Aust Crit Care
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In February 1991, the Intensive Care Unit (ICU) at Liverpool Hospital was extended and relocated to a larger area. It soon became apparent that noise levels within the newly renovated unit were particularly worrying to patients, staff and relatives. A Continuous Quality Improvement (CQI) group was formed to investigate, and develop measures to reduce these noise levels. ⋯ The results of the CQI investigations revealed that there was an inappropriately high level of noise in the ICU. Several key contributing factors were also identified. These findings provided the basis for several positive measures to be undertaken including: the installation of sound absorbing ceilings; removal of rubbish bin lids; revision of the telephone ringing system; revision of the mobile x-ray machine; prioritisation of audible machine alarms; education of staff in noise level awareness; The application of the Continuous Quality Improvement (CQI) process to the noise problem facilitated the exploration of the source of noise, the effects on staff and patients, and ways to reduce noise levels in the intensive care environment.
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This descriptive study looked at how nurses positioned the critically ill person in the Intensive Care Unit. Its objective was to identify what positions were utilised, and whether severity of illness influenced this choice. ⋯ As the severity of illness increased, more horizontal positions were utilised. These findings and review of the literature highlights a need for further research into specific aspects of the use of position during critical illness.
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Critical care management and staffing levels are under constant review to ensure efficient staff utilisation and to apply structural efficiency principles. The staffing of our general intensive care unit was reviewed and reorganised creating what we believed to be an unsafe environment. As a group of Clinical Nurse Specialists (CNS) and critical care Registered Nurses (RN) we investigated the after hours management of the unit using a retrospective study and a current practice survey which we submitted to our administration. The data collected provided us with a strong case against reclassification of the Team Leader position and illustrates the need for clinicians to look objectively into current issues to support all discussions and concerns.