Nursing in critical care
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Nursing in critical care · Mar 2008
Randomized Controlled Trial Comparative StudyComparison of complications and procedural activities of pulmonary artery catheter removal by critical care nurses versus medical doctors.
None of the nursing studies on PA catheter removal pointed out any differences in complications after removal and procedural activities for removal of PA catheter by CCNs vs MDs in Turkey. ⋯ Instructing CCNs to remove a PA catheter has been highlighted in keeping the number of complications associated with removal procedure of PA catheter.
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A medical emergency team (MET) comprises of a team of doctors and nurses with advanced life support skills, which are hospital based, who respond to emergency calls following a deterioration in a patient's clinical condition. The role and contribution of such approaches promoting the early recognition and intervention of these vulnerable patients demands critical appraisal. ⋯ The majority of published work relating to MET systems was conducted in single-centres. The introduction of MET systems appears to be linked to a reported reduction in adverse outcomes and early recognition and intervention in clinically deteriorating patients. Additionally, a consistent observation in the studies reviewed was the reported presence of clinically abnormal physiological observations prior to the clinical events such as the cardiac arrest. The evidence in support of MET or equivalent systems, is not straightforward. Issues such as education, resources (human and financial) and communication are vital to success with implementation. Responding promptly to patients who unexpectedly become acutely ill demands skill and competence; however, more research evaluating the role of early 'response' systems is warranted.
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Nursing in critical care · Mar 2008
ReviewSedation breaks: are they good for the critically ill patient? A review.
Tradition has led us to believe that a heavily sedated patient is a comfortable, settled, compliant patient for whom sedation will improve outcome. The current move witnessed in clinical practice today of limiting sedation has led health care in recent years to question the benefit and necessity of routine, continuous sedation for all patients requiring mechanical ventilation. However, as a result there has been a rise in the amount of agitation being reported as being experienced by patients with the daily withdrawal of sedation. ⋯ The recommendations of this review are that nurses should re-commence sedation if the patient becomes agitated following a sedation break.
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Nursing in critical care · Mar 2008
Development in service provision. Making major elective surgery happen. The development of a postoperative surgical unit.
Optimizing the provision of elective surgery and reducing waiting list times for elective surgery has been a central theme in this government's health-care agenda. The negative impacts of high levels of cancelled surgery have significant implications, for both patient and health-care resources. ⋯ This small project has illustrated how POSU has had a positive impact on decreasing the waiting list times and led to low levels of cancelled major elective surgery. These outcomes have resulted in improvements in delivery of services to patients and in the utilisation of resources.