Nursing in critical care
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Nursing in critical care · Jul 2002
Interviewing as therapy: researching parents' experiences of their child's life-threatening illness requiring ECMO.
This retrospective study explores the views of eight parents' experience of their child's critical illness requiring extracorporeal membrane oxygenation (ECMO) as to whether the same research investigation might be carried out contemporaneously It is acknowledged that a viewpoint elicited retrospectively may be altered by time and, therefore, in advance of any such prospective study being carried out, ethical concerns regarding the gathering of data at such a traumatic time must be given consideration In addition to material collected for the primary study, further data were gathered in order to elicit how the research process itself was defined and experienced by the parent participants Views were elicited through an informal debriefing interview immediately following the primary research interview and a follow-up, evaluative, postal questionnaire distributed one week later.
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In the absence of nationally accepted critical care competencies, each educational institution providing critical care programmes is forced to define the essential competencies necessary for practice, leading to variations in expected practice and the emergence of 'postcode' competencies. This research report aims to build upon competency activity for all areas of nursing practice within critical care levels 1, 2 and 3. A functional analysis to elicit core critical care competency statements was conducted and a modified Delphi technique was used to generate consensus opinion from a pan-London purposive sample of nurses working in critical care. ⋯ Consensus agreement of 80% was achieved with mean agreement scores that exceed 97%. A core critical care competency framework was refined and developed by expert nurses drawing on their own experience and knowledge of critical care nursing. The framework could be useful to: educationalists designing competency-based curricula; critical care managers as a tool for recruitment and retention and for education and training of staff; individual critical care nurses to facilitate continuous professional development.
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Nursing in critical care · May 2002
Measuring respiratory function to wean patients from non-invasive ventilation in a ward environment.
Non-invasive ventilation (NIV) is increasingly being introduced into various ward environments. NIV is usually used on wards to treat acute exacerbations of chronic obstructive pulmonary disease (COPD). ⋯ Obtaining arterial blood gas samples in a ward environment is problematic, and potentially dangerous. There is currently no reliable substitute for arterial sampling to monitor for hypercapnia in ward areas.
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Patients with acute lung injury pose significant problems for the intensive care team. The use of the prone position with these patients is attracting increasing interest. Information on the practicalities of proning was obtained from other intensive care units by using a simple questionnaire. The necessity for nursing guidelines for proning is discussed, and the consequent development of these is described.