Dynamics (Pembroke, Ont.)
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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
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.
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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 2008
ReviewBuilding a successful DCD program: planning and leading change.
In Canada, there is a growing gap between the number of organs donated each year and the number of organs needed for transplant. This gap is forcing health care professionals to re-examine end-of-life care and donation practices. ⋯ Clinical nurse specialist leadership, ethics consultation, partnerships with key physician colleagues and administrators, as well as comprehensive workshops are described as essential for success. Lessons learned throughout are shared.
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Dynamics (Pembroke, Ont.) · Jan 2008
ReviewThe importance of routine QT interval measurement in rhythm interpretation.
When monitoring a patient's cardiac rhythm, the QT interval should be routinely measured. A variety of factors can prolong the QT interval such as drug effects, electrolyte imbalances, acute myocardial infarction, and congenital factors. ⋯ One obstacle to the routine measurement of the QT interval is the lack of a standardized and simple approach. The purpose of this article is to detail factors that prolong the QT interval and describe methods used to measure the QT interval.