AACN clinical issues in critical care nursing
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AACN Clin Issues Crit Care Nurs · May 1994
ReviewPain management in the critically ill: what do we know and how can we improve?
Pain management in the critically ill is a challenge and a problem of great concern for critical care nurses. The authors review research on pain in the areas of pain assessment, nurses' knowledge and attitudes, pharmacologic interventions, and nonpharmacologic interventions for the management of pain. Although the research base is not completely developed in the critically ill population, implications for practice are provided, based upon the findings in populations akin to the critically ill. Strategies are outlined for achieving improved pain control in critical care units through education, adoption of standards on pain management, and quality improvement activities.
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One of the areas of clinical management where nurses have the most diagnostic influence is cardiac rhythm monitoring and dysrhythmia detection. The critical care nurse must recognize that continuous monitoring is a nursing responsibility, and competence in this skill must be assured. ⋯ In addition, the nurse must use current research in determining which monitoring lead is most appropriate for the patient requiring cardiac monitoring in the critical care environment. The author reviews the current research on continuous bedside monitoring and lead selection, examines why nurses continue to make less than optimal lead selection decisions, and offers recommendations to improve the consistency with which patients are accurately monitored.
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AACN Clin Issues Crit Care Nurs · May 1994
Organizational strategies to promote research-based practice.
Research-based practice is necessary for the consistent achievement of cost-effective, quality patient outcomes. Several organizational strategies can be implemented to facilitate research-based practice. These strategies, divided into six major categories and further organized at the individual, unit, and institutional levels, are believed to be most effective when comprehensively addressed and implemented.
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AACN Clin Issues Crit Care Nurs · May 1994
Overcoming the obstacles to research-based clinical practice.
The utilization of research findings in the practice of critical care nursing is essential to obtain optimal patient outcomes. However, the speed and extent to which new research-based findings are applied to clinical practice falls short of expectations. The authors identify obstacles to the timely utilization of research. Strategies to overcome the obstacles to research-based clinical practice are presented.
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AACN Clin Issues Crit Care Nurs · Feb 1994
ReviewAdvances in managing increased intracranial pressure: a decade of selected research.
There have been tremendous advances in the diagnosis and treatment of increased intracranial pressure in the past decade. The author presents a review of the pathophysiology of intracranial hypertension, incorporating recent data from neuroscience research. Additional investigations that have implications for the nursing care of patients with actual or potential intracranial pressure also are described.