American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Use of technology capable of electromagnetically tracking advancement of a feeding tube on a monitoring screen during insertion may enable detection of deviation of the tube from the midline as it advances through the chest, possibly indicating entry of the tube into the right or left main bronchus. ⋯ The ability of clinicians to place feeding tubes correctly by using an electromagnetic tube placement device varies. Thus, it is reasonable to question the wisdom of eliminating radiographic confirmation of tube position before starting feedings.
-
Case Reports
Pseudo-ventricular tachycardia mimicking malignant arrhythmia in a patient with rapid atrial fibrillation.
Artifacts can simulate arrhythmias such as atrial flutter, atrial fibrillation, and ventricular tachycardia. A case of pseudo-ventricular tachycardia is outlined in a patient with newly diagnosed atrial fibrillation, which made the diagnosis a special challenge. Characteristic signs of pseudo-ventricular tachycardia are described. This case reinforces the importance of recognizing artifacts to avoid unnecessary interventions, especially in the telemetry and critical care units.
-
Review
Delivering interprofessional care in intensive care: a scoping review of ethnographic studies.
The sustained clinical and policy interest in the United States and worldwide in quality and safety activities initiated by the release of To Err Is Human has resulted in some high-profile successes and much disappointment. Despite the energy and good intentions poured into developing new protocols and redesigning technical systems, successes have been few and far between, leading some to argue that more attention should be given to the context of care. ⋯ The fundamental insight that interprofessional interactions in intensive care do not happen in a historical, social, and technological vacuum must be brought to bear on future research in intensive care if patient safety and quality of care are to be improved.
-
Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. ⋯ The most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.