Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2007
ReviewNeuromuscular blocking agents: enhancing safety by reducing the risk of accidental administration.
Neuromuscular blocking agents (NMBAs) are often found as ward stock in critical care units to ensure their availability in case of urgent need. The unintentional administration of an NMBA to a non-intubated and non-ventilated patient can result in severe permanent injury or death. Incidents involving mix-ups with NMBAs have occurred within and outside of critical care units. Case reports are highlighted with the intent to increase practitioner awareness of situations that could lead to similar errors and to promote changes in the critical care environment in order to enhance medication safety with NMBAs.
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Dynamics (Pembroke, Ont.) · Jan 2007
Case ReportsEpidural medications given intravenously may result in death.
Anesthetics, such as bupivacaine, intended for epidural analgesia can cause severe cardio- and neurotoxicity when inadvertently administered via the intravenous route. This article highlights a case report and the dangers associated with the inadvertent administration of an epidural solution intravenously. Multiple system-based strategies for prevention are provided.
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The aim of resuscitation is to sustain life with intact neurological functioning and the same quality of life previously experienced by the patient. Advanced cardiac life support (ACLS) was designed to achieve this aim. However the requirement for ACLS training for critical care nurses working in Canadian critical care units is inconsistent across the country. ⋯ Using the search terms ACLS training, resuscitation, critical care, and nursing, two databases, CINAHL and MEDLINE, were used. The evidence supports the need for ACLS training for critical care nurses. The evidence also supports organized ongoing refresher courses, multidisciplinary mock code blue practice using technologically advanced simulator mannequins, and videotaped reviews to prevent knowledge and skill degradation for effective resuscitation efforts.
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Dynamics (Pembroke, Ont.) · Jan 2007
The standardization of critical care nursing education and training: strategies for advancing clinical practice in Ontario's adult ICUs.
In 2004/2005, the Ontario Ministry of Health and Long-Term Care (MOHLTC) launched a critical care transformation strategy with a goal to enhance service delivery through improved access, quality and system resource management. Health human resources planning was seen as essential to the success of the strategy, particularly recruitment, education/training and retention of critical care nurses. A nursing task group was invited to articulate core competencies and practice standards that can be applied across Ontario's adult ICUs and to make recommendations for implementation and the training needed to encourage compliance with the initiative. In this article, the opportunity to position nursing within the Ontario MOHLTC vision is described, as well as the work undertaken to prepare for a province-wide approach to critical care nursing education and training.