Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 2005
ReviewA review of the nursing care of enteral feeding tubes in critically ill adults: part II.
Enteral tubes are frequently used in critically ill patients for feeding and gastric decompression. Many of the nursing guidelines to facilitate the care of patients with enteral tubes have not been based on current research, but on ritual and opinion. Using a computerised literature search and an evidence-based classification system as described by the Joanna Briggs Institute for Evidence Based Nursing and Midwifery (JBI), a comprehensive review was undertaken of enteral tube management. ⋯ Other recommendations include continuous rather than intermittent feeding, semi-recumbent positioning to reduce the risk of airway aspiration and diligent artificial airway cuff management. Contamination of feeds can be minimised by minimal, meticulous handling and the use of closed rather than open systems. Generally, there was little high quality evidence to support practice recommendations leaving significant scope for further research by nurses in the management of patients with enteral tubes.
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Intensive Crit Care Nurs · Feb 2005
How do critical care nurses define the discharge planning process?
Professional, political and organisational factors have focused attention on the discharge planning process in the Victorian health care sector. Discharge planning for patients, as part of continuity of care, is seen as a key concept in the delivery of nursing care. However, there is no question that discharge planning has emerged as a complex area of practice, and is, perhaps, most complex in the critical care area. ⋯ The findings presented here suggest at a nursing level, the discharge planning process is not well understood and some degree of mutual exclusivity still remains. There is a need for further education of critical care nurses with regard to the underlying principles of the discharge planning process.
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Intensive Crit Care Nurs · Feb 2005
The Royal North Shore Hospital ICU nurse initiated telephone follow up service.
The intensive care follow up telephone service has been in progress since July 2001. The aims of the service are to offer former patients an opportunity to explore the intensive care experience and provide support during the recovery phase. Patient experiences vary during recovery but include physical fatigue, sleep disturbances and financial difficulties. ⋯ In addition we have been able to feed back patients' suggestions into existing quality frameworks. The information received from former patients has assisted in the development of a home based physical rehabilitation programme, which will be evaluated using a randomised control trial. The follow up service positively contributes to patient outcomes and the positive profile of critical care nursing in the community.
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Intensive Crit Care Nurs · Feb 2005
The relationship between dermal pressure ulcers, oxygenation and perfusion in mechanically ventilated patients.
More than 1.5 million hospitalized patients develop dermal pressure ulcers (DPUs) annually, which increases cost and prolongs length of stay. Mechanically ventilated patients may be at a high risk for DPU development, but research has not focused on the prevalence of dermal pressure ulcers in this population or the factors associated with dermal pressure ulcer development. ⋯ Mechanically ventilated patients are vulnerable to developing dermal pressure ulcers as evidence by 20% of the subject population developing a dermal pressure ulcer. The most significant factors related to a low Braden Score in this group are fluid shifts and fluid weight gain. This may be an important predictor of dermal pressure ulcers not currently assessed clinically.