Nursing in critical care
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Nursing in critical care · May 2003
A bereavement after-care service for intensive care relatives and staff: the story so far.
The Intensive Care Society (1998) developed Guidelines for Bereavement Care in Intensive Care Units. In response to the guidelines, a group of nurses from the intensive care units at Glenfield Hospital in Leicester have developed a bereavement after-care service for relatives and staff. So far, the service has evaluated well from the feedback received from both relatives and staff, but evaluation is ongoing and the service is being continually developed.
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The effects of critical illness not only affect the patient and relative during the intensive care stay but often affect for a considerable time afterwards. A growing body of opinion and evidence suggests that many of the needs of those who have been critically ill can be met through critical care follow-up services. ⋯ This paper describes Bassetlaw hospital's critical care follow-up service, how it was established and what an elementary service evaluation project has shown. The findings and experiences are compared with others in published literature, and the paper may be of interest to those who are currently involved in follow-up or who plan to develop such services in the future.
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Nursing in critical care · Mar 2003
Immediate follow-up after ICU discharge: establishment of a service and initial experiences.
Follow-up of patients discharged from the intensive care unit (ICU) is recommended as a means of service evaluation (Department of Health (2000). Comprehensive Critical Care: a Review of Adult Critical Care Services), in order to monitor the quality of the services provided Without patient follow-up, ICU staff have only 'death' or 'discharge alive from hospital' as clinical outcomes from which to judge practice performance, and limited evidence exists on which to base decisions about improvements to critical care practice (Audit Commission (1999). Critical to Success--the Place of Efficient and Effective Critical Care Services Within the Acute Hospital) To address these issues the Regional Intensive Care Unit (RICU) obtained information from patient assessment/interview on problems experienced by patients within 8-9 days (mean), following discharge from RICU A nurse-administered questionnaire was used to identify functional outcomes, nutrition and psychological issues such as anxiety and sleep disturbances Benefits of patient follow-up introduced and planned include: patient diaries for long-term patients, input from clinical psychologis, review of sedation used in RICU.
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High dependency care is a rapidly evolving area of critical care, with high patient turnover, which ultimately leads to high levels of pressure for beds. There is a growing trend emerging, recognizing the importance and value of nurse-led initiatives in delivering effective nursing care in acute care settings. ⋯ An audit of the current practice was undertaken, which ultimately led to the implementation of NLD. Early experiences indicate that HDU beds are now being used more effectively.