Aust Crit Care
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Patient care within an intensive care unit (ICU) can be a difficult and stressful task for even the most experienced and skilled critical care nurse. Good communication between the patient, relatives and nurse is integral to quality care of the patient and should extend to the entire health-care team. This article reviews the literature on nurse-patient communication in the ICU. ⋯ The literature indicates that nurses communicate extremely poorly with patients, despite a high level of knowledge and skill with respect to communication. Tentative explanations of high stress levels, a preoccupation with physical care and technology, and the attraction to critical care areas of nurses with specific personality types are discussed as possible reasons for this. The need for further research into, and attempts to alleviate, this problem is clearly demonstrated.
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Review
Use of continuous positive airway pressure (CPAP) in the critically ill--physiological principles.
CPAP therapy helps improve oxygenation in patients who are awake and able to maintain a good respiratory drive. In many cases this means that intubation and ventilation can be avoided. The main goals of CPAP are to minimise alveolar collapse, improve compliance, decrease work of breathing and improve ventilation/perfusion matching. ⋯ As CPAP has developed into a common therapy for patients with respiratory failure, it is essential that nurses using this therapy are familiar with the equipment and the physiological effects it produces. Assessment and management of the patient receiving CPAP therapy are also important. This paper will address the physiological principles of CPAP therapy so that nurses working with critically ill patients receiving CPAP therapy understand the system and are accurate and astute in their respiratory assessment, in order to provide optimum care.
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Review
Measuring the health outcomes of general ICU patients: a systematic review of methods and findings.
Studies that have measured patient outcomes following a critical illness and admission to a general intensive care unit (ICU) have used a variety of methods and variables. Traditionally, the measures have been mortality and morbidity, but they now also include assessment of indices such as functional status, health status, quality of life and patient satisfaction. This review paper examines 31 previously published primary studies that measured patient outcomes from adult general ICUs. ⋯ In addition, the heterogeneity of the ICU population in terms of age, acuity and diagnoses complicates any potential comparisons. There is an opportunity for further studies in this area by nurse researchers, in either intra- or multidisciplinary teams. Future studies should incorporate rigorous methodologies and a triangulated approach, in order to adequately examine patient outcomes following a critical illness and admission to a general ICU.