American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Problems persist with surrogate decision making in intensive care units, leading to distress for surrogates and treatment that may not reflect patients' values. ⋯ The Four Supports Intervention is feasible, acceptable, and was perceived by physicians and surrogates to improve the quality of decision making and the patient-centeredness of care. A randomized trial is warranted to determine whether the intervention improves patient, family, and health system outcomes.
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High-quality communication is a key determinant and facilitator of patient-centered care. Nurses engage in most of the communication with patients and patients' families in the intensive care unit. ⋯ Critical care, including communication, is a collaborative effort. Understanding how nurses engage in patient-centered communication in the intensive care unit can guide future interventions to improve patient-centered care.
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Comparative Study
Slim stroke scales for assessing patients with acute stroke: ease of use or loss of valuable assessment data?
Scientific guidelines recommend the National Institutes of Health Stroke Scale for ischemic stroke assessment. However, many nurses find "slim" National Institutes of Health Stroke Scale versions or the Glasgow Coma Scale easier to use. ⋯ Use of "slim" scales, and in particular the Glasgow Coma Scale, substantially decreases the value of a structured neurological assessment, particularly in patients with low National Institutes of Health Stroke Scale scores.