Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2008
ReviewIntermittent versus continuous renal replacement therapy: a matter of controversy.
Acute Renal Failure (ARF) requiring some form of replacement therapy is a frequent complication in the critically ill patient. Despite potential therapeutic advantages the expectation of an improvement in patient outcomes using Continuous Renal Replacement Therapy (CRRT) compared to conventional Intermittent Haemodialysis (IHD) remains controversial. ⋯ The decision to use IHD or CRRT should be guided by the therapeutic needs of the patient rather than the operational differences between the two techniques. The resources and expertise available at the organisation are also important in determining the mode best able to manage the critically ill patient at any stage and may change according to the severity of illness. The emergence of hybrid therapies provides a compromise option which encompasses many of the features of both systems, but does not embrace all options of either approach.
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Intensive Crit Care Nurs · Oct 2008
Research activities and perceptions of barriers to research utilization among critical care nurses in Korea.
Research utilization is vital to promote evidence-based practice in the critical care area, where nursing practice continues to grow in complexity and nurses have greater responsibility and accountability for patient care. However, information about research activities and barriers to research utilization of critical care nurses is limited. ⋯ Research activities were relatively low. A lack of guidance for clinical implication and insufficient time to implement new ideas in the clinical area were identified as the highest-ranking barriers to use of research in this group. Perceptions of barriers to research utilization were significantly higher in those staff nurses with lesser clinical experience. The critical care nurses in this study shared a strong sense of valuing the contribution of research, but also shared perceptions on barriers for administrative aspects. Organizational support is crucial for critical care nurses to achieve evidence-based practice.
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Intensive Crit Care Nurs · Aug 2008
Intensive care delirium monitoring and standardised treatment: a complete survey of Dutch Intensive Care Units.
Delirium is a frequent and serious problem in the Intensive Care Unit (ICU). Several international guidelines recommend daily monitoring for ICU-delirium. The purpose of this article is to give an up-to-date overview of the current status of monitoring and treatment of ICU-delirium in the Netherlands. ⋯ Despite an international guideline, not more than 7% of ICUs in our study routinely evaluated the presence of delirium with a validated instrument. Fewer than one-third of Dutch ICUs use a protocol to treat ICU-delirium.
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Intensive Crit Care Nurs · Aug 2008
Editorial Comment ReviewImproving rehabilitation following transfer from ICU.
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Intensive Crit Care Nurs · Aug 2008
Comparative StudyReliability of the Sedation-Agitation Scale between nurses and doctors.
This study determined the inter-rater reliability of the Sedation-Agitation Scale (SAS) when used by staff in a tertiary level general intensive care unit (ICU). The study was designed to answer the question in the 'real world', with minimum patient exclusion criteria, do nurses and doctors rate ICU patient's sedation levels using the SAS similarly? A convenient sample of 35 nursing and seven medical staff and a randomly selected sample of 69 patients were used. A nurse and a doctor rated each patient simultaneously using the SAS, with a systematic five-stage arousal process. ⋯ This research indicates nurses and doctors rate patients' levels of sedation similarly using the SAS. It also provides support for the use of the instrument in general ICUs outside the USA. Research is now needed to determine the value of the SAS in guiding clinical decision-making related to sedation management.