Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2013
Reducing risk for ventilator associated pneumonia through nursing sensitive interventions.
The purpose of this paper is to describe an improvement initiative designed to implement nurse sensitive interventions known to reduce patients' risk for ventilator associated pneumonia (VAP), in cardiothoracic intensive care patients. This initiative is a part of one Australian critical care unit's efforts to identify and measure compliance with key nursing interventions known to improve cardiac surgical patients' outcomes. The premise behind the initiative is that improved nursing process and surveillance systems allow emerging trends to catalyse action and motivate nurses to reduce patients' risk for infection acquisition. At five and nine months following implementation of the initiative a>70% compliance rate in 11 out of the 15 nurse sensitive interventions known to reduce patients' risks for VAP and a drop in VAP incidence from 13.4% to 7.69% from per 1000 ventilator days was accomplished.
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Intensive Crit Care Nurs · Oct 2013
APN-led nursing rounds: an emphasis on evidence-based nursing care.
In today's healthcare environment, nursing staff are challenged to care for patients with increasingly complex needs in an ever-changing environment. Nurses are expected to stay up to date on a tremendous number of institutional initiatives, best practice guidelines, and policies and procedures. These practice imperatives are often disseminated through passive means of information-sharing such as staff meetings and electronic mail. ⋯ The concept of Interventional Patient Hygiene emphasises that basic nursing functions are not only tasks, but also important evidence-based interventions that contribute to improved health for the patient. Interventional Patient Hygiene facilitates the integration of science and practice. This article describes a quality improvement intervention, Advanced practice nurse-led nursing rounds, which supports Interventional Patient Hygiene and be used to help staff integrate best practices while balancing the multiple priorities inherent in nursing care.
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Intensive Crit Care Nurs · Oct 2013
Interventional patient hygiene: discussion of the issues and a proposed model for implementation of the nursing care basics.
More than 140 years ago, Florence Nightingale wrote "It may seem a strange principal to enunciate as the very first requirement in a Hospital that it should do the sick no harm." Data suggests that 63% of all preventable errors are related to clinical problems that are within nursing's independent scope of practice. Many of these fall in the category of "interventional hygiene" activities and include prevention of skin injury, post-operative respiratory complications and failure to rescue. ⋯ The author of this paper, who coined the team "interventional patient hygiene", discusses the science related to many of these care issues and proposes an Interventional Care Model for use by nurses in redesigning how we approach nurse sensitive care practices in the future. Additionally, a change framework called "Sustaining Nursing Clinical Practice" is described to ensure reintroduction and valuing of evidence basic nursing care in conjunction with the right resources and systems to sustain the new practice.
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Intensive Crit Care Nurs · Aug 2013
Patient photographs--a landmark for the ICU staff: a descriptive study.
The purpose of this study was to investigate ICU staff's perceptions of photographs displayed at the bedsides of unconscious patients and whether profession, years in ICU and work status had any influence on these perceptions. ⋯ The ICU staff need to consider how close to the patient they want to be and why the patient's recovery is worth striving for. Keeping a professional approach is one of the challenges of working in ICU. A photograph can be an inexpensive and easy way of preventing the loss of identity of the patient as an individual within the technocratic environments of the ICU.
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Intensive Crit Care Nurs · Aug 2013
ReviewPatients' transition in the intensive care units: concept analysis.
Adequate preparation of critically ill patients throughout their transition experience within and following discharge from the Intensive Care Unit is an important element of the nursing care process during critical illness. However, little is known about nurses' perspectives of, and engagement in, caring for critically ill patients during their transition experiences. ⋯ Nurses' understanding of critically ill patients' transition may significantly impact the patients' care in the Intensive Care Unit. Thus, research is needed that focuses more on evaluating nurses' understanding of patients' transition and its consequences.