Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2012
A survey of nurses' perceptions of the intensive care delirium screening checklist.
Delirium in critically ill patients is common and is associated with increased morbidity and mortality. Routine delirium screening is recommended by the Society of Critical Care Medicine. The Intensive Care Delirium Screening Checklist (ICDSC) is one validated and commonly-used tool, but little is known about nurses'perceptions of using the ICDSC, and of barriers to delirium assessment and treatment. ⋯ The ICDSC is viewed favourably by nurses with experience using the tool. Future delirium screening programs should encourage physician engagement early in the planning process to help address perceived barriers to delirium assessment and treatment.
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Dynamics (Pembroke, Ont.) · Jan 2012
Journal club in a critical care unit: an innovative design triggering learning through reading and dialogue.
Journal club has been used for decades to incorporate reading clinical and research articles into professional practice of numerous health care providers to disseminate knowledge and to bridge the gap between research and clinical practice. In this article, the authors describe how such activity was implemented by and for the nursing team of an intensive care unit. ⋯ The authors describe the phases of this project: the co-development of the journal club, the implementation of the activity and its results. The authors detail how this journal club format incorporated additional teaching aids during each session and used narrative pedagogy as a conceptual framework.
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Dynamics (Pembroke, Ont.) · Jan 2011
Conversations about challenging end-of-life cases: ethics debriefing in the medical surgical intensive care unit.
Clinicians frequently encounter and grapple with complex ethical issues and perplexing moral dilemmas in critical care settings. Intensive care unit (ICU) clinicians often experience moral distress in situations in which the ethically right course of action is intuitively known, but cannot be acted on. Most challenging cases pertain to end-of-life issues. ⋯ Process changes were implemented based on the group's suggestions. The process changes resulted in increased awareness of the benefits, increased frequency of sessions and demonstrated utility. Lessons learned from the MSICU experience will inform the development of education curricula to help critical care nurses with challenging end-of-life situations.
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Dynamics (Pembroke, Ont.) · Jan 2011
Increased mortality among the critically ill patients admitted on weekends: a global trend.
Critical illness and injury have no concept of time and do not always occur within regular business hours or at times conducive to optimal hospital function. In fact, it is a global trend that critically ill patients admitted to hospitals on weekends suffer higher mortality rates than those admitted during the week. ⋯ Possible solutions include moving to a "closed" ICU system, increasing nurse staffing, intensivist coverage and diagnostic accessibility, and creating a true seven-day hospital system. Finally, it is unclear exactly how to solve the nurse staffing portion of this problem, as it appears internally linked to the nursing profession and externally to hospital management, recruiting difficulties and financial restraints, and a problem that will take more than change in nursing management strategy to resolve.