Nursing in critical care
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Nursing in critical care · Jul 2011
Nursing documentation prior to emergency admissions to the intensive care unit.
Early identification of prodromal signs of acute deterioration of patients is essential in high quality care. Rigorous monitoring of patients is facilitated by risk assessment tools, e.g. the Modified Early Warning Score (MEWS). ⋯ Respiratory failure was the primary cause of emergency admission of in-patients to the ICUs with respiratory rate the least documented vital sign. Nursing documentation according to the MEWS was insufficient. CONCLUSIONS/RELEVANCE TO CLINICAL PRACTICE: Nurses need to be alerted to the necessity of documenting early signs of deterioration of patients, particularly the respiratory rate. With better monitoring and documentation of physiological parameters, emergency admission to the ICU might be avoided.
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Nursing in critical care · Jul 2011
Case ReportsAcute cardiogenic pulmonary oedema: reflecting on the management of an intensive care unit patient.
The aim of this paper is to reflect upon the management interventions of non-invasive ventilation (NIV) and diuretic therapy that were implemented for a patient admitted to an intensive care unit (ICU) with acute cardiogenic pulmonary oedema. ⋯ By using a reflective analysis approach, this paper highlights how reflecting on practice improves knowledge and understanding of the use of NIV and diuretic therapy interventions and should facilitate nurses working in ICU to become more competent in ensuring that the treatment provided for acute cardiogenic pulmonary oedema is as successful as possible.
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Nursing in critical care · May 2011
Conversations in end-of-life care: communication tools for critical care practitioners.
Communication skills are the key for quality end-of-life care including in the critical care setting. While learning general, transferable communication skills, such as therapeutic listening, has been common in nursing education, learning specific communication tools, such as breaking bad news, has been the norm for medical education. Critical care nurses may also benefit from learning communication tools that are more specific to end-of-life care. ⋯ These communication tools offer nurses new strategies for approaching potentially difficult and emotionally charged conversations. A case example illustrated strategies for applying these skills to clinical situations. The three tools assist critical care nurses to move beyond compassionate listening to knowing what to say. Ask-Tell-Ask reminds nurses to carefully assess concerns before imparting information. Tell Me More provides a tool for encouraging dialogue in challenging situations. Finally, SBAR can assist nurses to distill complex and often long conversations into concise and informative reports for colleagues.
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Nursing in critical care · May 2011
The critical care nurse's role in end-of-life care: issues and challenges.
The purpose of this article is to discuss the challenges critical care nurses face when looking after patients needing End-of-Life (EoL) care in critical care environments. ⋯ Critical care nurses have an essential role in the provision of effective EoL care; however, this dimension of their role needs further exploration. It is noted that educational opportunities need to be provided for critical care nurses to increase the knowledge on planning and delivering EoL care. To inform this evaluation of current EoL care provision in critical care is necessary to address a knowledge deficit of the needs of nurses who seek to support patients and their families at a critical time.
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Nursing in critical care · May 2011
ReviewParental perceptions of end-of-life care on paediatric intensive care units: a literature review.
The aim of this study was to review the literature relating to parental perceptions on what constitutes quality end-of-life care (ELC) at the time of their child's death in paediatric intensive care units (PICUs). ⋯ Although the retrospective nature of the studies reviewed presents some limitations, it does provide a broad overview of the characteristics of parental needs, indicating the scope for further empirical research. The identification and acknowledgement of the fundamental needs of parents at this time can enable health professionals to provide competent and compassionate ELC which is as focussed and evidence based as other aspects of paediatric critical care medicine.