Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2009
Nurses' conceptions of facilitative strategies of weaning patients from mechanical ventilation--a phenomenographic study.
Mechanical ventilator withdrawal can amount up to 40% of total ventilator time. Being on a mechanical ventilator is associated with risk of anxiety, post-traumatic stress syndrome, nosocomial pneumonia and premature mortality. ⋯ Although these findings need to be confirmed by further studies we suggest that nurses' variable use of individual strategies more likely complicate an efficient and safe weaning process of the patients from mechanical ventilation.
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Intensive Crit Care Nurs · Oct 2009
Limitations and practicalities of CAM-ICU implementation, a delirium scoring system, in a Dutch intensive care unit.
Delirium is a frequently missed diagnosis in the intensive care unit (ICU). Implementation of the Confusion Assessment Method for the ICU (CAM-ICU) may improve recognition of delirium. However, the ICU team may be reluctant to adopt daily assessment by a screening tool. This report focusses on the obstacles and barriers encountered with respect to organisational context and prevailing opinions and attitudes when implementing the CAM-ICU in daily practice in a Dutch ICU. ⋯ Implementation of the CAM-ICU in daily critical care is feasible. A structural training programme is probably helpful for success of implementation.
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Intensive Crit Care Nurs · Oct 2009
Analysis of patient diaries in Danish ICUs: a narrative approach.
The objective was to describe the structure and content of patient diaries written for critically ill patients in Danish intensive care units (ICUs). ⋯ Patient diaries acknowledge the patient experience and provide new insights into nursing performance. This study offers a framework for understanding ICU patient diaries, which may facilitate cross-unit comparisons and support future guideline development. The dual perspectives of patient diaries and the ambiguous ownership of the narratives may pave the way for insights to improve critical care nursing and ICU rehabilitation.
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Intensive Crit Care Nurs · Aug 2009
Randomized Controlled TrialPatients' perception of music versus ordinary sound in a postanaesthesia care unit: a randomised crossover trial.
We performed an experimental single-blind crossover design study in a postanaesthesia care unit (PACU): (i) to test the hypothesis that patients will experience a higher degree of wellbeing if they listen to music compared to ordinary PACU sounds during their early postoperative care, (ii) to determine if there is a difference over time, and (iii) to evaluate the importance of the acoustic environment and whether patients prefer listening to music during their stay. Two groups received a three-phase intervention: one group (n=23) experienced music-ordinary sound-music and the second group (n=21) experienced ordinary sound-music-ordinary sound. ⋯ The results also revealed that most participants (n=32) preferred listening to music versus listening to ordinary sound (n=3) while in the PACU (p<0.001). These findings promote use of listening to music to establish a healing environment for patients in a postanaesthesia care unit.
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Intensive Crit Care Nurs · Aug 2009
ReviewWhat factors influence suboptimal ward care in the acutely ill ward patient?
As technological developments continue to offer patients more health care choices patient acuity increases. Patients that traditionally would have been cared for in a critical care environment are increasingly located on general wards. This change impacts on the acute care sector in a number of ways. ⋯ Confidential inquiry into quality of care before admission to intensive care. BMJ 1998;316(7148):1853-8] in relation to suboptimal ward care in an attempt to develop a conceptual analysis of the factors that influence suboptimal ward care and acutely ill ward patients. Thus, it aims to develop and enhance practitioners' knowledge and understanding of this topic and therefore improve patient care outcomes.