The Meaning of Comfort in the Intensive Care Unit
Providing comfort in an intensive care unit (ICU) setting is often related to pain relief and end-of-life care; environmental factors are often neglected, despite the major role of the environment on the patients' well-being and comfort. The aim of this article was to explore the meanings of comfort from a theoretical and empirical perspective to increase the understanding of what comfort means in ICU settings. A lexical analysis and serials of workshops were performed, and data were analyzed using a qualitative content analysis. The findings from the theoretical analysis show that comfort has a broad range of synonyms rel...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Palliative Care: A Systematic Review of Evidence-Based Interventions
The authors conducted an integrative review to determine evidence-based and most efficient strategies for improving the palliative care of patients at the end-of-life stage. Thirteen articles that met the overall inclusion criteria were evaluated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart approach was used for the screening process. The Critical Appraisal Skill Program and the Mixed-Methods Appraisal Tool were also used for the critical appraisal of the data. Full reports of relevant articles were retrieved, and data were extracted by 2 reviewers independently. The quality of studies ...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Pulmonary Artery Catheters: Impact of e-Learning on Hemodynamic Assessments
Pulmonary artery catheters (PACs) are invasive devices placed in critically ill patients to monitor hemodynamic data. They are a high-risk, and in some settings a low-volume, medical device due to the complex insertion procedure and potentially lethal complications. Smaller intensive care units (ICUs) have large variances in exposure to PACs, therefore strengthening ICU nurses' belief in their ability to manage these hemodynamic monitoring devices is of utmost importance. The design is a single-group, pre/posttest study conducted on a 15-bed ICU to survey nurses' self-efficacy, knowledge, and satisfaction of an e-learning ...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Thiamine Use in Sepsis: B: 1: for Everyone?
Every year, sepsis affects nearly 30 million people worldwide, with current annual estimates reporting as many as 6 million deaths. To combat the staggering number of patients who are affected by sepsis, clinicians continue to investigate novel treatment approaches. One treatment approach that has gained interest is the role that vitamins and nutrients play in the body's response to sepsis. Thiamine, in particular, has been studied because of its role in glucose metabolism and lactate production. This review provides a summary of the current literature surrounding the use of thiamine in the treatment of sepsis and describe...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Confrontation: Survival Strategies
This article reviews the adverse effect of the stress response on cognitive functioning, along with tools to mitigate the stress response and respond using appropriate communication tools. The author presents resources for self-care and techniques for resilience in assessing and responding to a challenging situation in a therapeutic manner. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Determining the Moral Sensitivities of Intensive Care Nurses
This article reports results from a descriptive study involving nurses working in intensive care units of hospitals in the province of Erzurum, eastern Turkey. A total of 110 nurses agreed to participate in the study. The Moral Sensitivity Questionnaire and a personal information form, which was developed by researchers in accordance with the relevant literature, were used for data collection. The results indicated that intensive care nurses face frequent ethical problem and that moral sensitivity is required to assist in coping with the issues. Researchers report that nurses who were highly satisfied with their work posse...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Room Design—A Phenomenological-Hermeneutical Study: A Factor in Creating a Caring Environment
Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed du...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Nurses' Use of Evidence-Based Practice at Point of Care: A Literature Review
The article reports results of an interrogative literature review designed to study the acquisition of research-based knowledge among practicing nurses who provide direct patient care for decision making at the point of care. Findings reveal that despite the amount of research done on the use of evidence-based practice among nurses, gaps continue to exist between what is known and what is done in practice. Nurses often cite the lack of time and support and the lack of knowledge as predominant factors that keep them from using evidence-based practice at the point of care. The past research has primarily been completed using...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Social Support, Self-Efficacy, and Helplessness Following Myocardial Infarctions
Numerous factors impact patient recovery following an acute myocardial infarction (AMI). Negative emotional outcomes, such as learned helplessness, are predictors of mortality following AMI, though little is known about these relationships. The purpose of this study was to examine the relationships between social support and self-efficacy with learned helplessness in individuals post-AMI. Using a descriptive cross-sectional design, subjects with a diagnosed AMI within 12 months were recruited. Standardized instruments were used to evaluate social support and self-efficacy and their impact on learned helplessness. A statist...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Patient Survival and Length of Stay Associated With Delayed Rapid Response System Activation
