American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Congenital heart disease (CHD) is a leading birth defect in the United States, affecting about 40 000 neonates each year. Despite efforts to prevent developmental delays, many children with CHD have neurological deficits that last into adulthood, influencing employability, self-care, and quality of life. ⋯ Preoperative neonates with CHD have poorer developmental outcomes and more hypoxemia than do controls.
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Comparative Study
Advancing In-Hospital Clinical Deterioration Prediction Models.
Early warning systems lack robust evidence that they improve patients' outcomes, possibly because of their limitation of predicting binary rather than time-to-event outcomes. ⋯ As early warning scoring systems are refined, they must use the best analytical methods that both model the underlying phenomenon and provide an understandable prediction.
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Health care work environments affect patient outcomes, staff satisfaction and retention, and organizational financial viability. The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Tool (HWEAT) is a resource for patient care units and organizations to assess the work environment and track progress on their journey to excellence. ⋯ The AACN HWEAT was both reliable and valid, supporting its interprofessional use as an organizational measure. Active evaluation of health care environments is critical to achieving optimal patient outcomes.
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Quality improvement efforts in sepsis management have increased patients' survival rates. Many sepsis survivors experience sequelae leading to unplanned hospital readmissions and subsequent mortality, especially when survivors delay seeking medical attention because they do not recognize the signs and symptoms of recurrent sepsis. Thus, increasing knowledge of sepsis among patients and caregivers before initial hospital discharge is essential. ⋯ The Sepsis Fact Sheet provides useful patient information as evaluated using established recommendations for printed materials and expert content validation. Areas for improvement include providing a summary, modifying images, and simplifying language. Results may be useful for sepsis education and discharge teaching.
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Family members of patients who die in an intensive care unit (ICU) may experience negative outcomes. However, few studies have assessed the effectiveness of bereavement care for families. ⋯ Bereavement follow-up after an ICU death reduced family members' prolonged grief and may also reduce their risk of posttraumatic stress disorder. This type of support did not have a measurable effect on depression or satisfaction with ICU care.