American journal of critical care : an official publication, American Association of Critical-Care Nurses
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New technologies in critical care and mechanical ventilation have led to long-term survival of critically ill patients. An early mobility and walking program was developed to provide guidelines for early mobility that would assist clinicians working in intensive care units, especially clinicians working with patients who are receiving mechanical ventilation. Prolonged stays in the intensive care unit and mechanical ventilation are associated with functional decline and increased morbidity, mortality, cost of care, and length of hospital stay. ⋯ Each phase includes guidelines on positioning, therapeutic exercises, transfers, walking reeducation, and duration and frequency of mobility sessions. Additionally, the criteria for progressing to the next phase are provided. Use of this program demands a collaborative effort among members of the multidisciplinary team in order to coordinate care for and provide safe mobilization of patients in the intensive care unit.
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Multicenter Study Comparative Study
Fecal containment in bedridden patients: economic impact of 2 commercial bowel catheter systems.
Fecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections. ⋯ Catheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day.
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Comparative Study
Comparison of glucose point-of-care values with laboratory values in critically ill patients.
Blood from central venous or arterial catheters as well as from fingersticks is often used for point-of-care glucose testing. ⋯ Glucose values obtained with a point-of-care device differ significantly from those obtained by laboratory analysis. The magnitude of these differences calls into question the widespread practice of using point-of-care glucose testing to guide insulin titration for tight glucose control. Errors in dosing could easily be made because of the large bias and precision associated with a point-of-care device.