Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 2010
Visits in an intensive care unit--an observational hermeneutic study.
The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU and to disclose a deeper understanding of the visiting situation. ⋯ The physical environment became a hindrance to the interplay as it was designed for medical and technical use and thus did not promote healing. The professionals are important for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact that promote interplay, which in turn strengthens connectedness.
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Intensive Crit Care Nurs · Feb 2010
Multicultural family members' experiences with nurses and the intensive care context: a hermeneutic study.
The aim of this study was to illuminate the experiences of multicultural family members in intensive care units in hospitals, when a loved one was critically ill. An increasing migration from non-Western countries to Norway and potential double-stress for multicultural families experiencing critical illness are pre-understandings. ⋯ Family members with a non-Western ethnic background experienced several challenges within the complex ICU environment. Multicultural family members had distinct strategies to deal with the hospitalisation of a critically ill loved one. Interaction difficulties and cultural traditions were not influenced by the environment alone, however the challenges seemed to deal with universal human interaction independent of the context. Nurses need to be sensitive to the families' cultural customs in order to meet their expectations in a respectful way.
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This literature review shows that sleep is important for healing and survival of critical illness (Richardson et al., 2007; Straham and Brown, 2004). Sleep deprivation impinges on recovery, ability to resist infection, brings about neurological problems such as delirium, respiratory problems because it weakens upper air way muscles thus prolonging the duration of ventilation, ICU stay and complicating periods just after extubation (Friese, 2008; Parthasarathy and Tobin, 2004). Noise, pain and discomfort (Jacobi et al., 2002; Honkus, 2003) modes of ventilation and drugs have been cited as causes of sleep deprivation in critically ill patients (Friese, 2008; Parthasarathy and Tobin, 2004). ⋯ More research is needed to ascertain the impact of mechanical ventilation on sleep disruption and more focused ways of sleep assessment are needed. Nurses need to minimise disruptions by clustering their care at night in order to allow patients to have the much needed REM sleep. Furthermore, more specific way of sleep assessment in the critically ill.
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Intensive Crit Care Nurs · Oct 2009
Doing one's utmost: nurses' descriptions of caring for dying patients in an intensive care environment.
The aim of this study was to explore nurses' experiences and perceptions of caring for dying patients in an intensive care unit (ICU) with focus on unaccompanied patients, the proximity of family members and environmental aspects. ⋯ This study contributes new knowledge about what ICU nurses focus on when providing EOLC to unaccompanied patients but also to those whose relatives were present. Nurses' EOLC was mainly described as their relationship and interaction with the dying patient's relatives, while patients who died alone were considered tragic but left a lesser impression in the nurses' memory.
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Intensive Crit Care Nurs · Oct 2009
Randomized Controlled TrialTo return or to discard? Randomised trial on gastric residual volume management.
The control of gastric residual volume (GRV) is a common nursing intervention in intensive care; however the literature shows a wide variation in clinical practice regarding the management of GRV, potentially affecting patients' clinical outcomes. The aim of this study is to determine the effect of returning or discarding GRV, on gastric emptying delays and feeding, electrolyte and comfort outcomes in critically ill patients. ⋯ The results of this study support the recommendation to reintroduce gastric content aspirated to improve GRV management without increasing the risk for potential complications.