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 the auth...
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
