Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2014
Case ReportsVasopressor stewardship: a case report and lesson shared.
A case report, focused on vasopressor use and presented in this article, is likely to resonate with many critical care nurses. In this article the authors describe opportunities to enhance safety with vasopressor therapy. ⋯ Vasopressors constitute the mainstay of therapy for nearly every hemodynamically unstable patient in critical care. It is hoped that the lessons and information shared help empower critical care nurses to facilitate vasopressor stewardship within their facilities and, ultimately, enhance patient safety.
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Dynamics (Pembroke, Ont.) · Jan 2013
Multicenter StudyConsenting to pediatric critical care research: understanding the perspective of parents.
Pediatric clinical research is dependent on obtaining consentfrom the parents or legal guardian of eligible patients. Little is known about parents' perspectives and the process by which they make the decision to enroll their child in a pediatric critical care trial. ⋯ Pediatric critical care researchers can improve the parental consent encounter experience by considering how parents perceive the approach to consent for a research trial for their child to balance the need to support parents with the need for participants in pediatric critical care research trials.
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Dynamics (Pembroke, Ont.) · Jan 2013
Reflective debriefing to promote novice nurses' clinical judgment after high-fidelity clinical simulation: a pilot test.
Novice nurses are increasingly beginning their career paths in critical care areas, where they are expected to care for patients whose lives are potentially threatened. They are unable to benefit from years of experience to facilitate their clinical decisions. Reflection after simulation could possibly improve nurses' clinical judgment in complex situations. ⋯ The results of this pilot test provide preliminary information that reflective debriefing may be a safe and potentially effective way for novice critical care nurses to learn from a clinical experience and enhance clinical judgment.
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Dynamics (Pembroke, Ont.) · Jan 2012
ReviewDelirium in the intensive care unit: role of the critical care nurse in early detection and treatment.
Critically ill patients are at increased risk of developing delirium, which has been considered one of the most common complications of intensive care unit (ICU) hospitalization. Despite the high occurrence of delirium in the ICU, researchers have shown it is consistently overlooked and often undiagnosed. An understanding of delirium and the three clinical subtypes of hyperactive, hypoactive and mixed-type delirium that exist are key to early detection and treatment. ⋯ The importance of the use of validated assessment tools, such as the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) to detect key features of delirium development is emphasized. Recommendations to improve the practice of critical care nurses include continuing education regarding the causes, risk factors and treatments of delirium, and education sessions on the use of validated assessment tools. Early prevention strategies, such as modification of the ICU environment to promote normal sleep/wake cycles, including reduction of unit noise and nighttime interruptions, are examined as interventions to avoid the development of delirium.
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Burnout and its development in critical care nurses is a concept that has received extensive study, yet remains a problem in Canada and around the world. Critical care nurses are particularly vulnerable to developing burnout due to the chronic occupational stressors they are exposed to, including high patient acuity, high levels of responsibility, working with advanced technology, caring for families in crisis, and involved in morally distressing situations, particularly prolonging life unnecessarily. The purpose of this article is to explore how the chronic stressors that critical care nurses are exposed to contribute to the development of burnout, and strategies for burnout prevention. ⋯ The results revealed that nurse managers play a crucial role in preventing burnout by creating a supportive work environment for critical care nurses. Strategies for nurse managers to accomplish this include being accessible to critical care nurses, fostering collegial relationships among the different disciplines, and making a counsellor or grief team available to facilitate debriefing after stressful situations, such as a death. In addition, critical care nurses can help prevent burnout by being a support system for each other and implementing self-care strategies.