American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Randomized Controlled Trial
Nurse- vs nomogram-directed glucose control in a cardiovascular intensive care unit.
Paper-based nomograms are reasonably effective for achieving glycemic control but have low adherence and are less adaptive than nurses' judgment. ⋯ In an intensive care unit where nurses generally accepted the need for tight glucose control, nurse-directed control was as effective and as safe as nomogram-based control.
-
Case Reports
Acute mediastinitis due to extravasation of parenteral nutritional formula via a central venous catheter.
Mediastinitis is a complication generally associated with thoracic surgery. Its occurrence after placement of a central venous catheter is uncommon, and only a few cases have been reported. ⋯ The signs and symptoms, diagnosis, and treatment of this unusual complication are described. This complication should be included in the differential diagnosis of mediastinitis in patients with a central venous catheter in place who have not had thoracic surgery.
-
The Richards-Campbell Sleep Questionnaire (RCSQ) is a simple, validated survey instrument for measuring sleep quality in intensive care patients. Although both patients and nurses can complete the RCSQ, interrater reliability and agreement have not been fully evaluated. ⋯ Patient-nurse interrater reliability on the RCSQ was "slight" to "moderate," with nurses tending to overestimate patients' perceived sleep quality.
-
Biography Historical Article
Clinical research: together, stronger, bolder.
Clinical inquiry is the ongoing process of questioning and evaluating practice, providing informed practice based on best-available data, and innovating practice though research. It is about noticing subtle differences at the bedside and asking "what if" questions. Critically ill patients and their families require care that is based on our best-available evidence. ⋯ In critical care, clinical research should be conducted in the same manner as we practice, collaboratively within multidisciplinary teams. Our core value of the primacy of patient and family, our spirit of inquiry, and our passion for innovation centers our practice. During this year's Distinguished Research Lecture, Martha Curley describes how together, we can build stronger, bolder clinical research.