American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Case Reports
Severe sepsis and acute respiratory distress syndrome from community-acquired legionella pneumonia: case report.
A case of a young man with community-acquired pneumonia, severe acute respiratory distress syndrome, and sepsis is reported. Treatment with antibiotics and various modes of mechanical ventilation in the intensive care unit were unsuccessful. A urinary legionella antigen test was positive for Legionella pneumophila.
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Little information is available on the types, causes, and treatment of pneumonia in intensive care unit patients in usual clinical practice. ⋯ Most cases of pneumonia were community acquired. The most common causative organisms were gram-positive cocci. Four quality improvement strategies were rationalization of antibiotic use during rounds, nurses' reporting of culture results, review of antibiotic appropriateness by a pharmacist, and redesign of the clinical information system.
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Survival rates after in-hospital cardiac arrest have not improved markedly despite improvements in technology and resuscitation training. ⋯ The high rate of survival to discharge after cardiac arrest is attributed to extensive education and the incorporation of semiautomatic external defibrillators into basic life support management.
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In 2002, a report indicated that tobacco-related curricular content in educational programs for acute care nurse practitioners was insufficient. To provide healthcare professionals with the necessary knowledge and skills to intervene with patients who smoke tobacco, the Summer Institute for Tobacco Control Practices in Nursing Education was implemented at Georgetown University in Washington, DC. ⋯ Use of the Rx for Change train-the-trainer program can enhance the level of tobacco education provided in acute care nurse practitioner programs. Widespread adoption of an evidence-based tobacco education in nursing curricula is recommended to help decrease tobacco-related morbidity and mortality.