Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2009
National collaborative: Top five drugs reported as causing harm through medication error in pediatrics.
The Canadian Association of Paediatric Health Centres (CAPHC) and the Institute for Safe Medication Practices Canada (ISMP Canada) are working collaboratively to enhance the safety of pediatric medication use. Eleven CAPHC member organizations submitted data on more than 4,000 medication incidents to ISMP Canada for the period October 2005 to June 2008, 305 of which were reported as resulting in harm. From this, the top five drugs causing harm through medication error and contributing factors to the incidents were identified. In this article, we intend to inform critical care practitioners of the medication incident analyses and the collaborative pediatric patient safety initiatives underway.
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Dynamics (Pembroke, Ont.) · Jan 2009
Comparative StudyTotal spinal anesthesia for cardiac surgery: does it make a difference in patient outcomes?
Heart disease is a major cause of morbidity and mortality. While cardiac surgery is a viable treatment option, it is a potent physiological stressor. The surgical stress response may result in patient decompensation and negative patient outcomes. The goal of a novel anesthetic approach, which combines high spinal anesthesia with intrathecal morphine and general anesthesia (TSA), is to attenuate this stress response. ⋯ This evidence highlights the clinical nursing relevance of the type of anesthesia on postoperative care and outcomes. The knowledge gained from these findings will help to enable the multidisciplinary critical care team to anticipate TSA patient outcomes and to facilitate the development of appropriate and effective evidence-based, patient-focused plans of care. This pilot study establishes sound rationale for subsequent larger prospective cohort research of the TSA patient population.
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Dynamics (Pembroke, Ont.) · Jan 2009
Innovations in technology--Novalung iLA: challenges for the field of critical care nursing.
The Novalung interventional lung assist (iLA) device is a new pumpless extracorporeal gas exchange device that imitates the native lung because it allows for protective mechanical ventilation by the reduction of tidal volumes and decreased end expiratory pressures. It is a rescue device for patients with refractory lung failure, as well as a bridge to lung transplantation. While used in Europe for some years, the Novalung iLA has been recently approved by both Health Canada and our facility, as a bridge to lung transplantation. ⋯ Particular attention is paid to the education of the nursing staff. A plan was developed to deliver information, education and training guidelines to prepare for patients requiring a bridge to lung transplantation with this device within the medical surgical intensive care unit in our hospital. Subsequently, these initiatives have expanded to include a workshop and a simulation experience.
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Dynamics (Pembroke, Ont.) · Jan 2009
Case ReportsALERT: Revatio is another brand name for sildenafil.
In this column, the authors highlight a medication incident that occurred with Revatio (sildenafil), along with the learnings and recommendations from a previously published ISMP Canada Safety Bulletin. It is well-known to health care practitioners that use of nitroglycerin therapy is contraindicated in patients taking sildenafil (commonly known as Viagra). Many health care practitioners may be unaware that sildenafil is also marketed under the brand name Revatio for treatment of primary pulmonary hypertension or pulmonary hypertension secondary to connective tissue disease. The following incident signals the need to heighten the awareness that Revatio is a brand name for sildenafil.
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Dynamics (Pembroke, Ont.) · Jan 2009
The Oxygen Supply and Demand Framework: a tool to support integrative learning.
Critically ill patients are at high risk for inadequate oxygen supply, increased oxygen demand and inadequate cellular oxygenation. Understanding and managing the physiological consequences of critical illness requires nurses to integrate knowledge of patient assessment, physiology and pathophysiology, and critical care interventions into their clinical decision-making. The Oxygen Supply and Demand Framework incorporates interrelated physiological concepts that influence balance between oxygen supply and demand and, consequently, supports an integrated understanding of critically ill patient situations. In this article, we present the Oxygen Supply and Demand Framework as an integrative tool for use by educators, students and critical care nurses to guide the process of patient assessment, interpret data, inform selection of appropriate interventions, and understand the rationale for all aspects of patient management.