Dynamics (Pembroke, Ont.)
-
Dynamics (Pembroke, Ont.) · Jan 2011
Clinical TrialCerebrospinal fluid collection: a comparison of different collection sites on the external ventricular drain.
Intracranial pressure monitoring using an external ventricular drainage (EVD) system is the most commonly used technology to monitor intracranial pressure or drain cerebrospinal fluid (CSF) in neurological and neurosurgical patients. CSF samples are collected routinely from the EVD system for laboratory tests. No study has been conducted to identify where the most appropriate site for CSF collection is in order to reduce the disruption of the closed EVD system and reduce the risk of infection. ⋯ The distal port of the EVD system is safe and easy for CSF collection. It also provides accurate results for CSF samples. When the CSF sample is collected from the distal port, the entire volume of CSF in the drip chamber should be collected and tested to obtain an accurate WBC count per unit of volume.
-
Dynamics (Pembroke, Ont.) · Jan 2011
Caring for patients and families at end of life: the experiences of nurses during withdrawal of life-sustaining treatment.
Withdrawal of life-sustaining treatment is a process in which active treatment and the accompanying technology are removed, ending in the death of the patient. ⋯ The essence of this experience was described by these nurses as "trying to do the right thing". Three major themes emerged: A journey--creating comfort along the way, working in professional angst, and providing memories.
-
Dynamics (Pembroke, Ont.) · Jan 2010
Development, dissemination and implementation of a sedation and analgesic guideline in a pediatric intensive care unit...it takes creativity and collaboration.
Sedation and analgesia are administered to critically ill children to provide comfort and pain relief, decrease anxiety and to promote patient safety in relation to life-saving treatments. A comprehensive practice guideline focused on ways to implement evidence-based sedation and analgesia practices was developed, disseminated and implemented by an interprofessional team in the pediatric intensive care unit (PICU) at the Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada. The goals of this quality of care initiative were to (1) reduce inconsistent practices, (2) improve patient outcomes related to comfort, and (3) enhance collaboration among health care team members caring for critically ill children. ⋯ The quality of patient care initiative focused on consistent use of (a) validated sedation and analgesia assessment tools, (b) a goal-directed approach by identifying daily therapeutic target scores and titrating interventions accordingly, and (c) non-pharmacologic, pharmacologic and adjunctive measures. The authors describe their experience in the development, dissemination and implementation of an interprofessional guideline directed at improving sedation and analgesia and patient safety in the PICU. Tools developed to support the practice change, challenges and lessons learned are shared.