · Oct 1998
Historical ArticleThe evolution and nursing history of a general intensive care unit (1962-1983).
In this paper we have reviewed the origin and evolution of Whiston Hospital's General Intensive Care Unit (ICU) from its humble beginnings as an offshoot of a general ward in the early 1960s. The length of service of the senior nursing staff over a period of 21 years was also calculated. ⋯ In addition, we have outlined the development of nurse training in intensive care as well as the role of the nurses in research in the ICU. The question as to whether later college-based training was superior to the previous hospital-based course remained unanswered.