Nursing in critical care
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This practice development review describes how the introduction of hypertonic saline in the treatment of raised intracranial pressure was brought about in one critical care unit. It considers the need for staff education and patient safety as an integral part of the change process. ⋯ Critical care and neurosurgical nurses need to be aware of the potentially serious side effects, actions and correct methods of administration of hypertonic saline to ensure its safe use and ensure patient safety. Effects and side effects of hypertonic saline are described, highlighting the need for care in introducing such agents into a clinical area. The methodology used was an electronic search. The change in practice relates to the introduction of hypertonic saline, but could be adapted for any change in clinical nursing practice.
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Nursing in critical care · Mar 2012
Critical care outreach referrals: a mixed-method investigative study of outcomes and experiences.
To explore referrals to a critical care outreach team (CCOT), associated factors around patient management and survival to discharge, and the qualitative exploration of referral characteristics (identifying any areas for service improvement around CCOT). ⋯ Mapping outreach episodes of care and patient outcomes can help highlight areas for improvement. This study outlines reasons for referral and how outreach can facilitate patient pathways in critical illness.
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This article reviews the current evidence, benefits and drawbacks for the use of continuous lateral replacement therapy in the treatment and prevention of nosocomial infections in the ventilated patient. ⋯ While there is some data to suggest that CLRT may have an impact on prevention of and treatment for nosocomial infections acquired by ventilated patients, there still remains insufficient evidence to its inclusion as a fully validated treatment. Clearly, there is a requirement for more robust, in-depth research into the efficacy of this proposed treatment.
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Nursing in critical care · Jan 2012
Critical care patients' experience of the helmet continuous positive airway pressure.
Continuous positive airway pressure (CPAP) is a common treatment modality for acute respiratory failure (ARF) in critical care. Historically, a tight-fitting mask is used to provide respiratory support. This however is not without risks to the patient. The helmet CPAP is a new product that provides the same treatment with a different method of delivery. There is minimal evidence to date explaining the patient's experience of the new helmet modality. ⋯ The study has provided an insight into the patient's experience of helmet CPAP in the critical care setting. The findings have provided a basis for policy and guideline development. It will also assist in developing future patient focused care.
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The aim of this article was to provide a resource for critical care nurses wishing to further their understanding of inotropic drugs used in critical care. The physiology of cardiac output and blood pressure is examined along with an explanation of adrenergic receptors acted on by inotropes. ⋯ Frequently, observed side effects of individual inotropes are also offered, enabling the nurse to maintain patient safety when administering these potent drugs. Some major nursing and professional issues related to inotrope therapy and medicine administration are discussed, as well as some recommended practices in renewing infusions.