The objective of this study was to investigate the difference in mortality and length of stay between patients who experienced a delay in rapid response system (RRS) activation and those who did not. A retrospective comparative cohort study investigated all adult inpatient cases that experienced an RRS activation from January 1, 2017, through January 1, 2018. Cases experiencing a delay in RRS activation were compared with cases without delay. During the study period a total of 3580 RRS activations that took place and 1086 RRS activations met inclusion criteria for analysis. Delayed RRS activations occurred in 325 cases (29...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Development and Pragmatic Evaluation of a Rapid Response Team
In response to national and local drivers, a clinical emergency response system (CERS) incorporating an intensivist-led rapid response team (RRT) was implemented at a Sydney (Australia) hospital. The authors present a pragmatic evaluation of the 5 years since this major initiative was commenced. A “partner not conquer” philosophy was adopted. Implementation of the RRT was based on a collaborative pragmatic quality improvement approach. A team of intensive care specialist trained medical doctors (n = 2) and clinical nurse consultants (n = 2) set up the service with executive support and funding. Roles and respon...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Clinical Opioid Withdrawal Scale (COWS): Implementation and Outcomes
The opioid crisis has shown evidence worldwide and locally. There was no protocol to detect opioid withdrawal at this organization. The purpose of this project was to develop a nursing-driven opioid withdrawal management tool using the validated Clinical Opioid Withdrawal Scale (COWS) to address an increase in opioid-addicted patients. Evidence-based practice change was executed using the San Diego 8A's method for adult trauma step-down patients experiencing opioid withdrawal with the COWS tool affecting frequency of nursing attempts at managing opioid withdrawal over an 8-week period. Training was provided to 45 nurses on...
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Original Articles Source Type: research

Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - May 29, 2019 Category: Nursing Tags: Foreword Source Type: research

Physician Engagement: A Key Concept in the Journey for Quality Improvement
In the 2001 Institute of Medicine report on patient outcomes in the United States, one of the key concepts was the importance of collaboration within the health care team by using quality improvement methodologies as a foundation and using data to drive change and improve patient outcomes and ultimately the health of the nation. Ensuring that all health care providers have a voice at the table on key initiatives has been a challenge to implement, especially when attempting to involve frontline staff including physicians and nurses. In regard to the particular organization to be discussed, it was important to have an unders...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Effect of Prehospital Blood Draws on Length of Stay for Chest Pain Patients in the Emergency Department: A Pilot Study
This article provides research of cardiac biomarkers being drawn in the prehospital setting compared with the emergency department (ED) on intervals critical to the diagnosis of acute myocardial infarction. This is a retrospective chart review of patients brought to the ED of a single, urban teaching hospital by a single emergency medical service (EMS) agency with a chief complaint of “chest pain.” We abstracted specific patient characteristics, intervals, positive troponin values, and rates of hemolysis from hospital records utilizing a custom data abstraction tool designed for this study through consensus of ...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Educating Parents About Vitamin K in the Newborn Using Knowles' Theory of Adult Learning Principles as a Framework
Parents must make an educated decision regarding vitamin K administration for their infant prior to birth. With an abundance of information available regarding this topic, the nurse needs to guide the parents through this process. Using Knowles' Theory of Adult Learning Principles as a framework can increase the parents' knowledge and assist the nurse in providing thorough information. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Neonatal Blood Loss Risks
This article looks at the most common risks to be aware of in the newborn infant. Babies are not just tiny versions of adults. They have differences in the maturity all body systems, and that includes circulating blood volume and factors that contribute to those differences. Circulating blood volume is about 80 to 100 mL/kg in the term infant and 90 to 105 mL/kg in the preterm infant. Red blood cells live for about a month and are replaced with immature red blood cells called reticulocytes that mature within 12 to 24 hours. Therefore, potential for blood loss and its impact are issues that must be part of our overall asses...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Knowledge Deficit of Sickle Cell Trait Status: Can Nurses Help?
