Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 1998
Brain death in ICUs and associated nursing care challenges concerning patients and families.
In order to document the incidence and causes of brain death (BD) and the frequency of organ donation (OD) in a Swedish University Hospital, a retrospective review of deaths in a neurosurgical department and in the general intensive care units (ICUs), was carried out for the period 1988-1994. BD diagnosis was established in 197 (10.6%) of all deaths (n = 1843). The hospital records of all BD patients were examined in detail following a specific study plan. ⋯ The BD diagnosis was established by neurological examination (60%) and by cerebral angiography (40%). Of the BD patients, 50% died within 48 hours in the ICU and the majority of requests for OD (67%) were made to the relatives of these patients. The findings are discussed with focus on the workload and psychological stress of ICU nurses when caring for BD patients and their families; a task which includes taking part in processes concerning BD diagnosis information and OD requests.
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Intensive Crit Care Nurs · Feb 1998
Establishing evidence-based practice: issues and implications in critical care nursing.
Evidence-based practice is the application of the best available empirical evidence, including recent research findings to clinical practice in order to aid clinical decision-making. The implementation of these findings is vital for optimizing patient outcomes, improving clinical practice, providing cost-effective high quality care and enhancing the credibility of nurses. The use of research findings to improve practice has been discussed and promoted for the last 20 years. ⋯ However, recent studies all document that a gap between research findings and their implementation in clinical practice still exists. This appears to hold true across a variety of practice settings, including nurses working in critical care. The diffusion of innovations in current critical care nursing practice at each stage of Rogers' theory will be examined, with recommendations given to facilitate the establishment of evidence-based practice (EBP).
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Intensive Crit Care Nurs · Feb 1998
Parental presence during resuscitation: attitudes of staff on a paediatric intensive care unit.
Although family presence during resuscitation is becoming more acceptable, many medical and nursing staff still have concerns and doubts about it. To ascertain paediatric medical and nursing staff's attitudes towards parents being present during resuscitation, 60 staff in a Paediatric Intensive Care Unit were surveyed. The results revealed that even though 89% of staff feel that parents should be able to be present, many have the same concerns and doubts that have been highlighted in previous, albeit adult-centred, studies. Increased stress to staff and parents were some of the concerns identified in a study which also showed interest in the subject and a need for further education.
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Intensive Crit Care Nurs · Feb 1998
Role extension or expansion: a qualitative investigation of the perceptions of senior medical and nursing staff in an adult intensive care unit.
The Scope of Professional Practice (UKCC 1992) has significantly altered the interpretation of nurses' roles, emphasizing individual professional accountability and clinical decision-making. However, 5 years after the issue of the document, uncertainties remain regarding interprofessional legal accountability between medicine and nursing. To investigate issues surrounding role extension or expansion in intensive care nursing, a small qualitative study was conducted centred on one intensive care unit (ICU) within a large teaching hospital. ⋯ However, there was evidence of a reluctance to empower more junior staff to perform extended or expanded roles. Medical respondents viewed extended or expanded roles as taking on mechanical tasks for which anyone could be trained to perform. In conclusion, it is argued that although nursing is maturing in its growth towards professionalization, broader issues such as the legal quagmire, failure to adopt the philosophy of role expansion and the existence of sacred boundaries intra- and inter-professionally need to be addressed.