Home About us Contact
|
Home About us Contact | ||
|
|
||
Critical Care Nurses (critical + care_nurse)
Selected AbstractsHealth care assistants' role, function and development: results of a national surveyNURSING IN CRITICAL CARE, Issue 4 2003The British Association of Critical Care NursesArticle first published online: 31 JUL 200 Summary ,,Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care ,,The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses ,,A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements ,,A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK ,,At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse [source] Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areasNURSING IN CRITICAL CARE, Issue 1 2003The British Association of Critical Care Nurses Summary ,Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care ,The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas ,During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient ,The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement [source] Review: nurses can improve patient nutrition in intensive careJOURNAL OF CLINICAL NURSING, Issue 17 2009Caroline Ros Aims and objectives., To review the literature and identify opportunities for nutritional practice improvement in the critically ill and opportunities to improve nurses' knowledge relating to enteral feeding. Background., The literature reports varying nutritional practices in intensive care. Design., Systematic review. Methods., A systematic search, selection, analysis and review of nursing, medical and dietetic primary research articles was undertaken. Fifteen studies met the selection criteria. Results., Delivery of nutrition to the critically ill varied widely. Patients were frequently underfed and less frequently, overfed. Both under- and overfeeding have been linked with unacceptable consequences including infections, extended weaning from mechanical ventilation, increased length of stay and increased mortality. Underfeeding was related to slow initiation and advancement of nutrition support and avoidable feed interruptions. The most common reasons for interrupting feeds were gastrointestinal intolerance and fasting for procedures. Certain nursing practices contributed to underfeeding such as the management of gastric residual volumes. Conclusions., Consistent and reliable nutrition support in intensive care units is hampered by a lack of evidence leading to varying nutrition practices. Factors impeding delivery of enteral nutrition were considered avoidable. A new concept of a therapeutic range of energy delivery in the critically ill has emerged implying the need for re-evaluation of energy recommendations and improved delivery of enteral nutrition. Relevance to clinical practice., This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process. [source] Reflection on the relationship between technology and caringNURSING IN CRITICAL CARE, Issue 3 2005Christopher Johns ABSTRACT Being attached to a piece of medical technology may cause patients physical and emotional distress. Critical care nurses need to empathize and respond to the patient's experience on being attached to all forms of medical equipment. The use of sedation must be carefully considered in response to agitation. Critical care is also palliative care. Compassion is a virtue. [source] Danish parents' experiences when their new born or critically ill small child is transferred to the PICU , a qualitative studyNURSING IN CRITICAL CARE, Issue 2 2005Elisabeth OC Hall Abstract The aim of this study was to describe Danish parents' experiences when their newborn or small child was critically ill. Thirteen parents were interviewed. Data were analysed using qualitative content analysis. The child's transfer to the paediatric intensive care unit (PICU) meant either help or death for the parents. The back transfer was experienced as joy and despair. The parents had confidence in most nurses, and they were kind, helpful, informative and capable. Less capable and distressed nurses made the parents feel uncomfortable and insecure. Parents need help and support during their child's transfer to and from the PICU. Critical care nurses have to discuss the policy of family-centred care. [source] Health care assistants' role, function and development: results of a national surveyNURSING IN CRITICAL CARE, Issue 4 2003The British Association of Critical Care NursesArticle first published online: 31 JUL 200 Summary ,,Intensive care has developed as a speciality since the 1950s; during this time there have been major technological advances in health care provision leading to a rapid expansion of all areas of critical care ,,The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem. For many, the answer lies in employing health care assistants to support the work of registered nurses ,,A key aim of the British Association of Critical Care Nurses is to promote the art and science of critical care nursing by providing representation for its members, by responding to political and professional change and by producing and publishing position statements ,,A primary component of the work surrounding the development of this second position statement was the gathering of contemporary information in relation to the role of health care assistants within critical care units throughout the UK, through a survey of 645 critical care units within the UK ,,At present the impact upon the role of the critical care nurse is not fully understood, with