American journal of critical care : an official publication, American Association of Critical-Care Nurses
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The limited literature on closed-system suctioning suggests a need for further research in this area. Information is lacking about the frequency of use of the closed versus the open system of suctioning and about the current patterns of practice of closed-system suctioning among nurses. ⋯ Further research on closed-system suctioning is warranted, especially on the practices of hyperoxygenation and hyperinflation and the effect of these interventions on the prevention of suctioning-induced hypoxemia.
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Randomized Controlled Trial Clinical Trial
Music: an intervention for pain during chest tube removal after open heart surgery.
Pain associated with chest tube removal is a major problem for patients who undergo open heart surgery. Because this pain is short-lived, timing the administration of pharmacological agents for pain relief is difficult and is therefore done inconsistently. ⋯ Although the findings were not statistically significant, most subjects enjoyed listening to the music, and therefore the use of music as an adjuvant to other therapies may be an appropriate nursing intervention.
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A computerized bibliographic search of published research and a citation review of English-language publications about prone positioning of patients with acute respiratory distress syndrome were done. Information on prone positioning related to technique, patients' responses, complications, and recommendations to prevent complications was extracted. In the 20 pertinent clinical studies found, 297 patients (mean age, 39 years) with acute respiratory failure were positioned prone. ⋯ The most serious complication, corneal abrasion requiring corneal transplantation, was reported in one patient. Clinical knowledge about prone positioning is limited. Phase 1 studies focusing on how to safely turn and care for critically ill patients positioned prone for prolonged periods are needed.
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Cyclical fluctuations in turnover of critical care nurses are a large and complex problem. Managers' leadership characteristics may be a determinant of critical care nurses' intent to stay in the job. ⋯ Inclusion of nurse-managers' characteristics explained more variance in intent to stay than did previous models. Managers with leadership styles that seek and value contributions from staff, promote a climate in which information is shared effectively, promote decision making at the staff nurse level, exert position power, and influence coordination of work to provide a milieu that maintains a stable cadre of nurses.