Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 2009
Lung recruitment--a nurse and/or physician task. A national survey on requirements for education, regulations and guidelines.
International and national guidelines on requirements for performing lung recruitment manoeuvres are lacking. This paper presents a nationwide descriptive survey of the occurrence of and conditions for lung recruitment in adult patients treated with mechanical ventilation in intensive care units (ICUs) in Sweden. All ICUs except neurological, cardiac, paediatric and neonatal ICUs were invited (N=73); of these, 60 ICUs participated in the study (82%). ⋯ Lung recruitment was performed more often in units where both physicians and nurses performed lung recruitment than in units where only physicians performed the manoeuvres (46% vs. 12%, p=0.03). Further, local guidelines on lung recruitment manoeuvres were more common in units where both physicians and nurses performed this treatment (71% vs. 41%, p=0.02). The results suggest that recommendations of repeated and prompt lung recruitment manoeuvres are better met if nurses, along with physicians, perform lung recruitment.
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The factors associated with policies for allowing visitors into intensive care units (ICUs) are a debated issue in the nursing literature. The aim of this survey was to describe visiting policies in the ICUs of North-East Italy and to verify the hypothesis of an association between attitudes regarding accessibility to visitors and environmental, organisational or logistic variables. Data were collected by means of questionnaires sent by mail to head nurses of ICUs. ⋯ Visiting times were not associated with logistic and organisational factors, but rather with the type of ICU (p=0.000), city setting (p=0.009), exceptions to rules (p=0.029), allowing more than one person (p=0.016) and opening to children (p=0.001). Restrictive visiting policies emerged; paediatric units were generally more flexible. The association between the variables regarding visiting policy, such as visiting times and exceptions to rules, or allowing more than one person or children, seem to confirm how the rules are influenced mainly by the staff's attitude, which could be changed by continuing professional education.
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Intensive Crit Care Nurs · Dec 2008
Comparative StudyThe importance of critical care nurses' caring behaviours as perceived by nurses and relatives.
This paper will report a research study conducted to compare the perceptions of nurses and relatives of critically ill patients on the importance of the caring behaviours of critical care nurses. ⋯ The results of this study have demonstrated that there are more similarities than differences between the perceptions of nurses and relatives on the importance of the caring behaviours of critical care nurses. The results of this study will give critical care nurses a greater understanding of how their caring behaviours are perceived by others. Incorporating the views of relatives into the delivery of care in the context of critical care will allow nurses to create a patient-centered service.
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Intensive Crit Care Nurs · Dec 2008
The role and effectiveness of a nurse practitioner led critical care outreach service.
Research measuring the effectiveness of critical care outreach (CCOR) has been mixed. The objective of this paper is to describe the role and effectiveness of a nurse practitioner (NP) led critical care outreach service (CCORS). Using a comparative study design, data on the number of intensive care unit (ICU) readmissions <72h were analysed 12 months prior to, and 12 months following implementation of the service. ⋯ The most common interventions completed by the NP during visits included requesting of diagnostic tests and prescribing. Following introduction of the NP CCORS, there was a sustained reduction in ICU readmissions <72h. In conclusion, a NP led CCORS has a positive effect on patient outcomes and supports development of further NP positions.
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Experiences of critically ill patients are an important aspect of the quality of care in the intensive care (ICU). ⋯ Although the nurses' expertise and technical skills are considered important, caring behaviour, relieving the patient of fear and worries were experienced as most valuable in bedside critical care.