American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of fever treatments in the critically ill: a pilot study.
Fever in critically ill patients is often treated with antipyretics or physical cooling methods. Although fever is a host defense response that may benefit some critically ill patients, others may not tolerate the cardiovascular demands associated with fever. ⋯ Although the study included only 14 subjects, the findings will provide information for future studies in febrile critically ill patients.
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Multicenter Study
Patients' perceptions and responses to procedural pain: results from Thunder Project II.
Little is known about the painfulness of procedures commonly performed in acute and critical care settings. ⋯ Procedural pain varies considerably and is procedure specific. Because procedures are performed so often, more individualized attention to preparation for and control of procedural pain is warranted.
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To investigate the knowledge, beliefs, and ethical concerns of nurses caring for patients dying in intensive care units. ⋯ Intensive care unit nurses strongly support good pain management for dying patients and withholding or withdrawing life-sustaining therapies to allow unavoidable death. The vast majority oppose assisted suicide and euthanasia. Wider professional and public dialogue on end-of-life care in intensive care units is warranted.
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Results from several research studies combined with increasing public tensions surrounding physician-assisted suicide have fueled a growing awareness of the inadequacies of end-of-life care. Investigators also suggest that intensive care unit nurses have a limited role in end-of-life decision making and care planning. ⋯ Recommendations for changing nursing practice include a model of end-of-life care that incorporates the goals of both cure and comfort care, as well as a shared decision-making process. Nurses are essential to improving end-of-life care in today's intensive care units.