Articles: intensive-care-units.
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There is strong support in the literature for involvement of nurses with patients and physicians in bioethical decision making about patient care. There are indications that nurses and physicians have different beliefs about decisions made and about the decision-making processes, such as who should be involved and what factors should influence such decisions. The literature also demonstrates that nurses often disagree with physicians or are not involved in ethical decision making or both. ⋯ Ethical principles also support collaborative decision making, involving nurses, as well as physicians, patients, and family. With collaboration there is sharing of information and perspectives, respect for patient and family autonomy, and disclosure. More studies of interdisciplinary bioethical decision making are needed, measuring both professions' perceptions of their roles in ethical decision making, as well as examining the effects of collaboration on care outcomes.
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Critical care medicine · May 1993
Multicenter Study Comparative StudyOne-year outcome of elderly and young patients admitted to intensive care units.
To compare the outcome of patients over and under age 65 admitted to two intensive care units (ICUs). ⋯ Age does not have an important impact on outcome from critical illness, which is most strongly predicted by severity of illness, length of stay, prior ICU admission and respiratory failure. Satisfaction with personal health should not be inferred from the functional status of elderly survivors of intensive care.
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Critical care medicine · May 1993
ReviewPediatric intensive care training: confronting the dark side.
To describe the dark side of pediatric intensive care fellowship training and offer educational approaches for understanding feelings of fallibility, anger, frustration, and loss. ⋯ Since the dark side is expected, normal, and inevitable, fellowship training programs should help fellows cope with and understand these feelings. Such understanding requires a sense of trust among intensive care staff and can be gained through group discussions, mentorship, specific team conferences, and child psychiatric consultation.
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To assess the beliefs and attitudes of critical care nurses about the effects of visiting on patients, staff and family. ⋯ To provide an optimal situation for visiting, its negative consequences must be minimized and nurses' attitudes and beliefs about visiting must be assessed and addressed.
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Aminoglycosides have historically been the mainstay of antibiotic therapy in the ICU. Despite the availability of numerous less toxic antibiotics, the clinical and microbiologic attributes of these agents have ensured their continued use in the management of infections in the critically ill patient. Innovative dosing regimens may replace traditional dosing methods if they are shown to provide improved clinical response with less toxicity potential.