Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Apr 2014
Multicenter StudyAttitudes of legal guardians in the ICU - a qualitative report.
Decision-making in intensive care units (ICUs) is often made by surrogates, since patients are unconscious or incompetent. In Israel, Legal Guardians (LGs), appointed by the court, are required to make these decisions. ⋯ The importance of communication and bureaucratic difficulties, making the best decision for the patient and uncertainty regarding decision outcomes were found to be important issue for the LGs. The healthcare team should try and alleviate some of these burdens, mostly by improving communication with relatives, stressing and educating the importance of advance directives. Reporting the problems found in the decision making process of LGs to the legislators in order to revise and simplify the current legal requirements is advised.
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Intensive Crit Care Nurs · Apr 2014
Factors affecting stress experienced by surrogate decision makers for critically ill patients: implications for nursing practice.
This study explores surrogate decision-makers' (SDMs) challenges making decisions related to the care of patients in critical care, to (1) characterise the SDM stress, (2) identify personal, social, care-related factors influencing stress and (3) consider implications of findings to improving critical care practice. ⋯ Stress is a very real factor influencing SDMs confidence and comfort making decisions. These findings suggest that stress can be minimised by improving communication between SDMs and medical providers. Nurses' central role in the ICU makes them uniquely poised to spearhead interventions to improve provider-SDM communication and reduce SDM decision-making anxiety.
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Intensive Crit Care Nurs · Apr 2014
Observational StudyRehabilitation activities, out-patient visits and employment in patients and partners the first year after ICU: a descriptive study.
To describe the influence of critical illness on patients and their partners in relation to rehabilitation, healthcare consumption and employment during the first year after Intensive Care Unit discharge. ⋯ Most patients had comprehensive recovery needs requiring months of rehabilitation. Some partners needed extensive sick leave. The study reveals the human cost of critical illness and intensive care for patients and partners in the Danish welfare system.
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Pulse oximeters utilise the pulsatile nature of arterial blood flow to distinguish it from venous flow and estimate oxygen saturation in arterial blood. Pulse oximetry is primarily used in hospital wards, emergency rooms, intensive care units, operating rooms and home care. ⋯ Only red nail polish did not yield statistically significant reading results. We conclude that different nail polish colours cause a clinically significant change in pulse oximeter readings in healthy volunteers.
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Intensive Crit Care Nurs · Apr 2014
Reducing ventilator associated pneumonia in adult patients through high standards of oral care: a historical control study.
Implement and evaluate the impact of oral hygiene measures (teeth brushing, 1% oral chlorhexidine and oropharyngeal suction) on the incidence of ventilator-associated pneumonia (VAP) and the costs of prevention and treatment. ⋯ An enhanced oral care bundle, incorporating 1% Chlorhexidine Gluconate, was associated with a significant reduction in VAP and the costs of treating VAP. Limitations of the study relate to analysis of other variables, in particular severity of illness, between the two groups and the lack of agreement in the literature on VAP criteria, which limits generalisation of these findings.