research in this area suggesting that although there is a role for the health care assistant in the critical care environment, this should only be undertaken with a full analysis of this impact upon the work of the registered nurse [source] The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral,Tracheal Intubation Success Rates in Novice IntubatorsACADEMIC EMERGENCY MEDICINE, Issue 4 2010Frank Thomas MD Abstract Objectives:, This exploratory study examined novice intubators and the effect difficult airway factors have on pre- and posttraining oral,tracheal simulation intubation success rates. Methods:, Using a two-level, full-factorial design of experimentation (DOE) involving a combination of six airway factors (curved vs. straight laryngoscope blade, trismus, tongue edema, laryngeal spasm, pharyngeal obstruction, or cervical immobilization), 64 airway scenarios were prospectively randomized to 12 critical care nurses to evaluate pre- and posttraining first-pass intubation success rates on a simulator. Scenario variables and intubation outcomes were analyzed using a generalized linear mixed-effects model to determine two-way main and interactive effects. Results:, Interactive effects between the six study factors were nonsignificant (p = 0.69). For both pre- and posttraining, main effects showed the straight blade (p = 0.006), tongue edema (p = 0.0001), and laryngeal spasm (p = 0.004) significantly reduced success rates, while trismus (p = 0.358), pharyngeal obstruction (p = 0.078), and cervical immobilization did not significantly change the success rate. First-pass intubation success rate on the simulator significantly improved (p = 0.005) from pre- (19%) to posttraining (36%). Conclusions:, Design of experimentation is useful in analyzing the effect difficult airway factors and training have on simulator intubation success rates. Future quality improvement DOE simulator research studies should be performed to help clarify the relationship between simulator factors and patient intubation rates. ACADEMIC EMERGENCY MEDICINE 2010; 17:460,463 © 2010 by the Society for Academic Emergency Medicine [source] Item selection and content validity of the Critical-Care Pain Observation Tool for non-verbal adultsJOURNAL OF ADVANCED NURSING, Issue 1 2009Céline Gélinas Abstract Title.,Item selection and content validity of the Critical-Care Pain Observation Tool for non-verbal adults. Aim., This paper is a report of the item selection process and evaluation of the content validity of the Critical-Care Pain Observation Tool for non-verbal critically ill adults. Background., Critically ill patients experience moderate to severe pain in the intensive care unit. While critical care clinicians strive to obtain the patient's self-report of pain, many factors compromise the patient's ability to communicate verbally. Pain assessment methods often need to match the communication capabilities of the patient. In non-verbal patients, observable behavioural and physiological indicators become important indices for pain assessment. Method., A mixed method study design was used for the development of the Critical-Care Pain Observation Tool in 2002,2003. More specifically, a four-step process was undertaken: (1) literature review, (2) review of 52 patients' medical files, (3) focus groups with 48 critical care nurses, and interviews with 12 physicians, and (4) evaluation of content validity with 17 clinicians using a self-administered questionnaire. Results., Item selection was derived from different sources of information which were convergent and complementary in their content. An initial version of the Critical-Care Pain Observation Tool was developed including both behavioural and physiological indicators. Because physiological indicators received more criticism than support, only the four behaviours with content validity indices >0·80 were included in the Critical-Care Pain Observation Tool: facial expression, body movements, muscle tension and compliance with the ventilator. Conclusion., Item selection and expert opinions are relevant aspects of tool development. While further evaluation is planned, the Critical-Care Pain Observation Tool appears as a useful instrument to assess pain in critically ill patients. [source] Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitalsJOURNAL OF ADVANCED NURSING, Issue 4 2001Wendy Chaboyer PhD RN Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitals Aim.,This study examines the extent to which hospital nurses view their working environment in a positive sense, working as a cohesive group. Background.,Despite the fact that nursing in Australia is now considered a profession, it has been claimed that nurses are an oppressed group who use horizontal violence, bullying and aggression in their interactions with one and other. Methods.,After ethical approval, a random sample of 666 nurses working directly with patients and all 333 critical care nurses employed in three large tertiary Australian hospitals were invited to participate in the study in the late 1990s. A mailed survey examined the perceptions of interaction nurses had with each other. The hypothesis, that level of employment (either Level I bedside nurses or Level II/III clinical leaders) and area of work (either critical care or noncritical care) would influence perceptions of cohesion, as measured by the cohesion amongst nurses scale (CANS) was tested. Results.,In total 555 (56%) surveys were returned. Of these, 413 were returned by Level I and 