This article will demonstrate how current literature supports the gaps in knowledge of trait status and its implications as well as knowledge deficit of inheritance patterns of prospective parents. The article will also elucidate how knowledge deficit in this subject adversely affects primary prevention strategies including genetic counseling. Primary prevention of sickle cell disease is a public health area that can be championed by registered nurses who have the tools and experiences to effectively handle case management and patient education. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Porphyria: A Rare, Complicated, and Misdiagnosed Disease
Diagnosis of porphyria is often difficult due to the range of symptoms, which are common in many other disorders, hence frequently leading to misdiagnosis. Attacks can be triggered through sunlight and contact with diverse substances, including medications. Signs are severe, appear quickly, and tend to last from days to weeks, affecting the skin, mentation, the digestive, cardiovascular, nervous, and muscular system. Neuropathy signifies a severe and potentially life-threatening attack. Porphyria is mainly an inherited disorder, but can be acquired, and emerges in adults and children. The exact rates of porphyria are unkno...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Blood Conservation: Exploring Alternatives to Blood Transfusions
The conservation of blood products and the use of alternatives to blood transfusion are the best practice. Patients treated with blood conservation techniques will have a reduced risk of blood-borne diseases and a reduced risk of human error that can occur during blood processing. The bedside nurse plays a vital role in educating the patient and the caregiver regarding risks, benefits, and alternatives. A combination of techniques explored focuses on minimizing blood loss, building the patient's own blood supply, or both. Medications, herbs, and supplements can increase bleeding and place the patient at risk for a transfus...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Implementation of a Blood Conservation Initiative to Effectively Reduce Blood Transfusions in Cardiac Surgery Patients
Perioperative and postoperative blood transfusions in cardiac surgery patients are associated with as much as a 16% increased risk of mortality and a significantly increased risk in morbid outcomes. At the project site, red blood cell transfusions in cardiac surgery patients undergoing isolated coronary artery bypass graft were above national benchmarks. The aim of the project was to reduce blood transfusions in cardiac surgery patients by 10% over 8 weeks. Primary interventions included engagement for the team and use of a shared decision-making tool for patients. Use of the Any RBC Transfusion online risk calculator was ...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Blood Transfusion: Cost, Quality, and Other Considerations for the Surgical Management of the Critically Ill
This article explores the average overall costs of blood transfusion for critically ill surgical patients and in particular explores the evidence supporting reduction of transfusion as part of guideline-based care in cardiothoracic surgical patients. Average cost data compiled from various sources are presented and quality and outcome considerations in blood transfusion in the critically ill are reviewed. Multiple strategies that have a high level of evidence to support their use in this population are noted. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Hemorrhage Control: Lessons Learned From the Battlefield Use of Hemostatic Agents That Can Be Applied in a Hospital Setting
This article covers the current hemostatic agents that have been used for more than 17 years on the battlefield and are slowly making their way into the hospital settings. The hemostatic agents covered include QuikClot Combat Gauze, QuikClot Control+, WoundClot Hemostatic Gauze, HemCon Nasal Plug, and RevMedx's XSTAT hemostatic device. The standard of care should not be affected by the location of a patient, whether that patient is in a remote village overseas, on the battlefield, a rural farm, or at a major metropolitan hospital here in the United States. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Management of Chronic Hypertension Following Intracerebral Hemorrhage
Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Clinical evidence is relatively lacking for clinicians to understand the extent of blood pressure lowering and the optimal agents to use in t...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Acute Management of Hypertension Following Intracerebral Hemorrhage
