Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 1998
Parental presence during resuscitation: attitudes of staff on a paediatric intensive care unit.
Although family presence during resuscitation is becoming more acceptable, many medical and nursing staff still have concerns and doubts about it. To ascertain paediatric medical and nursing staff's attitudes towards parents being present during resuscitation, 60 staff in a Paediatric Intensive Care Unit were surveyed. The results revealed that even though 89% of staff feel that parents should be able to be present, many have the same concerns and doubts that have been highlighted in previous, albeit adult-centred, studies. Increased stress to staff and parents were some of the concerns identified in a study which also showed interest in the subject and a need for further education.
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Intensive Crit Care Nurs · Feb 1998
Role extension or expansion: a qualitative investigation of the perceptions of senior medical and nursing staff in an adult intensive care unit.
The Scope of Professional Practice (UKCC 1992) has significantly altered the interpretation of nurses' roles, emphasizing individual professional accountability and clinical decision-making. However, 5 years after the issue of the document, uncertainties remain regarding interprofessional legal accountability between medicine and nursing. To investigate issues surrounding role extension or expansion in intensive care nursing, a small qualitative study was conducted centred on one intensive care unit (ICU) within a large teaching hospital. ⋯ However, there was evidence of a reluctance to empower more junior staff to perform extended or expanded roles. Medical respondents viewed extended or expanded roles as taking on mechanical tasks for which anyone could be trained to perform. In conclusion, it is argued that although nursing is maturing in its growth towards professionalization, broader issues such as the legal quagmire, failure to adopt the philosophy of role expansion and the existence of sacred boundaries intra- and inter-professionally need to be addressed.
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Intensive Crit Care Nurs · Oct 1997
ReviewPhysiological changes occurring with positive pressure ventilation: Part one.
Critically ill patients requiring mechanical ventilation are subject to a variety of complications and adverse effects associated with positive pressure ventilation. An awareness of the major physiological effects is important, as recognition, prevention and appropriate treatment of complications is critical to optimizing patient outcome. Pierson (1990) suggests that complications due to ventilation occur with greater frequency than is generally appreciated, and can be a response to suboptimal ventilatory management as a result of poor communication and lack of understanding. ⋯ This increases the nurses' confidence and allows them to focus on the patients and associated problems while maintaining safe and informed care. With the introduction of mechanical ventilation, major physiological changes occur, for example airway resistance and intrathoracic pressures are increased and lung mechanics are altered. The following article provides explanation as to how and why mechanical ventilation produces these changes, and highlights areas where they occur.
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Intensive Crit Care Nurs · Oct 1997
Comparative Study Clinical Trial Controlled Clinical TrialCore body temperature measurement: a comparison of axilla, tympanic membrane and pulmonary artery blood temperature.
This research study was undertaken to examine the relationship between pulmonary artery blood temperature (regarded as the 'gold standard' measurement for core body temperature), axilla temperature using the Tempa. DOT Ax chemical thermometer and tympanic membrane temperature using the Diatek 9000 InstaTemp thermometer. Sixty adult intensive care patients had their temperatures monitored. ⋯ The range of differences between the sites was particularly significant. Plotting limits of agreement showed that both left and right axilla temperatures may be up to 1.2 degrees C above or 1.6 degrees C below PA blood temperature: a clinically unacceptable range. Because the range of temperature differences found between PA blood and the other sites was so great, it is concluded that neither the chemical axilla thermometer nor the tympanic membrane thermometer used in this study are clinically reliable tools for adult intensive care patients.
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Intensive Crit Care Nurs · Aug 1997
ReviewAspects of pulmonary artery catheterization in critical care.
The concept of floating a balloon-tipped catheter into the pulmonary artery was first described in 1970 by Swan et al. Since then, many issues have surrounded the use of these catheters. Of particular concern for many physicians was the incidence of complications associated with use of the catheters. ⋯ Training nurses to use a PAC correctly has been highlighted in reducing the number of technical problems associated with the catheter, which in turn improves the accuracy of haemodynamic data obtained. Unfortunately, training programmes are few and far between, and this is an issue that must be addressed by critical care nurse managers. In this review of the literature regarding PACs and their use in the care of the critically ill patients, the role of the nurse is discussed with recommendations for practice.