Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 2012
The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: a phenomenological-hermeneutic study.
The aim of this study was to illuminate the lived experience of patients who were conscious during mechanical ventilation in an intensive care unit (ICU). ⋯ A patient's endurance whilst conscious during mechanical ventilation seems to be facilitated by the presence of nurses, who mediate hope and belief in recovery, strengthening the patient's will to fight for recovery and survival.
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Intensive Crit Care Nurs · Feb 2012
Nurses' near-decision-making process of postoperative patients' cardiosurgical weaning and extubation in an Italian environment.
Despite the fact that Italian nurses have only recently gained autonomy when making health-care decisions, there is little evidence available regarding the decisions actually taken in clinical practice. ⋯ The near-decision-making process of nurses expressed a pattern determined by personal factors, clinicians, organisations, structures and cultural reported unwritten rules. To ensure that the nurses become responsible and independent decision makers, it is necessary to pay particular attention to structural and cultural conditions in order to help them reach their full potential in the future.
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To describe the experience and perceptions of nurse study participants regarding a communication intervention (training and communication tools) for use with nonspeaking, critically ill patients. ⋯ The results suggest that the communication skills training programme could be valuable in reinforcing basic/intuitive communication strategies, assisting in the acquisition of new skills and ensuring communication supply availability. Practice integration will most likely require unit-wide interdisciplinary dissemination, expert modelling and reinforcement.
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Intensive Crit Care Nurs · Dec 2011
Multicenter StudyICU nurses' perceptions of responsibilities and organisation in relation to organ donation--a phenomenographic study.
According to the Istanbul declaration, health services should create better routines for identifying potential donors. A previous study involving 702 intensive and critical care (ICU) nurses revealed that only 48% trusted clinical diagnosis of brain death without a confirmatory cerebral angiography. The aim was to study ICU nurses' perceptions of their experiences of professional responsibilities and organisational aspects in relation to organ donation and how they understand and perceive brain death. ⋯ The ambiguity and various perceptions of brain death diagnosis seem to be a crucial aspect when caring for a brain dead patient. The lack of structured and sufficient organisation also appears to be a limiting factor. Both these aspects are essential for the ICU nurses' opportunities to fulfil their professional responsibility during the organ donation process.
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Intensive Crit Care Nurs · Dec 2011
Acute post-traumatic stress in survivors of critical illness who were mechanically ventilated: a mixed methods study.
This study investigated the severity of post-traumatic stress (PTS) symptoms, the relationships between PTS symptoms and clinical and demographic characteristics and the subjective experiences of patients who were critically ill and mechanically ventilated in intensive care. Study participants (n=97) completed the Impact of Event Scale (IES) to assess avoidance and intrusive symptoms of PTS within one week of hospital discharge. A subset (n=5) with IES scores suggestive of symptoms of PTS participated in semistructured interviews analysed with content analysis. ⋯ In conclusion, high levels of symptoms of PTS were present in one-third of ICU survivors. There were no independent relationships between PTS and patient characteristics studied. Experiences of interviewees with high distress scores were consistent with those reported in other studies of ICU survivors.