American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Whether delayed cerebral ischemia (DCI) mediates the relationship between Hunt and Hess grade and outcomes after aneurysmal subarachnoid hemorrhage remains unknown. ⋯ DCI does not mediate the relationship of Hunt and Hess grade to functional outcome or death. The relationship between cerebral perfusion pressure and DCI was most likely due to induced hypertension and hypervolemia. Clinical guidelines may need to include limits for induced hypertension.
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Comparative Study
Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks.
Device-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort. ⋯ The full-face mask resulted in significantly fewer pressure ulcers and was more comfortable for patients. The full-face mask is a reasonable alternative to traditional nasal-oral masks for patients receiving noninvasive ventilation.
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Comparative Study
Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study.
Most scoring systems used to predict clinical outcome in critical care were not designed for application in cardiac surgery patients. ⋯ CASUS can be recommended as the most reliable and beneficial option for benchmarking and risk stratification in cardiac surgery patients.
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Research at the bedside makes a difference for our patients, and also for our nurses. However, it is now time to broaden our focus from research on interventions or events at a narrow point in time to research that addresses care across the continuum. This continuum may start at the point of injury, such as the battlefield through en route care delivered during the 8000-mile journey home for our wounded warriors, or for critically ill patients as they move between the emergency department, operating room, and intensive care unit. ⋯ A culture of inquiry is a critical element in the successful translation of evidence into practice. In a culture of inquiry, nurses are encouraged to question and evaluate their practice, provide evidence-based care, and actively participate in and lead clinical inquiry. This article draws from a program of applied clinical research reflecting care across the continuum within both military and civilian health care settings and discusses how the application of these research findings and the advancement of a culture of inquiry make a difference for both patients and nurses.
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Maintaining oral hygiene is a key component of preventing ventilator-associated pneumonia; however, practices are inconsistent. ⋯ The content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses. Future studies examining how institutional guidelines could best be incorporated into routine workflow are needed.