Intracerebral hemorrhage (ICH) is responsible for approximately 15% of strokes annually in the United States, with nearly 1 in 3 of these patients dying without ever leaving the hospital. Because this disproportionate mortality risk has been stagnant for nearly 3 decades, a main area of research has been focused on the optimal strategies to reduce mortality and improve functional outcomes. The acute hypertensive response following ICH has been shown to facilitate ICH expansion and is a strong predictor of mortality. Rapidly reducing blood pressure was once thought to induce cerebral ischemia, though has been found to be sa...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Foreword Source Type: research

Prevention of Pressure Injury by Using Silicone Foam Dressings: Experience at a University Hospital in Hong Kong
Pressure injury is a serious problem and is common in critical care units. Over the last decade, there is new evidence suggesting that the use of multilayered silicone foam dressing as preventive measures can decrease the incidence and prevalence rate of hospital-acquired pressure injury. The purpose of this study was to investigate the clinical efficacy of this dressing in reducing sacral and coccygeal pressure injury incidence rate as compared with standard preventive interventions in critical care settings. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Effect of Interventional Educational Programs on Intensive Care Nurses' Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Postclinical Trial
The article reports results of an educational program designed to modify negative attitudes of intensive care nurses regarding the use of physical restraints. Findings revealed that increased knowledge about appropriate utilization of various types of restraints positively impacted perceptions, attitudes, and patient care practices. Authors also explore restraint use in several countries and identify variations in use of restraining methods. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Case Study Investigation Decreases Burnout While Improving Interprofessional Teamwork, Nurse Satisfaction, and Patient Safety
Prevention of burnout is a national imperative, and blame-free investigations of clinical events are advocated. Reflective inquiry techniques are helpful in processing adverse events while minimizing blame. The purpose of this project was to develop an interprofessional peer review program (Case Study Investigation) to process emotions, improve teamwork, and optimize patient outcomes. This evidence-based practice project was conducted in a 12-bed intensive care unit using reflective inquiry techniques to perform peer case review across disciplines. Significant improvements were seen in percent strongly agree to the 2 satis...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Effect of Intensive Care Unit Nurses' Empowerment Program on Ability in Visual Differential Diagnosis of Pressure Ulcer Classification
This study was conducted to investigate the effect of an empowerment program on nurses' ability to visually determine the stage of a pressure ulcer. This study was a nonrandomized clinical trial involving an intervention group and a control group. Prior to the empowerment program, data indicated that there was a significant deficit in the ability of nurses in both groups to accurately determine the stage of a pressure ulcer. Following the empowerment program, the mean scores of nurses in the intervention group were significantly higher than the mean score of nurses in the control group (P ≤ .001). This study indicates t...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Symptom Management and Hospital Readmission in Heart Failure Patients: A Qualitative Study From Portugal
This study revealed that patients with heart failure seem to struggle with management of multiple treatment regimens during the long course of their chronic illness. Based on these interviews, authors conclude that a disease management program be tailored expressly for the Portuguese culture and their lifestyle. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Measurement and Nonpharmacologic Management of Sleep Disturbance in the Intensive Care Units: A Literature Review
