Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
-
Intensive Crit Care Nurs · Dec 2006
ReviewBeyond comfort: oral hygiene as a critical nursing activity in the intensive care unit.
The role of oral hygiene in maintaining the health and well being of patients in the intensive care unit (ICU) is indisputable. This importance is not reflected in the body of research related to ICU practice. While a number of studies have examined oral hygiene practices in oncological patients there is significantly less attention devoted to these practices in the critically ill. ⋯ It is clearly evident from this review of oral hygiene practices in intensive care that the need for ongoing research is of paramount importance. ICU nurses undeniably require rigorous research studies in order to inform their practice in the provision of oral hygiene for critically ill patients.
-
Intensive Crit Care Nurs · Dec 2006
Delusional memories from the intensive care unit--experienced by patients with physical trauma.
During and after intensive care unit (ICU) stays some patients report unreal experiences or so called delusional memories, which can be a source of distress. The aims of this study were: to describe trauma patients' memories of their stay in the ICU, factors that may influence delusional memories, problems experienced after discharge from the ICU and the patients' return to work. In this multi-centre study, 239 trauma patients filled in a self-administered questionnaire (ICUM tool) 6-18 months after their ICU stay. ⋯ A logistic regression analysis of all significant factors revealed that age was the best predictor of delusional memories. Significantly more patients with delusional memories reported unexplained feelings of panic after discharge from the ICU and had still not returned to work 1 year after the trauma. In conclusion, patients with delusional memories are younger and these memories affect them even after discharge from the ICU.
-
Intensive Crit Care Nurs · Dec 2006
Developing a care program to better know the chronically critically ill.
Patients requiring prolonged periods of intensive care and mechanical ventilation are termed chronically critically ill. These patients present a challenge to the healthcare team. In the fast-paced environment of the intensive care unit, their slow progress can be a source of frustration. ⋯ New interventions focused on communication, physical care, and providing a context of understanding for the patient beyond hospitalisation, operationalised as a patient diary. The structure of the new program allowed the nurses to develop new skills and provided an environment for dynamic reflection. The care of this demanding patient population is beginning to be perceived by nurses as challenging and interesting.
-
Intensive Crit Care Nurs · Dec 2006
Investigating nurses' perceptions of their role in managing sedation in intensive care: an exploratory study.
Most patients who are admitted to intensive care in need of ventilator support may also require sedation. It is a part of the nurses' role to manage sedation therapy according to patients' needs, avoiding complications of over and under sedation. The purpose of the study was to explore nurses' perceptions of their role in sedation management. ⋯ However, the impact of this role depends on the experience and confidence of the nurse as knowledge and skills are required in order to provide effective sedation for patients. Recommendations from this study are to incorporate a team approach within a locally devised sedation protocol. This should be supported by an education programme aiming to improve decision-making about sedation management at the bedside.
-
Intensive Crit Care Nurs · Oct 2006
Case ReportsPatients' dreams in ICU: recall at two years post discharge and comparison to delirium status during ICU admission. A multicentre cohort study.
Discharged intensive care unit (ICU) patients often recall experience vivid dreams, hallucinations or delusions. These may be persecutory in nature and are sometimes very frightening. It is possible that these memories stem from times when the patient was experiencing delirium, a common syndrome in the critically ill. ⋯ Dreaming was significantly associated on logistic regression with increased length of stay (OR 1.39, 95% CI 1.08-1.79, p=0.01), but not delirium status (OR 1.56, 95% CI 0.45-5.41, p=0.49). A longer ICU stay was significantly associated with the experience of ICU dreaming. As many dreams are disturbing, we suggest providing information and counselling about delirium to patients who remain in ICU for longer periods.