Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2010
Health care providers' perceptions of family presence during pediatric resuscitation.
The Pediatric Intensive Care Unit (PICU) team strives to achieve the family-centred care philosophy consistent with the organization's vision and mission. In 2006, a team of nurses began exploration of the evidence on family presence during pediatric resuscitation with the primary goal to integrate this knowledge into practice. From the literature search, it was apparent there was limited published research, especially in a Canadian pediatric setting. This led to a staged research project to explore and, subsequently, integrate family presence during resuscitation into the culture. ⋯ In 2007, data demonstrated sufficient support to move this project forward. In addition, the survey indentified facilitators and barriers to assist in both the development of an evidence-based guideline and the successful integration into practice. In 2010, the post-implementation survey supported the evidenced-based practice guideline had achieved its goal of integration into practice.
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Dynamics (Pembroke, Ont.) · Jan 2010
Case ReportsHospital-acquired acute hyponatremia and reports of pediatric deaths.
Information from four voluntary reports of hospital-acquired acute hyponatremia leading to the death of otherwise healthy children is highlighted. In this column, we present two cases and information from a recent ISMP Canada Safety Bulletin, as well as two cases reported to ISMP United States. Information is shared to enhance health care practitioners' awareness of the potential for acute hyponatremia and to provide an overview of some of the potential underlying factors.
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Dynamics (Pembroke, Ont.) · Jan 2010
Where is end expiration? Measuring PAWP when the patient is on pressure support ventilation.
The hemodynamic information obtained from the pulmonary artery catheter provides physiologic rationale for a selected therapy and allows rapid determination of patients' response to the therapy. A wide range of pressure support levels have been used in pressure support ventilation (PSV), and patients' breathing patterns change from a spontaneous breathing pattern with low levels of PSV to a pressure control pattern with high levels of PSV. Different levels of pressure support have different effects on intrathoracic pressure. Changes in intrathoracic pressure may change the respiratory pattern and affect the timing for measuring the pulmonary artery wedge pressure. ⋯ Different levels of pressure support have various impacts on the intrathoracic pressure and alter the respiratory pattern. Using the proximal airway pressure, nurses can identify the location of end-expiration and measure the PAWP accurately.
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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
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.