American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Aplasia cutis congenita, a rare congenital disorder involving defects of some or all of the layers of the cranium, is associated with potential life-threatening complications. Although treatment involves both nonsurgical and surgical techniques, the importance of perioperative management cannot be overstressed. A multidisciplinary team, including personnel from nursing, neonatology, pediatrics, radiology, neurosurgery, and plastic surgery services, diagnosed aplasia cutis congenita and planned local wound care, surgical correction, and prevention of potentially life-threatening complications in a 1-day-old boy with a 6×5-cm full-thickness scalp defect.
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Randomized Controlled Trial Multicenter Study
Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study.
Relatives of patients recovering from critical illness are at risk of developing posttraumatic stress disorder. ⋯ Provision of a diary may help psychological recovery in patients' families after critical illness.
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Observational studies have consistently revealed wide variation in nutritional practices across intensive care units and indicated that the provision of adequate nutrition to critically ill patients is suboptimal. To date, the potential role of critical care nurses in implementing nutritional guideline recommendations and improving nutritional therapy has received little consideration. ⋯ Future research and quality improvement strategies are required to correct these deficits and successfully empower nurses to become nutritional champions at the bedside. Using nurses as agents of change will help standardize nutritional practices and ensure that critically ill patients are optimally fed.
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A collaboration led by the American Heart Association recently released the scientific statement "Prevention of Torsade de Pointes in Hospital Settings." Patients receiving proarrhythmic drugs, who have electrolyte disturbances, or who have bradyarrhythmias require QT-interval monitoring. Prior studies have demonstrated that physicians have a poor level of proficiency at calculating QT intervals. The ability of nurses at calculating QT intervals remains untested. ⋯ Our study results demonstrate that nurses' baseline ability to perform QT interval monitoring is extremely poor. An unacceptable amount of error persists after an educational intervention. Accurate computer-assisted methods are needed to reduce the error associated with manual QT-interval monitoring.