Articles: critical-care.
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Promoting the quiet and relaxation necessary for sleep in a busy, noisy critical care environment is a problem critical care nurses face daily. Descriptive studies have defined and increased understanding of this problem, but few interventional studies have been accomplished. Interventions that have demonstrated significant improvements in sleep quality in the critical care environment are an audiotape of the sounds of the ocean or rain, a masking signal, and a back massage.
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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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Comparative Study
Care of the critically ill patient: the impact of stress on the use of touch in intensive therapy units.
The literature suggests that stress is a major factor for nurses personally 'disengaging' from patients who are critically ill. This research aimed to investigate if nurses in a general intensive therapy unit (ITU) disengage from their patients by using touches that are mainly task orientated, rather than caring/social touches. This study sought to establish whether there was a relationship between categories of touch deployed by nurses and the individual characteristics of the nurses. ⋯ However, there was a significant relationship between caring/social touch and a nurse's length of service (rs = -0.54, P < 0.01). The interview data discovered that the stressors were related to the organizational pressures of the environment in which care was delivered, rather than the involvement of caring for critically ill patients. This apparent contradiction of the literature contributes a further dimension in considering the impact of management changes and organizational structures upon nurses' stress, which has further implications for the delivery of care in ITUs.
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Unplanned extubation is a complication of endotracheal intubation that occurs despite close patient monitoring in the intensive care unit. The authors describe one method of analyzing unplanned extubations that critical care nurses can use to determine the quality of care provided. This method uses a data collection tool that focuses on incidence of unplanned extubation, structure, process and outcome as indicators of quality of care. This article will help you identify patient characteristics that determine if a particular patient population is at greater risk for unplanned extubations.