American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Oral chlorhexidine prophylaxis can decrease occurrence of ventilator-associated pneumonia. However, the importance of timing has never been fully explored. ⋯ Early administration of oral chlorhexidine in intubated patients was not associated with a reduction in the incidence of ventilator-associated pneumonia in a surgical intensive care unit with high rates of chlorhexidine administration before 12 hours.
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Losing a loved one in the intensive care unit (ICU) is stressful for family members. Providing bereavement support to them is recommended. However, little is known about the prevalence of bereavement services implemented in adult ICUs. ⋯ The study findings provide insight into what type of bereavement evaluation methods are being used, what barriers are present that hinder use of bereavement follow-up services, and potential interventions to overcome those barriers in adult ICUs in the United States.
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Headache profoundly affects management of spontaneous subarachnoid hemorrhage but is poorly characterized. ⋯ Headache after spontaneous subarachnoid hemorrhage was often severe, necessitating multiple opioid and nonopioid analgesics. Many patients reported persistent headache and inadequate pain control.
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Although most intensive care patients are at risk for pressure ulcers, not all experience such ulcers. ⋯ Several variables within the model of pressure, oxygenation, and perfusion were significantly associated with development of pressure ulcers.
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Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs. ⋯ Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients' family members and referring physicians.