Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Dec 2010
ReviewProbiotics and diarrhoea management in enterally tube fed critically ill patients--what is the evidence?
The aim of this literature review is to identify the role of probiotics in the management of enteral tube feeding (ETF) diarrhoea in critically ill patients. ⋯ Evidence to support probiotic use in the management of ETF diarrhoea in critically ill patients remains unclear. This paper argues that probiotics should not be administered to critically ill patients until further research has been conducted to examine the causal relationship between probiotics and mortality, irrespective of the patient's disease state or projected prophylactic benefit of probiotic administration.
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Intensive Crit Care Nurs · Dec 2010
ReviewFacial expression and pain in the critically ill non-communicative patient: state of science review.
The aim of this review is to analyse the evidence related to the relationship between facial expression and pain assessment tools in the critically ill non-communicative patients. Pain assessment is a significant challenge in critically ill adults, especially those who are unable to communicate their pain level. During critical illness, many factors alter verbal communication with patients including tracheal intubation, reduced level of consciousness and administration of sedation and analgesia. ⋯ Although use of facial expression is an important behavioural measure of pain intensity, there are inconsistencies in defining descriptors of facial behaviour. Therefore, it is important to understand facial expression in non-communicative critically ill patients experiencing pain to assist in the development of concise descriptors to enhance pain evaluation and management. This paper will provide a comprehensive review of the current state of science in the study of facial expression and its application in pain assessment tools.
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Intensive Crit Care Nurs · Dec 2010
Diarrhoea risk factors in enterally tube fed critically ill patients: a retrospective audit.
Diarrhoea in the enterally tube fed (ETF) intensive care unit (ICU) patient is a multi-factorial problem. Diarrhoeal aetiologies in this patient cohort remain debatable; however, the consequences of diarrhoea have been well established and include electrolyte imbalance, dehydration, bacterial translocation, peri anal wound contamination and sleep deprivation. This study examined the incidence of diarrhoea and explored factors contributing to the development of diarrhoea in the ETF, critically ill, adult patient. ⋯ Diarrhoea in ETF critically ill patients is multi-factorial. The early identification of diarrhoea risk factors and the development of a diarrhoea risk management algorithm is recommended.
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Intensive Crit Care Nurs · Oct 2010
Multicenter StudyPhysical restraint use in intensive care units across Europe: the PRICE study.
The use of physical restraint has been linked to delirium in ICU patients and a range of physical and psychological outcomes in non-ICU patients. However, the extent of restraint practice in ICUs is largely unknown. This study was designed to examine physical restraint practices across European ICUs. ⋯ Variation in the number of units per country limits generalization of findings. However, further examination is needed to determine whether there is a causal element to these relationships. Attention should be paid to developing evidence based guidelines to underpin restraint practices.
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Intensive Crit Care Nurs · Oct 2010
Multicenter StudySedation practice in three Norwegian ICUs: a survey of intensive care nurses' perceptions of personal and unit practice.
To describe intensive care nurses' perceptions of unit and personal sedation practice in the context of nursing and medical treatment of adult intensive care patients sedated and ventilated for more than 24 hours. ⋯ The study shows that a focus on analgesia-based sedation and continual control of the sedation level should be considered in order to decrease the risk of oversedation. Inclusion of relatives' opinions, increased collaboration between nurses and physicians, and implementation of sedation tools, may contribute to even better patient outcome and should be focus in further studies.