Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Apr 1998
ReviewNeeds of the critically ill child: a review of the literature and report of a modified Delphi study.
There has been a wealth of guidance from both policy-makers (Department of Health, (DoH) 1991, DoH 1997a, DoH 1997b) and other interested parties (Audit Commission 1993, British Paediatric Association 1993, Paediatric Intensive Care Society 1992) regarding how and where care should be provided for critically ill children. Latest recommendations indicate that designated general ICUs will continue to provide care for children requiring life support and that all general ICUs will need to initiate such care (DoH 1997a). ⋯ This paper explores the literature regarding the needs of the critically ill child, incorporating the role of parents and previous studies exploring needs. The findings of a modified Delphi study exploring the needs of the critically ill child are also outlined.
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Intensive Crit Care Nurs · Apr 1998
The education of registered nurses for practice in paediatric intensive care units in Australia and New Zealand.
This article summarizes a report on the findings of a study of the education and training of registered nurses for practice in Paediatric Intensive Care Units (PICUs) in Australia and New Zealand. The study was funded by the Florence Nightingale Foundation and Sandra Charitable Trust, and was carried out in late 1997. One element of the study was the exploration of four Paediatric Intensive Care Courses in Australia and New Zealand. ⋯ In terms of clinical practice, the issue of assessment of competence, and the importance of clear delineation of the roles and responsibilities of those involved were identified. Assessor preparation were also discussed. Many of these issues have relevance in England, particularly in view of the identified need for increased provision of PIC courses.
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Intensive Crit Care Nurs · Apr 1998
Optimizing the human experience: nursing the families of people who die in intensive care.
This paper describes a study of the experiences of seven nurses working with the families of people who die in the Intensive Care Unit (ICU). A phenomenological approach is taken, which is informed by Heidegger and hermeneutics. Van Manen's methodological suggestions are used to shape and focus the study. ⋯ This is achieved through strategies such as Being there, Supporting, Sharing, Involving, Interpreting and Advocating. These strategies are enabled by three domains: Nurse as Person, Nurse as Practitioner and Nurse as Colleague which describe a wider context to working effectively with families rather than merely looking at direct interactions between nurse and family. Optimizing the human experience is proposed as the central essence or phenomenon of nursing the families of people who die in intensive care.
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Intensive Crit Care Nurs · Feb 1998
Brain death in ICUs and associated nursing care challenges concerning patients and families.
In order to document the incidence and causes of brain death (BD) and the frequency of organ donation (OD) in a Swedish University Hospital, a retrospective review of deaths in a neurosurgical department and in the general intensive care units (ICUs), was carried out for the period 1988-1994. BD diagnosis was established in 197 (10.6%) of all deaths (n = 1843). The hospital records of all BD patients were examined in detail following a specific study plan. ⋯ The BD diagnosis was established by neurological examination (60%) and by cerebral angiography (40%). Of the BD patients, 50% died within 48 hours in the ICU and the majority of requests for OD (67%) were made to the relatives of these patients. The findings are discussed with focus on the workload and psychological stress of ICU nurses when caring for BD patients and their families; a task which includes taking part in processes concerning BD diagnosis information and OD requests.
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Intensive Crit Care Nurs · Feb 1998
Establishing evidence-based practice: issues and implications in critical care nursing.
Evidence-based practice is the application of the best available empirical evidence, including recent research findings to clinical practice in order to aid clinical decision-making. The implementation of these findings is vital for optimizing patient outcomes, improving clinical practice, providing cost-effective high quality care and enhancing the credibility of nurses. The use of research findings to improve practice has been discussed and promoted for the last 20 years. ⋯ However, recent studies all document that a gap between research findings and their implementation in clinical practice still exists. This appears to hold true across a variety of practice settings, including nurses working in critical care. The diffusion of innovations in current critical care nursing practice at each stage of Rogers' theory will be examined, with recommendations given to facilitate the establishment of evidence-based practice (EBP).