American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
Effect of Delirium on Physical Function in Noncardiac Thoracic Surgery Patients.
The effect of delirium on physical function in patients undergoing noncardiac thoracic surgery has not been well described and may differ from that in other surgical populations. ⋯ Postoperative delirium was not associated with change in muscle strength. Follow-up studies using other muscle measures may be needed.
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Physical restraints are frequently used for intensive care patients and are associated with substantial morbidity. The effects of common evidence-based critical care interventions on use of physical restraints remain unclear. ⋯ Several potentially modifiable risk factors are associated with next-day use of physical restraints.
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Stress and burnout are plaguing critical care nurses across the globe and leading to high levels of turnover. Resilience-building strategies such as mindfulness, self-care, and well-being can help shield nurses from the negative effects of workplace stress. As the first line of defense, nursing schools could provide students with strategies that build resilience; however, little is known about the availability of such resources in nursing education. ⋯ Training in practices to build resilience and prevent burnout is essentially absent from accredited nursing schools. This highlights an important opportunity to modify existing curricula to include preventative strategies-such as developing positive coping skills- that could mitigate symptoms of workplace stress in future generations of nurses.
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Pain, agitation, and delirium are associated with negative outcomes in critically ill patients. Reducing variation in pain, agitation, and delirium management among institutions could improve care. ⋯ Variation in assessment and management of pain, agitation, and delirium in British Columbia intensive care units highlights opportunities to improve care.