Nursing in critical care
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A number of interventions have been shown to improve the outcomes of patients who are invasively ventilated in intensive care units (ICUs). However, significant problems still exist in implementing research findings into clinical practice. The aim of this study was to assess whether the systematic and methodical implementation of evidence-based interventions encapsulated in a care bundle influenced length of ventilation and ICU length of stay (LOS). ⋯ Unit patient throughput increased by 30.1% and the number of invasively ventilated patients increased by 39.5%. Care bundles encourage the consistent and systematic application of evidence-based protocols used in particular treatment regimes. Since the introduction of the ventilator care bundle, length of ventilation and ICU LOS have reduced significantly.
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Nursing in critical care · Jul 2005
Nurses' knowledge of chest drain care: an exploratory descriptive survey.
Chest drains are a common feature of patients admitted to acute respiratory or cardio-thoracic surgery care areas. Chest drains are either inserted intraoperatively or as part of the conservative management of a respiratory illness or thoracic injury. Anecdotally, there appears to be a lack of consensus among nurses on the major principles of chest drain management. ⋯ Several service-led options exist with regard to improving knowledge in this area, such as service study days as well as ward-based tutorials. However, in an era of increasing accountability together with the impetus for each nurse to provide evidence-based care, it is crucial for individual nurse responsibility in the pursuit of knowledge in this area. Nurses must be supported by local practice development and through personal portfolio use to identify gaps in knowledge and seek appropriate training and resources.
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Nursing in critical care · Jul 2005
The handover process and triage of ambulance-borne patients: the experiences of emergency nurses.
One of the most important tasks that a nurse faces in the emergency room, when receiving a patient, is handover and the triage function. The aim of the study was to explore the experiences of nurses receiving patients who were brought into hospital as emergencies by ambulance crews through an analysis of the handover and triage process. A qualitative descriptive interview study inspired by the phenomenological method was used with six emergency nurses. ⋯ The handover function was pivotal in ensuring that the patient received the correct care and that care was provided at the appropriate level. The most seriously afflicted patients arrived by ambulance; therefore, the interplay between pre-hospital and hospital personnel was vital in conveying this important information. To some extent, this functioned well, but this research has identified areas where this care can be improved.
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Nursing in critical care · May 2005
Review Comparative StudyGoing home from ICU to die: a celebration of life.
There is much literature regarding going home to die in terminally ill cancer patients however, little is written about withdrawing treatment at home in critical care. One intensive care unit's experience in New Zealand demonstrates how this can be done safely. ⋯ There are challenges to be overcome including supportive resources in the community, staffing and safety of the patient and family. It is possible to withdraw/withhold treatment in a patient's home and this is highly valued by the families.
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As a professional group, nurses, whether as academics or practitioners, are increasingly expected to contribute to the development of quality nursing care and service provision by disseminating the findings of research, sharing innovations in clinical practice or examples of best practice. Yet, many individuals find it difficult to write informatively about their practice or to translate the outputs of academic studies into accessible publications. However, in most instances, a lack of confidence remains a key obstacle as is the lack of familiarity with processes required in preparing a paper for publication. ⋯ The main body of the paper provides a detailed analysis on the importance of deciding what to write about, selecting a suitable journal, organizing the content and structure of a paper and using appropriate language to make the article more accessible to the audience. The discussion also explores the concepts of authorship order, peer-review process and how to respond to written reviewer's comments once the paper has been returned by the publishers. The paper concludes by stressing that success requires undertaking the necessary preparatory work, time, commitment and enthusiasm.