Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
-
Intensive Crit Care Nurs · Feb 2002
Utilizing TISS to differentiate between intensive care and high-dependency patients and to identify nursing skill requirements.
An identification system utilizing the therapeutic intervention scoring system (TISS) was developed to differentiate between intensive care and high-dependency unit (HDU) patients. ⋯ TISS is an effective triage tool for differentiating between ICU and HDU patients and identifying nursing skill requirements to care for the ICU and HDU patient groups.
-
Intensive Crit Care Nurs · Dec 2001
Randomized Controlled Trial Comparative Study Clinical TrialLevel of dyspnoea experienced in mechanically ventilated adults with and without saline instillation prior to endotracheal suctioning.
The purpose of this study was to compare the level of dyspnoea with and without the use of 5-cc saline instillation prior to endotracheal suctioning of mechanically ventilated adults. A crossover, quasi-experimental design was used. Seventeen alert, mechanically ventilated adults were asked to rank their level of dyspnoea using the vertical visual analogue scale at specific time intervals surrounding two suctioning events. ⋯ This study documented no beneficial effects of saline. However, it did demonstrate that saline instillation might precipitate a significantly increased level of dyspnoea for up to 10 minutes after suctioning in patients older than 60 years of age. Recommendations based on the results of this study would be to avoid the use of saline instillation prior to suctioning.
-
Intensive Crit Care Nurs · Dec 2001
Nursing the ARDS patient in the prone position: the experience of qualified ICU nurses.
The revival of the use of the prone position as a treatment for acute respiratory distress syndrome (ARDS) has been well documented in the medical literature, but there is little information regarding the difficulties of nursing patients in this position. The purpose of this study was to increase the body of knowledge by exploring the experiences of nurses who had cared for a patient in the prone position. A questionnaire was sent to all registered nurses in four large intensive care units (ICUs) to determine the main areas of concern when nursing patients in the prone position. ⋯ Problems experienced in providing nursing care related to pressure areas, suctioning, accidental injuries and management of emergencies. Deficits in knowledge of ARDS and skills in handling communication with relatives were also identified. As a result of this exploration, guidelines have been developed, focusing mainly on the manoeuvre, organizational and nursing issues, to provide guidance in caring for a patient when being nursed in the prone position.
-
Small volume resuscitation fluids are a combination of hypertonic crystalloid with a colloid. SVR fluids have the advantage of logistical convenience in the field situation. ⋯ Trials so far have been carried out in small numbers of patients and improved survival benefit has only become evident on meta-analysis and sub-group analysis. Further large scale blinded randomized trials are required to confirm the promise of survival advantages.
-
Intensive Crit Care Nurs · Oct 2001
Perceptions and experiences of primary nursing in an ICU: a combined methods approach.
With the introduction of the Patient's Charter, greater emphasis has been placed on 'named nursing' (Department of Health 1991). While there is much literature extolling the benefits of this method of delivering care to patients (Reed 1988; Manley 1989; Macguire 1991); there is a dearth of empirical studies exploring primary nursing in an adult intensive care unit (ICU). In addition, little is known about how nurses feel about being a 'primary nurse'. ⋯ This is an important finding and highlights the need for primary nurses in ICU to have the opportunity (in some instances), to be relieved of their responsibility for a named patient, thereby reducing some of the potential for stress. It is acknowledged that the findings of this study may not be generalized beyond the identified sample. Further empirical studies exploring nurses' perceptions and experiences of primary nursing in an ICU are therefore needed.