Aust Crit Care
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Review Meta Analysis Comparative Study
Pharmacological versus non-pharmacological antipyretic treatments in febrile critically ill adult patients: a systematic review and meta-analysis.
Fever is common in critically ill patients and there are myriad of antipyretic and cooling treatments used. A systematic review was undertaken of the safety and efficacy of methods used to reduce fever. ⋯ Additional studies are needed to explore and clarify the role of antipyretic treatments in febrile critically ill adult patients.
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Randomized Controlled Trial
Should gastric aspirate be discarded or retained when gastric residual volume is removed from gastric tubes?
Nursing care of patients with enteral feeding tubes is common in the intensive care unit but the evidence that surrounds the practice is limited. Recent research by Juve-Udina and colleagues (2010) "To return or to discard? Randomised trial on gastric residual volume management" compares two methods of managing gastric residual volume. This critique provides a brief summary of their research and critically appraises the paper. The implications for nursing practice are discussed.
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To determine the relationship between paracetamol administration and skin blood flow (skBF) and blood pressure (BP) in critically ill patients treated for fever. ⋯ Paracetamol induced increases in skBF consistent with its antipyretic action and may be associated with significant falls in BP in the critically ill.
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Comparative Study
Determination of body weight and height measurement for critically ill patients admitted to the intensive care unit: A quality improvement project.
Measuring body weight and height of critically ill patients in intensive care often challenge nurses. Estimated weight and height is thought to be inaccurate. This quality improvement project was to determine one effective method of how all patients in intensive care unit (ICU) could be measured and weighed accurately and cost effectively. The determined method also was to be Occupation Health and Safety safe, adhere to infection control standards and minimises risks of patient handling. The focus for this quality improvement was that the measurement methods were to be utilised in conjunction with a baseline patient assessment in the ICU. ⋯ It was found that critically ill patients could be weighed effectively and accurately with a scale usable for every type of bed available in this ICU. All supine positioned patients can also be measured effectively and accurately with one height measurement method. These methods do not require the patient to be moved. There is no need to disconnect lines or monitoring equipment at any time during the measuring procedures.
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To achieve improvement in healthcare quality and safety, all four domains (outcome, process, structure and culture) must be considered in conjunction with the best available clinical evidence to improve patient care and reduce harm. A range of improvement initiatives have targeted processes of care in recognition of: (1) complexities of patient care and (2) evidence that a large portion of adverse events are preventable, occur during ongoing care, and result in poorer patient outcomes. ⋯ This integrative review has outlined potential for achieving practice improvements in intensive care and highlighted the need for further evaluative research to improve patient care at the bedside.