Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2007
ReviewPart 1. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: contributing factors.
Chemical and physical restraints are frequently used in the intensive care unit (ICU) to control agitated patients and to prevent self-harm and unplanned extubations. Published work relating to the numerous issues of the care and treatment strategies for these patients remains conflicting and unclear. Literature regarding sedation and chemical restraint reveals a trend towards management with lighter sedation, use of sedation assessment tools and sedation protocols. ⋯ The purpose of this paper is to provide a summary of the existing literature on the use of physical and chemical restraints in the ICU setting. In Part 1 of this two-part paper, the evidence on chemical and physical restraints is explored with specific focus on definition of terms, unplanned extubation, agitation, delirium and the impact of nurse-patient ratios in the ICU on these issues. Part 2 of the paper examines the evidence related to chemical and physical restraints from the perspective of the mechanically ventilated patient.
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Intensive Crit Care Nurs · Oct 2007
Randomized Controlled TrialInfluence of bright light therapy on postoperative patients: a pilot study.
Bright light therapy is a method of maintaining or restoring the natural circadian rhythm by assisting daytime awakening using bright lights. Postoperative delirium is one of the potential complications encountered by patients receiving postoperative care in the intensive care unit (ICU), but there have been no studies on the use of light for the prevention of postoperative delirium. The objective of this study was to examine whether the circadian rhythms of patients after surgery for oesophageal cancer can be adjusted and whether the postoperative delirium crisis rate can be reduced by bright light therapy. ⋯ Bright light therapy may reduce the rate of postoperative delirium and make early ambulation possible. However, our study involved a very small sample size. We want to increase the sample in the future after having reviewed clinical application methods.
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Intensive Crit Care Nurs · Oct 2007
The relationship between moral distress and perception of futile care in the critical care unit.
Study the relationship between moral distress (MD) and futile care in the critical care unit (CCU). ⋯ MD associated with clinical situations representing futile care increased with time in CCU. Future interventions are required to minimize the exposure to futile care situations and develop mechanisms to mitigate the effects of MD in the CCU.
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Intensive Crit Care Nurs · Oct 2007
Fever and standard monitoring parameters of ICU patients: a descriptive study.
To investigate the effect of fever episodes and fever characteristics on heart rate, arterial blood pressure and arterial oxygen saturation of intensive care unit (ICU) patients. ⋯ The present findings confirmed the effect of fever episodes on standard monitoring parameters of ICU patients. However, alterations of these parameters, although statistically significant, were not clinically important and cannot guide antipyretic treatment.
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Intensive Crit Care Nurs · Oct 2007
The use of a daily goals sheet to improve communication in the paediatric intensive care unit.
To assess the impact of the implementation of a daily goals sheet upon nursing perception of communication in an academic, tertiary care paediatric intensive care unit (PICU). ⋯ The institution of a daily goals sheet led to an improvement in nursing perception of communication. Future studies are required to determine if this change in process has a demonstrable effect on health care outcomes of critically ill children, or whether this tool can have the same beneficial effects in other academic and non-academic PICUs.