American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Meta Analysis
Prevention of Tracheostomy-Related Pressure Injury: A Systematic Review and Meta-analysis.
In the critical care environment, individuals who undergo tracheostomy are highly susceptible to tracheostomy-related pressure injuries. ⋯ Use of hydrophilic dressings and foam collars decreases the incidence of tracheostomy-related pressure injury in critically ill patients. Evidence regarding individual interventions is limited by lack of sensitive measurement tools and by use of bundled interventions. Further research is necessary to delineate optimal interventions for preventing tracheostomy-related pressure injury.
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As more life-sustaining treatments become available, the need to provide patients and families clarity about what these treatments are and what they do is increasing. Little is known about how patients and families conceptualize life support. ⋯ Understanding how patients and families make sense of major medical treatments can help clinicians during decision-making conversations.
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Safe, reliable, high-quality critical care delivery depends upon interprofessional teamwork. ⋯ Teamwork and work environment health were rated by ICU team members as good but not excellent. Care coordination and meaningful recognition can be improved.
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Physiological functions with circadian rhythmicity are often disrupted during illness. ⋯ Circadian rhythmicity of vital signs at ICU discharge is not predictive of GOS-6 in patients with TBI.
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In 2019, an interprofessional team at Texas Children's Hospital designed and instituted developmental care rounds to better coordinate developmentally appropriate care within the cardiac intensive care unit. During the first 2 years, we conducted 230 developmental care rounds on 169 patients; for these rounds, family participation was greater than 85%. ⋯ Importantly, the structure of these rounds has evolved to prominently integrate family members' perspectives and experiences. Lessons learned through developmental care rounds have formed a foundation for implementing other developmentally appropriate practices and initiatives throughout the hospital's Heart Center.