142 by Level II/III nurses. Of this sample, 189 were critical care and 355 noncritical care nurses. There was no difference between Level I and II/III nurses in mean CANS scores. It is interesting to note that the item rated most positively was ,nurses on the units worked well together', however, the item rated least positive was ,staff can be really bitchy towards each other' for both Level I and II/III nurses. There was no difference in CANS scores between critical care and noncritical care nurses. Conclusions.,Nurses working in Australian hospitals perceived themselves to be moderately cohesive but, as would be expected in other work settings, some negative perceptions existed. [source] The challenges of caring in a technological environment: critical care nurses' experiencesJOURNAL OF CLINICAL NURSING, Issue 8 2008ITU cert, Mary McGrath MSc Purpose., This paper presents and discusses the findings from a phenomenological study which illuminated the lived experiences of experienced critical care nurses caring within a technological environment. Background., While nursing practice is interwoven with technology, much of the literature in this area is speculative. Moreover, there is a debate as to whether and how ,high tech' and ,high touch' are reconcilable; this orientation is referred to as the optimism vs. pessimism debate. On a personal level, the motivation for this study came from the author's 13 years' experience in the critical care area. Method., Following ethical approval, 10 experienced nurses from two cardiothoracic critical care units in Ireland participated in the study. A Heideggerian phenomenological methodology was used. Data collection consisted of unstructured interviews. A method of data analysis described by Walters was used. Findings., The findings provide research-based evidence to illuminate further the optimistic/pessimistic debate on technology in nursing. While the study demonstrates that the debate is far from resolved, it reveals a new finding: life-saving technology that supports the lives of critically ill patients can bring experienced nurses very close to their patients/families. The three main themes that emerged: ,alien environment', ,pulling together' and ,sharing the journey' were linked by a common thread of caring. Conclusion., Experienced critical care nurses are able to transcend the obtrusive nature of technology to deliver expert caring to their patients. However, the journey to proficiency in technology is very demanding and novice nurses have difficulty in caring with technology. Relevance to clinical practice., It is recommended that more emphasis be placed on supporting, assisting and educating inexperienced nurses in the critical care area and that the use of technology in nursing be given serious consideration. [source] Caring for patients of Islamic denomination: critical care nurses' experiences in Saudi ArabiaJOURNAL OF CLINICAL NURSING, Issue 12 2006ITU cert., Phil Halligan MSc Aim., To describe the critical care nurses' experiences in caring for patients of Muslim denomination in Saudi Arabia. Background., Caring is known to be the essence of nursing but many health-care settings have become more culturally diverse. Caring has been examined mainly in the context of Western cultures. Muslims form one of the largest ethnic minority communities in Britain but to date, empirical studies relating to caring from an Islamic perspective is not well documented. Research conducted within the home of Islam would provide essential truths about the reality of caring for Muslim patients. Design., Phenomenological descriptive. Methods., Six critical care nurses were interviewed from a hospital in Saudi Arabia. The narratives were analysed using Colaizzi's framework. Results., The meaning of the nurses' experiences emerged as three themes: family and kinship ties, cultural and religious influences and nurse,patient relationship. The results indicated the importance of the role of the family and religion in providing care. In the process of caring, the participants felt stressed and frustrated and they all experienced emotional labour. Communicating with the patients and the families was a constant battle and this acted as a further stressor in meeting the needs of their patients. Conclusions., The concept of the family and the importance and meaning of religion and culture were central in the provision of caring. The beliefs and practices of patients who follow Islam, as perceived by expatriate nurses, may have an effect on the patient's health care in ways that are not apparent to many health-care professionals and policy makers internationally. Relevance to clinical practice., Readers should be prompted to reflect on their clinical practice and to understand the impact of religious and cultural differences in their encounters with patients of Islam denomination. Policy and all actions, decisions and judgments should be culturally derived. [source] Evidence-based algorithms for diagnosing and treating ventilator-associated pneumonia,JOURNAL OF HOSPITAL MEDICINE, Issue 5 2008Richard J. Wall MD Abstract BACKGROUND: Ventilator-associated pneumonia (VAP) is widely recognized as a serious and common complication associated with high morbidity and high costs. Given the complexity of caring for heterogeneous populations in the intensive care unit (ICU), however, there is still uncertainty regarding how to diagnose and manage VAP. OBJECTIVE: We recently conducted a national collaborative aimed at