American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care. ⋯ Education on bereavement/end-of-life care could affect nurses' comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.
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An accurate and reliable noninvasive method for determining cardiac output/cardiac index would be valuable for patients with acutely decompensated advanced systolic heart failure. ⋯ Determinations of cardiac output and index by both methods were significantly correlated. Mean bias between the 2 methods was small, suggesting clinical utility for bioimpedance in patients with complex decompensated heart failure.
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Information about the contributions of acute care nurse practitioners to medical management teams in critical care settings is limited. ⋯ Responses reflected unique advantages of acute care nurse practitioners as members of medical management teams in critical care settings. Despite perceptions of the acute care nurse practitioner's role as medically oriented, the themes reflect a clear nursing focus.
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Postoperative pulmonary complications are the most frequent and significant contributor to morbidity, mortality, and costs associated with hospitalization. Interestingly, despite the prevalence of these complications in cardiac surgical patients, recognition, diagnosis, and management of this problem vary widely. ⋯ In the absence of evidence-based practice guidelines for the care of cardiac surgical patients with postoperative pulmonary dysfunction, an understanding of the pathophysiological basis of the development of postoperative pulmonary complications is fundamental to enable clinicians to assess the value of current management interventions. Previous research on postoperative pulmonary dysfunction in adults undergoing cardiac surgery is reviewed, with an emphasis on the pathogenesis of this problem, implications for clinical nursing practice, and possibilities for future research.
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During resuscitative efforts, patients' family members are often barred from the patients' rooms and may never have the opportunity to see their loved ones alive again. Recently, the need to ask family members to leave the room is being questioned. Little is known about families' perceptions of cardiopulmonary resuscitation. ⋯ During the period of resuscitation, healthcare professionals neglect to recognize that patients' family members are experiencing crisis along with the patients and that coping mechanisms are impaired. Moreover, the family members' informational and proximity needs are often ignored during this time of crisis. Addressing these needs through appropriate nursing interventions will become increasingly important as patients' family members begin to remain with their loved ones during cardiopulmonary resuscitation.