AACN clinical issues
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Credentialing and privileging are increasingly common administrative processes that advanced practice nurses must complete. With the intention of assuring the public of safe health care provided by qualified personnel, several federal and state organizations have developed criteria that licensed practitioners must meet. ⋯ This article explains the guidelines from federal, state, and institutional agencies and offers recommendations to practitioners as they prepare for the credentialing process. Also included are sample forms for establishing a practice agreement and a privilege-delineation request.
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AACN clinical issues · Aug 1999
Review Case ReportsManaging congestive heart failure with thoracic electrical bioimpedance.
Because of clinical utility, immediate feedback, absence of risk to the patient, portability, and use in virtually any practice setting, facilities using thoracic electrical bioimpedance monitoring are increasing throughout the world. Specialized centers treating patients with heart failure have shown remarkable benefits, both in health care costs and patient morbidity, attributable to the careful monitoring and management of patients with heart failure. The ability of thoracic bioimpedance monitoring to provide objective data in the management of congestive heart failure provides practitioners with the clinical reassurance to optimize pharmacologic therapy safely.
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Costs for hemodynamic monitoring can comprise a large segment of an institution's budget. Noninvasive monitoring with thoracic electrical bioimpedance is a cost-effective alternative to invasive monitoring. It can decrease not only materials costs but also costs related to patient complications.
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AACN clinical issues · May 1999
ReviewThe current status of lung transplantation: a nursing perspective.
Since the first lung transplantation was attempted in 1963, the use of the procedure has gradually increased. The first successful operation was performed in 1983, and during the past decade the number of lung transplantations and heart-lung transplantations has increased rapidly, with 75% of recipients surviving past the first year. ⋯ Recipient selection criteria are reviewed, together with the listing process and donor organ criteria. Recommendations for care of patients before and after lung transplantation are outlined, with a description of the postoperative course, including complications, pain control, rehabilitation, discharge procedures, and outpatient treatment.
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AACN clinical issues · Feb 1999
ReviewInitial resuscitation after burn injury: therapies, strategies, and controversies.
Thermal injury disrupts normal hemostasis and sets off a cascade of events: cellular alterations and release of inflammatory mediators cause hypovolemic and cellular shock. Fluid resuscitation in burn injuries has been in use for more than a century, and much research has been devoted to development of resuscitation formulas and appropriate choice of fluid. Parameters for adequate monitoring of resuscitation are greatly debated. Current research efforts focus on minimizing burn edema through mediator modulation and on development of definitive endpoints of resuscitation monitoring.