The general goal of this review is to summarize, clarify, and evaluate what is known about patients' sleep in the intensive care units (ICUs) in terms of sleep measurement and management. In addition, this review focuses on the gap in knowledge in this field. A review of online databases for relevant articles in the period between 2000 and 2017 was conducted. The results of this study indicate that there are several methods to measure patients' quality of sleep. Polysomnography and actigraphy are the most common standard objective and valid methods used to measure sleep disorders in the ICU. On the contrary, several subjec...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Lifestyle Modifications in Adults and Older Adults With Chronic Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a chronic disorder that causes the unwanted backflow of gastric contents into the esophagus, throat, and mouth.1 Gastroesophageal reflux disease affects roughly 20% of the US population. It is estimated that older adults experience GERD symptoms more commonly and with greater severity because of age-related physiologic changes. Comorbidities and polypharmacy, common in older adults, can also exacerbate GERD symptoms, which can allow the disease to progress. This integrative review aims to identify key lifestyle-associated risk factors and interventions appropriate for older adults ...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Teaching Critical Care Nursing Online for RNs
Registered nurses are choosing to further their educational careers by seeking a bachelor's of science degree online (RN-to-BSN). The impetus for choosing the online delivery method is related to the ability to sign into a Learning Management System during times that are advantageous to their hospital work schedules, family, and daily living activities. The RN-to-BSN online option degree requires a Critical Care/Advanced Health Care Course as part of their curriculum plan; therefore, the article presents an overall view of the critical care course, the theoretical underpinnings for progression to the online delivery method...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Horseshoe, Cockpit, and Dragonfly: Nurse Movement in Headwall Patient Rooms
An exploratory, qualitative study conducted on 6 units in 4 hospitals featured field observations of 20 experienced nurses during complete 12-hour day and night shifts, followed by semistructured participant interviews. All patient rooms featured conventional headwall-type life support systems in which the head of the bed is against the wall where multiple electrical, gas, and communication utilities are located. Critical care nurses displayed repetitive movement patterns around the patient and the bed. Movement patterns observed varied according to room size, availability of supplies, and positions of fixed and/or mobile ...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Spurious Laboratory Values in Patients With Leukocytosis
Physiological derangements such as hypoxemia and hyperkalemia are medical emergencies that warrant prompt interventions to prevent further patient clinical deterioration. However, in patients with myeloproliferative diseases or malignancies that result in extreme leukocytosis, hypoxemia and hyperkalemia demonstrated in laboratory results could be deceiving due to in vitro reactions and may not reflect actual patient condition. Clinicians have to be familiar with these phenomena so as to not cause harm by treating these spurious laboratory values. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Clinical Education to Decrease Perceived Barriers to Delirium Screening in Adult Intensive Care Units
Despite current advances in critical care medicine, delirium remains a frequent complication of an intensive care unit stay. The consequences can be severe and far reaching, including an increase in mortality, length of stay, and long-term cognitive sequelae. Frequently, delirium can be missed by clinicians who fail to complete a standardized delirium screening tool and, therefore, many cases go unrecognized and untreated. A multidimensional education program is one of the most effective methods to increase awareness of the condition and increase compliance in utilizing standardized delirium screening tools at the bedside....
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Nursing Considerations When Using Neuromuscular Blocking Agents to Assist With Intubation: A Review of Literature
The use of neuromuscular blocking agents (NMBAs) in acute care settings during intubation is vitally important. The NMBAs increase first pass success rates significantly while protecting patients from gastric aspiration, tracheal injury, and death. During emergent intubations, succinylcholine and rocuronium are commonly used, but each comes with specific risks and individualized interventions. First pass success can be increased by ensuring correct dosing for overweight patients and employing the use of video laryngoscope. For planned, nonemergent intubations with sustained paralysis, the chosen NMBA can be individualized ...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Recognition, Assessment, and Pharmacotherapeutic Treatment of Alcohol Withdrawal Syndrome in the Intensive Care Unit
Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. No clinical assessment tools have been validated to assess for AWS in the intensive care unit, particularly for patients requiring mechanical ventilation. The Clinical Institute Withdrawal Assessmen...
