Aust Crit Care
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Nurses are usually the first to identify delirium in ICU patients. We aimed to assess the attitudes of Australian critical care nurses when we introduced the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). ⋯ Critical care nurses in our Australian ICU who responded to our survey think delirium assessment is important. Although they find unstructured assessments easier to perform, they wanted to persist with the CAM-ICU, in part because it facilitated more appropriate pharmacological treatment of delirium for their patients. We recommend the CAM-ICU as a tool to improve communication between nurses and physicians in the management of delirium.
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Case Reports
A case of pressure ulceration and associated haemorrhage in a patient using a faecal management system.
Diarrhoea is a difficult patient problem to manage in the intensive care setting, causing odour, discomfort and embarrassment for the patient and potential for loss of skin integrity and cross contamination. Caring for these patients is resource-intensive. A recently developed product for the management of faecal incontinence is the Flexi-Seal Faecal Management System (FMS(©)). ⋯ Similar complications have been described by others. Although, based on the number of reported complications, the incidence of serious complications appears to be low, a publication bias cannot be ruled out. Knowledge of the complications associated with the device is important for evaluating the appropriateness of insertion and for ensuring the safe and effective on going care of patients using Flexi-Seal FMS(©).
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Why don't intensive care nurses perform routine delirium assessment? A discussion of the literature.
Delirium is a well recognised and serious problem in adult intensive care patients. With a reported incidence as high as 87%, it has been associated with increased length of stay, higher costs of care, ongoing cognitive impairment and increased mortality rates. ⋯ The aim of this paper is to discuss what is currently known about intensive care nurses' attitudes and beliefs in relation to caring for adults who are experiencing delirium, with a focus on identifying possible barriers to formal delirium assessment. It will be argued that intensive care nurses are well placed to perform regular delirium assessment and therefore have a responsibility to promote an improvement in delirium assessment practices.