American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Nursing handoff is a communication activity with a high risk for loss or omission of information. Efforts to improve handoffs include standardization of the processes and content of handoff communications. ⋯ A standardized approach to handoff based on unit and organizational needs will be more successful than a broad mandate of content and organization. Individual preference is prevalent and strongly influences the information conveyed and the structure of handoff communication.
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Randomized Controlled Trial
Arterial Monitoring System Leveling Method, Transducer Location, and Accuracy of Blood Pressure Measurements.
Many critically ill patients have invasive arterial catheters inserted for blood pressure monitoring. Whether catheter leveling method and alternative transducer location affect the accuracy of blood pressure measurements is unknown. ⋯ The findings indicate that any of the transducer locations evaluated may be useful in clinical prac-tice. Also, visual alignment rather than laser device leveling may be acceptable, except for DBP in the control location. More research is needed to strengthen these findings.
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Large-scale efforts to train clinicians in serious-illness communication skills are needed, but 2 important gaps in knowledge remain. (1) No proven training method exists that can be readily scaled to train thousands of clinicians. (2) Though the value of interprofessional collaboration to support incapacitated patients' surrogates is increasingly recognized, few interventions for training intensive care unit (ICU) nurses in important communication skills can be leveraged to provide interprofessional family support. ⋯ Nurses testing this web-based training program judged it usable, acceptable, and effective. These data support proceeding with an appropriately powered efficacy trial.
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Observational Study
Prospective Validation of Sedation Scale Scores That Identify Light Sedation: A Pilot Study.
Intensive care unit (ICU) sedation guidelines recommend targeting a light sedation level, but light sedation has no accepted definition, and inconsistent levels have been proposed. ⋯ The level of sedation most associated with the ability to follow commands appears higher than previously recommended. Further study is needed regarding the effects of sedation level on ICU patients' ability to follow commands and assessment of delirium, pain, and patient preferences.