Articles: intensive-care-units.
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Comparative Study
Decision making of nurses practicing in intensive care in Canada, Finland, Northern Ireland, Switzerland, and the United States.
In this study, our intention was to describe the decision making of nurses practicing in intensive care, and the differences of nurses' decision making in Canada, Finland, Northern Ireland, Switzerland, and the United States. The instrument used in the study was a 56-item Likert-type questionnaire that has been used in previous studies and has proved to be a reliable tool. The target group comprised a nonrandom sample of nurses (N = 314) from five countries. ⋯ In contrast, decision making related to the implementation and evaluation of nursing is quite similar in the different countries. Canada and the United States on the one hand, and Finland, Northern Ireland, and Switzerland on the other, showed more similarities with each other in data collection, problem definition, and nursing planning related to decision making. Neither experience nor nurse's knowledge structure was associated with different decision-making approaches.
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The efficiency and access to existing perinatal resources has become a focus of debate. Despite inconsistent references to the number of neonatologists and unsubstantiated personnel requirement recommendations, recent commentaries have suggested a current 30% to 50% excess in workforce. ⋯ Significant discrepancies between earlier projected neonatologist requirements and current neonatology workforce and service responsibilities are discussed in relation to demands of reallocation of subspecialty resources within an evolving health care system.
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To address the accuracy of a bedside jugular bulb oxygen saturation (SjO2) catheter monitor (Baxter-Edwards, Santa Ana, CA) versus in vitro co-oximetry measurements in the intensive care unit (ICU). ⋯ Continuous ICU SjO2 monitoring correlates significantly with in vitro values, but less so than previously described during intracranial surgery. Although sensitivity of the bedside monitor to detect confirmed desaturations remains an issue, the high specificity indicates that it is less of a concern that patients may be misdiagnosed as having desaturations resulting in unnecessary interventions. Nonetheless, suspected jugular bulb desaturation should be verified before taking therapeutic actions.
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Neonatal network : NN · Mar 1998
Developmentally supportive care in a neonatal intensive care unit: a research utilization project.
To implement three aspects of developmental care: lower noise levels, decreased light levels, and flexed, midline positioning. ⋯ Mean light levels and mean noise levels decreased during "quiet time" on all three shifts during the project. Optimal positioning was achieved 78 percent of the time during the project period observations.
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To compare three noise exposure measurement methods and determine the effect of location within the nursery, time of day, day of week, shift, and activities such as nursing shift change and physicians' rounds on noise measurements. ⋯ In an open nursery with excessive noise levels central site measurements over a relatively short time accurately reflect the noise exposure. A protocol for measuring noise exposure in the neonatal intensive care unit is appended.