Nursing in critical care
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Nursing in critical care · May 2019
Nurses' perceptions of intensive care unit palliative care at end of life.
Significant barriers can block the provision of palliative care at the end of life in the intensive care unit (ICU). However, the relationship between perceptions of ICU quality palliative care and barriers to palliative care at the end of life is not well documented. ⋯ Barriers to palliative care are still common in the ICU. Increased training and education are recommended to decrease barriers and improve the quality of ICU palliative care.
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Nursing in critical care · May 2019
Outcomes and experiences of relatives of patients discharged home after critical illness: a systematic integrative review.
Patients discharged from intensive care may experience psychological and physical deficits resulting in a long and complex rehabilitation upon discharge. Relatives are also vulnerable to psychological pathologies and diminished health-related quality of life following the patients' critical illness. Relatives often provide care during the patients' rehabilitation, which may influence their health. ⋯ If informal care giving is to be sustainable, there is a need to design effective strategies of supporting families through all stages of the critical illness trajectory.
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Nursing in critical care · Mar 2019
Unintentional endotracheal tube cuff deflation during routine checks: a simulation study.
Endotracheal tube cuff pressures should be maintained between 20 and 30 cm H2 O to prevent the aspiration of subglottic secretions past the cuff. Guidance recommends regular monitoring of the cuff pressure, performed using a handheld manometer/inflator. Poor technique can lead to transient deflation of the cuff, leading to the bolus aspiration of upper respiratory tract secretions, tracheal colonization and, ultimately, ventilator-associated pneumonia. ⋯ Cuff deflations can easily occur during routine cuff pressure checks. Staff should be aware of the implications of cuff deflations and seek to improve training with manometers.
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Nursing in critical care · Mar 2019
Frequency and outcome of post-extubation dysphagia using nurse-performed swallowing screening protocol.
Post-extubation dysphagia reportedly occurs in 3%-60% of patients and is independently associated with poor patient outcomes. ⋯ The current study emphasizes the poor prognosis of patients with dysphagia after extubation. Dysphagia developed in more than 1 in 10 patients post-extubation; therefore, monitoring for a swallowing disorder is crucial in daily nursing in the intensive care unit.
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Nursing in critical care · Jan 2019
Lived experiences of intensive care nurses in caring for critically ill patients.
Caring for critically ill patients requires competent nurses to help save and secure the lives of patients, using technological developments while maintaining humanistic care. Nepal is a developing country with limited advanced technologies and resources. It is important to understand nursing care for critically ill patients under these shortages. ⋯ Intensive care nurses need to enhance their knowledge and skills related to the use of technologies and patient care by attending training programs and gaining further education. This study recommends that hospital administrators should support sufficient facilities and technologies of care and, in particular, increase the competency of nurses in caring for critically ill patients as the whole person.