American journal of critical care : an official publication, American Association of Critical-Care Nurses
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In 1997, the AACN Certification Corporation, in conjunction with Professional Examination Service, undertook a role delineation study as 1 component of a large-scale, comprehensive, and systematic study of practice to update previous data. Focus groups made up of practicing critical care nurses were used to determine trends and changes in adult, pediatric, and neonatal critical care nursing practice. ⋯ The results of these focus groups can be used to update the test blueprints that underlie the CCRN certification examination programs for adult, pediatric, and neonatal critical care nurses. Critical care nursing practice is changing. Specific knowledge of the changes is important for educators, managers, and clinicians. The results of this role delineation study can be used to teach, adapt systems, and validate practice.
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Nurses have not been formally trained in assessing the oral status of patients in intensive care units, and no oral care protocols for these patients are available. ⋯ Implementation of a well-developed oral care protocol by bedside nurses can improve oral health of patients in the intensive care unit.
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Comparative Study
Reliability of an intravenous intermittent access port (saline lock) for obtaining blood samples for coagulation studies.
Patients admitted to rule out myocardial infarction often receive a heparin infusion that requires measurement of partial thromboplastin time every 6 to 8 hours until coagulation values stabilize. If the patient's acuity at admission does not necessitate placement of arterial or central catheters, insertion of an intermittent intravenous access port (saline lock) would decrease the need for frequent venipuncture. Many studies on obtaining blood samples via arterial and central catheters have been reported, but no reports have described the method of using a saline lock or the amount of blood discarded during that procedure. ⋯ The untoward effects of frequent venipunctures to obtain blood samples for measurement of prothrombin and partial thromboplastin times can be lessened by using an 18-gauge saline lock to obtain blood samples and discarding the first 0.5 mL of blood withdrawn before the samples for coagulation studies are collected.
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Randomized Controlled Trial Clinical Trial
The effect of earplugs on sleep measures during exposure to simulated intensive care unit noise.
Sleep deprivation may contribute to impaired immune function, ventilatory compromise, disrupted thermoregulation, and delirium. Noise levels in intensive care units may be related to disturbed sleep patterns, but noise reduction has not been tested in this setting. ⋯ The results provide a reasonable basis for testing the effects of earplugs on the sleep of critically ill subjects.
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Randomized Controlled Trial Clinical Trial
Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction.
Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. ⋯ Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.