Aust Crit Care
-
Multicenter Study
Certainty and uncertainty about end of life care nursing practices in New Zealand Intensive Care Units: a mixed methods study.
With end-of-life (EOL) central to the nursing role in intensive care, few studies have been undertaken to explore EOL care in the context of New Zealand (NZ) intensive care nursing. ⋯ Whilst results from this NZ study broadly align with European studies, uncertainty about specific areas of EOL practices highlight that further guidance for nurses is required.
-
Multicenter Study
Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: nurses' emotional talk and sources of discomfort. A mixed methods study.
The majority of in-hospital deaths of children occur in paediatric and neonatal intensive care units. For nurses working in these settings, this can be a source of significant anxiety, discomfort and sense of failure. ⋯ This study provided rich insights into the experiences of nurses who are caring for dying children including the nurses' need to balance the often aggressive treatments with preparation of the family for the possibility of their child's death. There is some room for improvement in nurses' provision of anticipatory guidance, which encompasses effective and open communication, focussed on preparing families for the child's death.
-
This research appraisal, guided by the CASP Randomised Controlled Trial Checklist, critiques a randomised, controlled trial of patient-directed music therapy compared to either noise-cancelling headphones or usual care. This study recruited 373 alert, mechanically-ventilated patients across five intensive care units in the United States. The Music Assessment Tool, administered by a music therapist, facilitated music selection by participants in the intervention group. ⋯ While some participants utilised the intervention or active control for many hours-per-day, half the music therapy participants listened for 12min or less per day and half of the noise-cancelling headphone participants did not appear to use them. While the results suggest that patient-directed music therapy and noise-cancelling headphones may be useful and cost-effective interventions that lead to an overall improvement in anxiety and sedation exposure, these may appeal to a subset of ICU patients. The self-directed use of music therapy and noise-cancelling headphones means these findings may not transfer to sedated or cognitively-impaired patients.
-
The extent and application of patient diaries in Australian intensive care units: a national survey.
Critical illness can be a psychological stressor for patients and family members. Scandinavian studies have portrayed patient diaries as a supporting catalyst for patients and their families through a process of reflection and fact presentation. However, the small number of randomisation trials exhibits theoretical and methodological limitations. Given the increased interest amongst Australian Critical Care Nurses, further understanding of nurses' perceptions and use of patient diaries was warranted. ⋯ Patient diary use appears to be in its infancy in Australia with a lack of guiding policy for format and processes including evaluation. Nurses using diaries were enthusiastic about the initiative, holding optimistic perceptions about the potential positive impact of diaries on patient and family outcomes. Further research on their efficacy is required.