American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Traditional/Restrictive vs Patient-Centered Intensive Care Unit Visitation: Perceptions of Patients' Family Members, Physicians, and Nurses.
Patient-centered intensive care units (ICUs) are advocated by professional organizations for critical care nursing and medicine. The patient-centered ICU paradigm recognizes the patient-family unit as inseparable and supports visitation designed to meet the needs of patients and patients' families. ⋯ Patient-centered care is an expectation among patients, patients' families, and health quality advocates. These exploratory methods increased understanding of the powerful perceptions of family members, physicians, and nurses involved with patient care and provided direction to plan interventions to implement patient-centered, family-supportive ICU services.
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Identifying risk factors for unplanned extubation in patients receiving mechanical ventilation can help guide prevention strategies. ⋯ Strategies of no sedation or intermittent sedation are both associated with higher rates of unplanned extubation when compared to a strategy of continuous sedation with daily interruption of sedatives. Sedation strategies that allow agitation may increase the risk of unplanned extubation.
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Agitation is a frequent complication in critically ill adults, can result in life-threatening events for patients or care providers, and extends the hospital length of stay, thereby increasing hospital costs. ⋯ Agitation was present in more than one-half of the patients in the sample, typically developed on the first day, and involved consecutive days.