Nursing in critical care
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Nursing in critical care · Sep 2004
Standardizing the assessment of clinical competence: an overview of intensive care course design.
Rationale for the development of the Certificate in Health Studies: Intensive Care and High Dependency for Adults course developed at Queens University Belfast, Northern Ireland. Structure and content of clinical module reviewed. ⋯ Focus on the utilization of a standardized portfolio, individualized learning contract and objective structured clinical examination (OSCE) to evaluate clinical competence. Evaluation of OSCE as an assessment tool and of the course provision.
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Nursing in critical care · Jul 2004
Patients' dreams and unreal experiences following intensive care unit admission.
Dreams and unreal experiences occur commonly in critically ill patients admitted to intensive care unit. This study describes 31 patients' dreams and explores the relationship between patients' subjective recall 12-18 months after intensive care unit discharge and their observed behaviour during their intensive care unit stay. Semi-structured interviews revealed that 74% of longer-term ICU patients (> or = 3 days) reported dreaming, with the majority also describing frightening hallucinations. Only two patients reported long-term negative psychological sequelae, but the short-term consequence of hallucinations may also have an undiscovered impact on patients' recovery.
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Nursing in critical care · May 2004
ReviewGastric tonometry and monitoring gastrointestinal perfusion: using research to support nursing practice.
The principles and physiological underpinnings of gastric tonometry are reviewed. Tonometric variables, including the PtCO2, pHi and CO2 gap, are described and critiqued as measurements of gastrointestinal perfusion. ⋯ The technical limitations of gastric tonometry, including procedural errors and PtCO2 measurement are discussed in relation to the accuracy of tonometric measurements. Tonometric measurement using semi-continuous air tonometry is introduced as a strategy to minimize technical limitations.
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Nursing in critical care · May 2004
Introducing an early warning scoring system in a district general hospital.
One of the critical care outreach service's aims in this local hospital was to develop an assessment tool to help identify patients in danger of deterioration. This paper describes the introduction of an early warning scoring system between April 2001 and March 2002 to the surgical unit of a district general hospital. ⋯ Explanations are given of the training processes undertaken, the pilot evaluation and lessons learned from the process. Using the experiences of the outreach service in introducing the early warning scoring system, this paper aims to provide thought for others considering a similar initiative in their area
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Nursing in critical care · May 2004
'Do not attempt resuscitation' decision-making: a study exploring the attitudes and experiences of nurses.
At the time of the research being undertaken, a policy regarding resuscitation decisions did not exist at a local hospital. However, it was proposed that a new 'do not attempt resuscitation' policy should be implemented. Nurses' attitudes to, and experiences of, the communication involved in 'do not attempt resuscitation' decision-making were explored and compared with five variables (nurses' age, nurses' grade, years of nursing, area of nursing practice and length of nursing experience on current ward). ⋯ There were no significant differences between nurses' attitudes to current 'do not attempt resuscitation' decision-making and the five variables. However, there was one significant difference identified between nurses' experiences and the area of nursing practice (p=0.008). To adhere to the principles of the forthcoming 'do not attempt resuscitation' policy at the local hospital, the research findings have suggested that changes need to occur to both nurses' attitudes to and nurses' experiences of current 'do not attempt resuscitation' decision-making.