Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Delirium is an acute, reversible disorder of attention and cognition and may be viewed as cerebral dysfunction similar to the failure of any other organ. The development of delirium is associated with increased morbidity and mortality, extended length-of-stay in the intensive care unit and longer time spent sedated and ventilated. Nearly every clinical, pharmacological and environmental factor present and necessary in the ICU setting has the potential to cause delirium. ⋯ All patients admitted to ICU for more than 72 h, with a hospital length-of-stay less than 96 h prior to ICU admission were screened. Patients admitted following neurological insults or with pre-existing altered mental state were excluded. The QI project showed the incidence of delirium to be 40% of the total sample (n = 73) in a mixed medical/surgical and elective/emergency patient population.
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Intensive Crit Care Nurs · Aug 2004
Clinical Trial Controlled Clinical TrialReducing family members' anxiety and uncertainty in illness around transfer from intensive care: an intervention study.
This intervention study examines anxiety and uncertainty in illness in families transferring from intensive care to a general ward. ⋯ Families at the time of transfer experience uncertainty and anxiety, which are significantly related in this study. The intervention significantly reduced uncertainty scores. When the family member was a parent, when admissions were unexpected, and those with fewer social supports represent potential 'at risk' groups whose adaptation to transfer may limit their coping ability. The structured individualised method of transfer is recommended with further research of ICU families to further examine the dimension of uncertainty and how it affects patient outcomes.
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Intensive Crit Care Nurs · Aug 2004
Comparative StudyPractical considerations in the administration of intravenous vasoactive drugs in the critical care setting. Part II--how safe is our practice?
Vasoactive drugs (e.g. inotropes), namely adrenaline and noradrenaline, are frequently used in critical care to maintain cardiovascular function. This is achieved by ensuring that a continuous infusion of the vasoactive drug is administered so that when one infusion is about to finish another infusion is commenced. This is known as "double pumping" or "piggy backing". Failure to administer these drugs appropriately may result in haemodynamic instability (hypotension and hypertension) and in extreme cases death. ⋯ As a direct result of these audits, and the development of guidelines, inotrope administration practice on the unit has improved.