American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Regular pain assessment can lead to decreased incidence of pain and shorter durations of mechanical ventilation and stays in the intensive care unit. ⋯ A substantial proportion of intensive care unit nurses did not use pain assessment tools for patients unable to communicate and were unaware of pain management guidelines published by professional societies.
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BACKGROUND PATIENT: ventilator dyssynchrony is common and may influence patients' outcomes. Detection of such dyssynchronies relies on careful observation of patients and airway flow and pressure measurements. Given the shortage of specialists, critical care nurses could be trained to identify dyssynchronies. ⋯ Specifically trained nurses can reliably detect ineffective inspiratory efforts during expiration.
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The Richards-Campbell Sleep Questionnaire (RCSQ) is a simple, validated survey instrument for measuring sleep quality in intensive care patients. Although both patients and nurses can complete the RCSQ, interrater reliability and agreement have not been fully evaluated. ⋯ Patient-nurse interrater reliability on the RCSQ was "slight" to "moderate," with nurses tending to overestimate patients' perceived sleep quality.
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Nursing and organizational characteristics influence patients' outcomes. Little is known about nursing structure and process supports in the intensive care units of children's hospitals. Objectives To describe and understand nursing and organizational characteristics of cardiovascular care in children's hospitals. ⋯ Cardiovascular intensive care varies widely across children's hospitals. Opportunities exist for support and retention of an intergenerational nursing workforce. These findings may serve as a contemporary benchmarking source and foundation to standardize models of care, support, and resource utilization in pediatric intensive care units.