Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Jun 2015
The effectiveness of a patient at risk team comprised of predominantly ward experienced nurses: A before and after study.
Improving care to deteriorating ward patients require systems to trigger a response and a response team. This paper describes the effectiveness of a Patient at Risk team (PART) comprised predominantly of experienced ward nurses. ⋯ A PART comprising of experienced ward nurses was associated with reduced ward cardiac arrests but no change in the number of MET calls. This suggests this team composition may be effective in providing care to the deteriorating patient.
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Intensive Crit Care Nurs · Jun 2015
The experience of communication difficulties in critically ill patients in and beyond intensive care: Findings from a larger phenomenological study.
Communication difficulties in intensive care units (ICU) with critically ill patients have been well documented for more than three decades. However, there is only a paucity of literature that has explored communication difficulties beyond the ICU environment. This paper discusses the experience of communication difficulties in critically ill patients in ICU and beyond as part of findings from a larger study that explored the lived experiences of critically ill patients in ICU in the context of daily sedation interruption (DSI). ⋯ However, not many studies have reported ongoing communication difficulties after ICU hospitalisation. Recommendations are made for new models of care and support to mitigate critically ill patients' communication concerns in ICU and for further research into the causes and treatment to benefit this group of patients. Most importantly, extra care is recommended not to damage vocal cords during intubation and cuff inflation in the course of mechanical ventilation.
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Intensive Crit Care Nurs · Apr 2015
How accurate is the AVPU scale in detecting neurological impairment when used by general ward nurses? An evaluation study using simulation and a questionnaire.
to evaluate accuracy, sensitivity, specificity and inter-rater agreement of AVPU (Alert, Voice, Pain, Unresponsive) when used by non-specialist nursing staff assessing consciousness, and to investigate users' views. ⋯ AVPU had low rates of accuracy, sensitivity and agreement in distinguishing between "Alert" and "Voice", and low specificity overall, suggesting it may be unsuitable for early warning scoring. Participants expressed doubts about the use of AVPU.
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Intensive Crit Care Nurs · Apr 2015
The impact of a nurse led rapid response system on adverse, major adverse events and activation of the medical emergency team.
To identify the relationship between one example of a rapid response system (RRS), specifically, an after-hours Clinical Team Co-Ordinator (CTC), and the incidence of Medical Emergency Team (MET) activations and, adverse and major adverse events in medical patients. ⋯ The introduction of an after-hours CTC service in a specific clinical site was associated with an increase in the identification of adverse and major adverse events in medical patients. Further exploration of nurse-led rapid response systems should be undertaken in different clinical settings.
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Intensive Crit Care Nurs · Apr 2015
Observational StudyWhat impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study.
The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. ⋯ Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved.