Nursing in critical care
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Nursing in critical care · Jul 2008
Experiences of intensive care nurses assessing sedation/agitation in critically ill patients.
Patients admitted to the intensive care unit (ICU) will more often than not require sedative and analgesic drugs to enable them to tolerate the invasive procedures and therapies caused as a result of their underlying condition and/or necessary medical interventions. ⋯ This paper reinforces the potential benefits to patients as a direct result of implementing the SAS scoring tool and clinical guidelines. Furthermore, it highlights the reluctance of a number of staff to adhere to such guidelines and discusses the concerns regarding less experienced nurses administering sedative agents. Attention was also drawn to the educational requirements of nursing and medical staff when using the SAS scoring tool.
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Nursing in critical care · May 2008
ReviewTherapeutic hypothermia following cardiac arrest: a review of the evidence.
This paper aims to undertake a review on the current evidence available on therapeutic hypothermia (TH) following cardiac arrest. ⋯ All adult patients who have return of spontaneous circulation and remain unconscious following cardiac arrest should be considered for TH between 32 degrees C and 34 degrees C for at least 12-24 h as this will improve patient mortality and morbidity. Acute hospitals need to devise policies and guidelines on the use of TH following cardiac arrest that include methods on how to achieve effective cooling by cold i.v. infusions, ice packs or purchasing specific cooling mattresses.
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Nursing in critical care · May 2008
ReviewEnd-of-life care in UK critical care units--a literature review.
To appraise literature concerning end-of-life care (ELC) in adult critical care units in the UK in order to improve clinical practice. ⋯ Although medico-legal decision-making is not part of their professional role, critical care nurses have an extraordinary opportunity to make a difference to the dying patient and their family and their acceptance of death.
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Between 2002-2005 the Trust undertook an action research project to evaluate a corporate practice development strategy. During this period clinicians became practitioner-researchers utilising a variety of methods to evaluate the influence of practice development. One aspect of this focused upon evaluation of evidence based guidelines. This article concentrates upon this process and the learning from this within critical care. ⋯ Action resulting from analysis of the findings of cycle 1 led to a cultural change in which the structure of a tool such as the AGREE instrument could be beneficial in the development of future guidelines. This has been sustained both within critical care and Trust wide with various initiatives such as the establishment of critical care multidisciplinary guideline development groups and a Trust wide electronic library management system.