Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Jun 2008
ReviewOral care and the risk of bloodstream infections in mechanically ventilated adults: A review.
Bacteraemia, defined as the presence of viable bacteria in the circulating blood can result in bloodstream infection, which is one of the most frequent and challenging hospital-acquired infections. Bacteraemia occurs in healthy populations with manipulation of the oral mucosa, including toothbrushing. Oral care is commonly administered to mechanically ventilated patients, it is important to determine whether this practice contributes to the incidence of bacteraemia. This paper reviews the literature on the link between the manipulation of the oral cavity and the development of bacteraemia in mechanically ventilated adults. ⋯ Additional research is needed to understand the relationship of oral care practices to bacteraemia in mechanically ventilated adults.
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There has been renewed interest in weaning from mechanical ventilation in critical care since the publication of the Modernisation Agency paper in 2002. There have been many papers reporting ways of improving the weaning process but these are specific to single elements and neglect the contextual issues that influence the weaning process. Care bundles have been introduced nationally to standardise patient care and improve patient outcome. ⋯ One critical care network has written a weaning care bundle. This is an example of a service improvement initiative the aim of which was to improve weaning from mechanical ventilation. This paper reviews this approach and presents results from a pilot in one teaching hospital.
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Intensive Crit Care Nurs · Jun 2008
A qualitative study into the lived experience of post-CABG patients during mechanical ventilator weaning.
Research into mechanical ventilator weaning has predominantly been devoted to analysis and evaluation of predictors of weaning success. Few studies have examined the patient experience of weaning. The aim of this study was to provide a contemporary description of the patient experience of weaning, in order to up-date this aspect of knowledge in the context of newer modalities of mechanical ventilation and sedation. ⋯ Newer modalities of sedation and mechanical ventilation have not entirely eliminated the discomforts of critical illness; the human aspects of suffering remain. In order to address some of the general, psychological, and existential patient experiences, care should be taken to acknowledge the patient and to respect the patient domain and individual time frames. In nurse-patient communication, it is recommended that caregivers give accurate and unambiguous information.
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Intensive Crit Care Nurs · Apr 2008
Controlled Clinical TrialThe impact of offering a relatives' clinic on the satisfaction of the next-of-kin of critical care patients-a prospective time-interrupted trial.
Families have been shown to be dissatisfied with the frequency of doctor communication in the Critical Care setting. Discussions with families are often conducted in an ad-hoc fashion. We hypothesised that the offer of a formal daily weekday clinic for the relatives of Critical Care patients would increase the relatives' satisfaction. ⋯ Offering a relatives' clinic does not significantly improve the satisfaction of the next-of-kin in this setting. Other means of improving satisfaction have been highlighted as a result of the study.
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Intensive Crit Care Nurs · Apr 2008
ReviewRisk factors for intensive care delirium: a systematic review.
Delirium has been a recognised syndrome in the intensive care unit for some years. This systematic review reports risk factors for delirium studied in the intensive care unit. ⋯ The APACHE II score and hypertension were the only factors reported twice. Risk factors for the development of intensive care delirium were understudied and underreported in the literature.