American journal of critical care : an official publication, American Association of Critical-Care Nurses
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The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. ⋯ This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.
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Estimates of the height of patients in the intensive care unit are required to adhere to clinical guidelines for drug dosages, ventilatory support, and nutrition. The gold standard of standing height cannot be used because these patients are often unconscious and recumbent. The ability of physiotherapists or dietitians to measure height in unconscious, recumbent patients has not been evaluated. ⋯ Physiotherapists' measurements of supine height of recumbent critical care patients, obtained by using a nonrigid measuring tape, are more accurate than measurements obtained by physicians and dietitians.
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Use of an evidence-based tool for routine assessment for delirium by bedside nurses in the intensive care unit is recommended. However, little is known about patient outcomes after implementation of such a tool. ⋯ No change in patient outcomes or diagnosis of delirium occurred 1 year after implementation of the Confusion Assessment Method for the Intensive Care Unit. Lessons learned and barriers to adoption and use, however, were identified.