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Pharmacologic Approach to Management of Clostridium difficile Infection
This article briefly reviews the current literature and guideline recommendations for treatment and prevention of CDI, with a focus on antibiotic treatment considerations including dosing, routes of administration, efficacy data, adverse effects, and monitoring parameters. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Original Articles Source Type: research

Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - December 2, 2018 Category: Nursing Tags: Foreword Source Type: research

Emergency Airway Response Team (EART) Documentation: Criteria, Feasibility, and Usability
This study identified EART documentation criteria and incorporated them into a nursing documentation instrument to be completed by a nurse scribe during the event. The EART instrument was tested by nurses for usability, feasibility, and completeness. Twenty-one critical care nurses participated in this study. The results confirmed good usability, positive feasibility, and 79% documentation completeness using this tool. These criteria and this instrument can be important in documenting the EART and in evaluating the quality of the team performance. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Transport of Critically Ill Cardiovascular Patients
Intra-hospital transport (IHT) of intensive care unit (ICU) patients is associated with a 30% to 60% incidence of adverse events (AEs). This prospective observational study collected data from 200 patient transports from a 24-bed cardiovascular intensive care unit (ICU) between July 2017 and December 2017. Phase 1 of the study focused on identifying and correcting deficiencies in nurses' knowledge regarding IHT. Phase 2 observed the occurrence and type of AEs during the IHT of ICU patients with and without physician accompaniment. The preeducation mean nursing knowledge score was 30.8 ± 10.2 (scale 0-100), and postc...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Operational Excellence in the CTSICU
This article discusses how the Operational Excellence concept and board was used in a busy cardiothoracic intensive care unit to affect employee safety and empowerment as well as improvements in patient safety and care quality. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Blood Glucose Management for Reducing Cardiac Surgery Infections
This article describes the effectiveness of a Glucose Management Team tasked with ensuring that blood glucose levels are maintained within these recommended guidelines, starting with day of admission and extending through the first postoperative day. Team members review blood glucose levels and provide clinical data relevant to regulating insulin infusions and nutritional intake, major factors in influencing positive patient outcomes. This article reports the successes of the Glucose Management Team in reducing cardiac surgery infections. The successes of the endeavor led other hospital surgical divisions to adopt the prot...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

ECMO: Nursing Care of Adult Patients on ECMO
Extracorporeal membrane oxygenation (ECMO) is used for both cardiac and pulmonary failure when conventional measures are no longer substantial in supporting life. ECMO is not a permanent device. It is used as a temporary measure to allow the lungs and heart, as well as other organs to recover. If recovery is not possible, it may also be used as a bridge to a more permanent device such as the left ventricular assist device or heart or lung transplantation. This is a detailed description of the differences between venovenous ECMO and venoarterial ECMO and the nursing care that is associated with the two. A case study of a 37...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Learning to Live Again: The Role of Education in Heart Transplant Recipients
The heart transplant nurse coordinator plays a key role in educating and supporting the postoperative heart transplant patient to achieve the best outcomes for a long and healthy life. The time leading up to transplantation, wait-list candidates will hear vital information regarding life after they have received their life-sustaining heart transplant. Unfortunately, at times, the information is minimally retained. The first few days to weeks following surgery are a crucial period of time for education of patients to be discharged from the hospital setting to home where they will need to care for themselves independently. E...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Common Postoperative Heart Transplant Complications
This article reviews the history of heart transplantation, complications post–heart transplantation, and nursing management considerations for the immediate period after heart transplant surgery. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

The Use of Left Ventricular Assist Devices in End-Stage Heart Failure
Heart failure is one of the most common diagnoses in patients requiring multiple hospitalizations. The use of mechanical circulatory support (both temporary and durable), especially left ventricular assist devices (LVADs), in this patient population has evolved over the last decade. There are thousands of durable LVADs implanted in the United States annually as bridge to transplantation, destination therapy, or bridge to recovery. LVAD therapy, just like cardiac transplantation, takes a multidisciplinary team approach to achieve success. Appropriate patient selection is the key to good clinical outcomes. As the technology ...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research

Managing Patients With Heart Failure All the Way to a Heart Transplant
Heart transplantation is a viable option for many patients with end-stage heart failure. An extensive evaluation by specialists and in-depth testing are done to determine the risks of advanced therapies including the left ventricular assist device, since most patients need one to safely make it to transplant. A multidisciplinary approach is the most effective approach to successfully progressing a patient to transplant safely and helping him or her prosper after transplant. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research