American journal of critical care : an official publication, American Association of Critical-Care Nurses
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A cardiovascular single-unit-stay program began at North Memorial Medical Center, Robbinsdale, Minn, in January 2000. Before then, cardiac surgery patients had been admitted to the intensive care unit directly from the operating room and then transferred to the postcoronary care unit on postoperative day 1 or 2. ⋯ The cardiovascular single-unit-stay program allows patients to stay in the same room with a consistent care team throughout the patients' postoperative course. Decreased lengths of stay, decreased morbidity and mortality, increased satisfaction among patients and their families, and improved collaboration between members of the multidisciplinary team are just a few of the positive trends since the program's inception.
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Randomized Controlled Trial Clinical Trial
Randomized trial of an intensive care unit-based early discharge planning intervention for critically ill elderly patients.
Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness. ⋯ Intensive care unit-based early discharge planning can affect elderly patients' preparation for discharge.
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Randomized Controlled Trial Clinical Trial
Appropriately timed analgesics control pain due to chest tube removal.
Pain during chest tube removal can be moderately to severely intense and distressful to patients. Little evidence-based research has guided clinicians in attempts to alleviate such pain. ⋯ If used correctly, either an opioid (morphine) or a nonsteroidal anti-inflammatory (ketorolac) can substantially reduce pain during chest tube removal without causing adverse sedative effects. Thus, clinicians may choose among several safe and effective analgesic interventions during chest tube removal.
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Patients' charts have been a source of data for retrospective studies of the quality of end-of-life care. In the intensive care unit, most patients die after withdrawal of life support. Chart reviews of this process could be used not only to assess the quality of documentation but also to provide information for quality improvement and research. ⋯ Comprehensive documentation of end-of-life care is lacking.