American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study.
Music is considered an ideal therapy for reducing stress in patients receiving mechanical ventilation. Previous studies of the effect of music on stress in such patients have focused solely on indirect markers of the stress response rather than on serum biomarkers. ⋯ Additional research is needed with a larger sample size to evaluate further the influence of music on biochemical markers of the stress response in patients receiving mechanical ventilatory support. In future studies, confounding factors such as endotracheal suctioning and administration of medications that influence the stress response should be controlled for.
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Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. ⋯ Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance.
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Pulse oximetry is commonly used to monitor oxygenation in neonates, but cannot detect variations in hemoglobin. Venous and arterial oxygen saturations are rarely monitored. Few data are available to validate measurements of oxygen saturation in neonates (venous, arterial, or pulse oximetric). Purpose To validate oxygen saturation displayed on clinical monitors against analyses (with correction for fetal hemoglobin) of blood samples from neonates and to present the oxyhemoglobin dissociation curve for neonates. ⋯ The safety limits for pulse oximeters are higher and narrower in neonates (95%-97%) than in adults, and clinical guidelines for neonates may require modification.
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A new forehead noninvasive oxygen saturation sensor may improve signal quality in patients with low cardiac index. ⋯ In patients with low cardiac index, the forehead sensor was better than the digit sensor for pulse oximetry.
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Models for delivery of patient care that recognize the relationship between the characteristics of the patient and the competencies of the nurse are essential for high-quality outcomes. ⋯ The case report form for assessing characteristics of patients showed utility in a general population of adult and pediatric patients, some critically ill and some not. Nurses without previous knowledge of the AACN Synergy Model were able to apply the model during routine patient care.