Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2018
ReviewGaps in pain, agitation and delirium management in intensive care: Outputs from a nurse workshop.
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation. Where do the gaps exist in pain, agitation and delirium management, what are the barriers to guideline implementation and how can these problems be addressed to ensure patients receive optimised care? As an international professional consensus exercise, a panel of seven European intensive care nurses convened to discuss how to address these questions and establish how the provision of pain, agitation and delirium management can be improved in the intensive care unit.
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Intensive Crit Care Nurs · Oct 2018
Multicenter StudyCritical care nurses' knowledge of alarm fatigue and practices towards alarms: A multicentre study.
To determine critical care nurses' knowledge of alarm fatigue and practices toward alarms in critical care settings. ⋯ Alarm fatigue has the potential for serious consequences for patient safety and answering numerous alarms drains nursing resources.
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Intensive Crit Care Nurs · Oct 2018
Application of prone position in hypoxaemic patients supported by veno-venous ECMO.
Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) is an advanced respiratory care therapy allowing replacement of pulmonary gas exchange. Despite VV-ECMO support, some patients may remain hypoxaemic. A possible therapeutic procedure for these patients is the application of prone positioning. ⋯ The application of prone positioning during VV-ECMO has shown to be a safe and reliable technique when performed in a recognised ECMO centre with the appropriately trained staff and standard procedures.
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Intensive Crit Care Nurs · Oct 2018
Multicenter StudyBurnout and resilience in critical care nurses: A grounded theory of Managing Exposure.
Many critical care nurses experience burnout; however, resilience shows promise as a potential solution to burnout. This study was conducted to better understand nurse burnout and resilience in response to workplace adversity in critical care. ⋯ Resilience and burnout are connected, as indicators of the same process for critical care nurses. Nurse leaders can intervene throughout this process to reduce workplace adversity and support resilience among nurses.
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Intensive Crit Care Nurs · Oct 2018
ReviewThe gastro-renal effects of intra-abdominal hypertension: Implications for critical care nurses.
Intra-abdominal hypertension is classified as either primary or secondary - primary occurs due to intra-abdominal or retro-peritoneal pathophysiology, whereas secondary results in alterations in capillary fluid dynamics due to factors, such as massive fluid resuscitation and generalised inflammation. The renal and gastro-intestinal effects occur early in the progression of intra-abdominal hypertension, and may lead to poor patient outcomes if not identified. ⋯ Mucosal and submucosal tissue hypo-perfusion causes considerable damage to the intestinal cells, potentially resulting in bacterial translocation, endotoxin release, sepsis and multiple organ failure. The critical care nurse plays an important role in the early identification of intra-abdominal hypertension however, without this essential knowledge base and comprehension of intra-abdominal hypertension, clinical signs and symptoms may go unnoticed or be misinterpreted as signs of other critical illnesses.