Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Apr 2010
Are vital signs valid indicators for the assessment of pain in postoperative cardiac surgery ICU adults?
The aim of this study was to examine the discriminant and criterion validity of vital signs (mean arterial pressure [MAP], heart rate [HR], respiratory rate [HR], transcutaneous oxygen saturation [SpO(2)], and end-tidal CO(2)) for pain assessment in postoperative cardiac surgery ICU adults. A repeated-measure within-subject design was used. A convenience sample of 105 patients from a cardiology health center in Canada participated. ⋯ Some of the vital signs (HR, RR, and SpO(2)) were associated with the patients' self-reports of pain but were dependent on the patients' status (mechanically ventilated or not). Findings regarding the use of vital signs for pain assessment are not consistent and should be considered with caution. As recommended by experts, vital signs should only be used as a cue when behavioural indicators are no longer available in mechanically ventilated or unconscious patients.
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Intensive Crit Care Nurs · Apr 2010
Serial evaluation of SOFA score in a Brazilian teaching hospital.
To evaluate the application of the Sequential Organ Failure Assessment (SOFA) in describing the severity of organ dysfunctions and the associated mortality rates in critically ill patients at a teaching hospital. ⋯ Applying SOFA to critically ill patients effectively described the severity of organ dysfunctions, and higher SOFA scores had a positive association with mortality.
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Intensive Crit Care Nurs · Apr 2010
Improving safety and documentation in intrahospital transport: development of an intrahospital transport tool for critically ill patients.
Transporting the critically ill patient is described within the literature as a high-risk procedure. Both guidelines and minimum standards are available to inform practice. However, a practical, clinically useful, and evidence-based document (tool) for the ICU nurse to use when transporting a critically ill patient was not identified in the literature. ⋯ This transport tool was designed to mitigate the risks associated with patient transport by providing the Intensive Care Unit (ICU) nurse with an integrated documentation record, incorporating patient assessment with a procedural guideline. The result is a framework for the ICU nurse to use throughout intrahospital transfers, informing and supporting them to provide and document continuity of nursing care. The potential benefit of using this tool is enhanced patient outcomes through safer ICU intrahospital transport processes.
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Intensive Crit Care Nurs · Feb 2010
Track, trigger and teamwork: communication of deterioration in acute medical and surgical wards.
The majority of hospitals in the United Kingdom (UK) use some form of track and trigger scoring system, such as early warning scores, to identify deteriorating patients; however, response by the multi-professional team is not always timely and problems with recognition of deterioration persist. ⋯ The results of this study suggest that clinicians need a better understanding of the value of track and trigger scoring systems in identifying trends in the patient's condition. Further, our data suggest that steps need to be taken in acute hospital wards to improve team members' understanding of each others' roles and capabilities.
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Intensive Crit Care Nurs · Feb 2010
Factors influencing nurse sedation practices with mechanically ventilated patients: a U.S. national survey.
Mechanically ventilated patients commonly receive sedative medications. There is increasing evidence that sedative medications impact on patient outcomes. Nursing behaviour is a key determinant of sedation administration. The purpose of this study was to determine factors that influence nurse sedation administration to mechanically ventilated patients. ⋯ Nurses' attitudes impact sedation administration practices. Modifying nurses' attitudes on sedation and the experience of mechanical ventilation may be necessary to change sedation practices with mechanically ventilated patients.