American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Readiness of critical care physicians and nurses to handle requests for organ donation.
Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. ⋯ Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.
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Understanding the challenges faced by family members involved in decisions about the use of life-sustaining treatment for incompetent patients in the ICU is necessary for developing empirically based supportive interventions. ⋯ Family members of patients in the ICU are willing and able to take responsibility for decisions about the use of life-sustaining treatment for their loved ones. The long-term acceptance of the experience and the decisions made depends greatly on the interactions between the family member who makes the decision and nurses and physicians in the clinical setting.
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Approximately half of the families asked to consider donation of a relative's organs decline to give consent. Understanding the difference between stated public support of organ donation and actual behavior is key to decreasing the shortage of donor organs. ⋯ Organ donation rates could be increased by enhancing the quality of hospital care and ensuring that the request for donation is handled in a way that meets the families' informational and emotional needs.
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Outcomes management that uses critical pathways may decrease costs while improving outcomes for patients who require prolonged mechanical ventilation. ⋯ Outcomes-managed care did not have a significant effect on duration of ventilation, length of stay in the hospital, or outcome in patients receiving long-term mechanical ventilation.
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Comparative Study
Hemodynamic monitoring: a comparison of research and practice.
Measurement of hemodynamic parameters is a common practice and is well researched, but little information is available on the translation of the research into actual practice. ⋯ Research findings are generally being implemented at the bedside, although not completely or consistently. Minimizing the barriers to use of research is within the scope of nurses' practice.