reducing health care,associated infections in ICUs of hospitals operated by the Hospital Corporation of America (HCA). As part of this collaborative, we developed algorithms for diagnosing and treating VAP in mechanically ventilated patients. In the current article, we (1) review the current evidence for diagnosing VAP, (2) describe our approach for developing these algorithms, and (3) illustrate the utility of the diagnostic algorithms using clinical teaching cases. DESIGN: This was a descriptive study, using data from a national collaborative focused on reducing VAP and catheter-related bloodstream infections. SETTING: The setting of the study was 110 ICUs at 61 HCA hospitals. INTERVENTION: None. MEASUREMENTS AND RESULTS: We assembled an interdisciplinary team that included infectious disease specialists, intensivists, hospitalists, statisticians, critical care nurses, and pharmacists. After reviewing published studies and the Centers for Disease Control and Prevention VAP guidelines, the team iteratively discussed the evidence, achieved consensus, and ultimately developed these practical algorithms. The diagnostic algorithms address infant, pediatric, immunocompromised, and adult ICU patients. CONCLUSIONS: We present practical algorithms for diagnosing and managing VAP in mechanically ventilated patients. These algorithms may provide evidence-based real-time guidance to clinicians seeking a standardized approach to diagnosing and managing this challenging problem. Journal of Hospital Medicine 2008;3:409,422. © 2008 Society of Hospital Medicine. [source] Australian hospital generalist and critical care nurses' perceptions of doctor,nurse collaborationNURSING & HEALTH SCIENCES, Issue 2 2001Wendy P. Chaboyer RN Abstract Previous researchers have indicated that collaborative practice between doctors and nurses results in positive effects on patient care, health-care costs and provider satisfaction. Despite these benefits, collaborative practice appears to be the exception, rather than the dominant pattern, within health care. A collaborative relationship cannot evolve if individuals do not value and respect others' competencies. This study, a mailed survey, used the Collaboration with Medical Staff Scale to compare the perceptions of doctor,nurse collaboration held by critical care nurses and generalist hospital nurses. The hypothesis that critical care nurses perceive there to be greater collaboration with doctors than their generalist nurse colleagues was supported even after taking into consideration education and experience. These results suggest that critical care is an area that might be useful when trying to understand the dimensions and implications of collaboration among health professionals. [source] Developing best practice in critical care nursing: knowledge, evidence and practiceNURSING IN CRITICAL CARE, Issue 3 2003Paul Fulbrook Summary ,Because the current drive towards evidence-based critical care nursing practice is based firmly within the positivist paradigm, experimentally derived research tends to be regarded as ,high level' evidence, whereas other forms of evidence, for example qualitative research or personal knowing, carry less weight ,This poses something of a problem for nursing, as the type of knowledge nurses use most in their practice is often at the so-called ,soft' end of science. Thus, the ,Catch 22' situation is that the evidence base for nursing practice is considered to be weak ,Furthermore, it is argued in this paper that there are several forms of nursing knowledge, which critical care nurses employ, that are difficult to articulate ,The way forward requires a pragmatic approach to evidence, in which all forms of knowledge are considered equal in abstract but are assigned value according to the context of a particular situation ,It is proposed that this can be achieved by adopting an approach to nursing in which practice development is the driving force for change [source] Factors associated with safe patient handling behaviors among critical care nursesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Soo-Jeong Lee RN Abstract Background Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment. Methods A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors. Results More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort,reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior. Conclusions Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury. Am. J. Ind. Med. 53:886,897, 2010. © 2010 Wiley-Liss, Inc. [source] Correlates of fatigue in critical care nurses,,RESEARCH IN NURSING & HEALTH, Issue 6 2003Jeanne S. Ruggiero Abstract The purposes of this study were to examine shift-related differences in chronic fatigue and the contributions of sleep quality, anxiety, and depression to chronic fatigue among a random nationwide sample (N,=,142) of female critical care nurses. Twenty-three percent of this sample met criteria for clinical depression. Day and night nurses did not differ in their reports of chronic fatigue. Night nurses reported more depression and poorer sleep quality than did day nurses. Regression analyses indicated that among the variables of global sleep quality, depression, and anxiety, depression and sleep quality were the most relevant to the explanation of chronic fatigue. These findings suggest the need for studies of strategies to promote sleep and improve mood in critical care nurses. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:434,444, 2003 [source] | ||||||||||