Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2009
Doing one's utmost: nurses' descriptions of caring for dying patients in an intensive care environment.
The aim of this study was to explore nurses' experiences and perceptions of caring for dying patients in an intensive care unit (ICU) with focus on unaccompanied patients, the proximity of family members and environmental aspects. ⋯ This study contributes new knowledge about what ICU nurses focus on when providing EOLC to unaccompanied patients but also to those whose relatives were present. Nurses' EOLC was mainly described as their relationship and interaction with the dying patient's relatives, while patients who died alone were considered tragic but left a lesser impression in the nurses' memory.
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Intensive Crit Care Nurs · Oct 2009
Randomized Controlled TrialTo return or to discard? Randomised trial on gastric residual volume management.
The control of gastric residual volume (GRV) is a common nursing intervention in intensive care; however the literature shows a wide variation in clinical practice regarding the management of GRV, potentially affecting patients' clinical outcomes. The aim of this study is to determine the effect of returning or discarding GRV, on gastric emptying delays and feeding, electrolyte and comfort outcomes in critically ill patients. ⋯ The results of this study support the recommendation to reintroduce gastric content aspirated to improve GRV management without increasing the risk for potential complications.
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Intensive Crit Care Nurs · Oct 2009
Nurses' conceptions of facilitative strategies of weaning patients from mechanical ventilation--a phenomenographic study.
Mechanical ventilator withdrawal can amount up to 40% of total ventilator time. Being on a mechanical ventilator is associated with risk of anxiety, post-traumatic stress syndrome, nosocomial pneumonia and premature mortality. ⋯ Although these findings need to be confirmed by further studies we suggest that nurses' variable use of individual strategies more likely complicate an efficient and safe weaning process of the patients from mechanical ventilation.
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Intensive Crit Care Nurs · Oct 2009
Limitations and practicalities of CAM-ICU implementation, a delirium scoring system, in a Dutch intensive care unit.
Delirium is a frequently missed diagnosis in the intensive care unit (ICU). Implementation of the Confusion Assessment Method for the ICU (CAM-ICU) may improve recognition of delirium. However, the ICU team may be reluctant to adopt daily assessment by a screening tool. This report focusses on the obstacles and barriers encountered with respect to organisational context and prevailing opinions and attitudes when implementing the CAM-ICU in daily practice in a Dutch ICU. ⋯ Implementation of the CAM-ICU in daily critical care is feasible. A structural training programme is probably helpful for success of implementation.
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Intensive Crit Care Nurs · Oct 2009
Analysis of patient diaries in Danish ICUs: a narrative approach.
The objective was to describe the structure and content of patient diaries written for critically ill patients in Danish intensive care units (ICUs). ⋯ Patient diaries acknowledge the patient experience and provide new insights into nursing performance. This study offers a framework for understanding ICU patient diaries, which may facilitate cross-unit comparisons and support future guideline development. The dual perspectives of patient diaries and the ambiguous ownership of the narratives may pave the way for insights to improve critical care nursing and ICU rehabilitation.