American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
Clinicians' perceptions of the usefulness of a communication facilitator in the intensive care unit.
Despite its documented importance, communication between clinicians and patients' families in the intensive care unit often fails to meet families' needs, and interventions to improve communication are needed. Use of a communication facilitator-an additional staff member-to improve communication between clinicians and patients' families is the focus of an ongoing randomized trial. The clinical team's acceptance of the communication facilitator as an integral part of the team is important. ⋯ Clinicians in the intensive care unit saw the facilitator intervention as enhancing communication and supporting both patients' families and clinicians. They also identified the importance of the facilitator within the interdisciplinary team. Negative perceptions about the use of a facilitator should be addressed before the intervention is implemented, in order to ensure its effectiveness.
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Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors. ⋯ Important issues identified were perceived importance of interprofessional collaboration and communication, need to combine subjective knowledge of the patient with objective clinical data, balancing of weaning systematization with individual needs, and appreciation of the physical and psychological work of weaning.
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Randomized Controlled Trial
Cleanliness of Disposable vs Nondisposable Electrocardiography Lead Wires in Children.
Mediastinitis costs hospitals thousands of dollars a year and increases the incidence of patient morbidity and mortality. No studies have been done to evaluate adenosine triphosphate (ATP) counts on disposable and nondisposable electrocardiography (ECG) lead wires in pediatric patients. ⋯ Results of this study support the use of disposable ECG lead wires in postoperative pediatric cardiac surgery patients for at least the first 48 hours as a direct strategy to reduce the ATP counts on ECG lead wires.
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Observational Study
Depressive symptoms and the relationship of inflammation to physical signs and symptoms in heart failure patients.
Depressive symptoms in patients with heart failure can affect the relationship between physical signs and symptoms and inflammation. ⋯ Both depressive symptoms and inflammation should be considered along with physical signs and symptoms in patients with heart failure. Further studies are needed to determine the effects of improvement in inflammation on improvement in physical signs and symptoms, with consideration given to the effects of depressive symptoms.
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Agitation in critically ill adults is a frequent complication of hospitalization and results in multiple adverse outcomes. Potential causes of agitation are numerous; however, data on factors predictive of agitation are limited. ⋯ Predictors of agitation on admission and within 24 hours before the onset of agitation were primarily clinical variables.