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 postcurricu...
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
Evolution of a TAVR Program
Transcatheter aortic valve replacement (TAVR) is quickly becoming the new standard of care for high- and intermediate-risk patients requiring aortic valve replacement. From May 2012 through April 2018, 1850 patients were evaluated for severe aortic valve stenosis, and over 900 TAVR procedures were performed at the author's institution, Allegheny General Hospital, Pittsburgh. Efficient screening processes, comprehensive review of data, and the less invasive delivery of care have made the TAVR program a viable and sustainable treatment option for patients with severe symptomatic aortic valve stenosis. Developing an efficient...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research
Coronary Artery Bypass Grafting: A Clinical Overview
Coronary artery bypass grafting remains a viable and successful option for treating high-grade coronary artery stenosis. The postoperative recovery is individual for each patient, but when following long-standing guidelines and physician orders, outcomes are generally positive. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research
When Transfusion Is Not an Option—the Challenges and Rewards
The decision to develop a formal Bloodless Medicine Program to attract and effectively care for patients who decline blood transfusion was made in 1998 by clinical and administrative leaders at our flagship hospital, Allegheny General Hospital, part of the Allegheny Health Network. The Bloodless Medicine Program has more than 20 years of experience in caring for this sometimes challenging patient population and with this experience has provided extensive insight into best practices related to effective, safe, patient blood management. Patient blood management is a patient-centered, evidence-based approach to transfusion th...
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Original Articles Source Type: research
Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - August 31, 2018 Category: Nursing Tags: Foreword Source Type: research
Multifactorial Strategies for Sustaining Safe Patient Handling and Mobility
Reduction in nursing staff injuries has occurred with the use of an evidence-based approach to safe patient handling and mobility. Parts of the evidence-based practice initiative include having the appropriate equipment, such as mechanical patient-lifting devices, a no-lift policy, and the use of peer coaches. The combination of the implementation of a culture of safety can sustain evidence-based, safe patient-handling practices that reduce patient-handling injuries. Patient-handling programs should include adaptations for an aging nursing workforce. The use of safety checklists in health care can improve communication and...
Source: Critical Care Nursing Quarterly - June 1, 2018 Category: Nursing Tags: Original Articles Source Type: research
A Multidisciplinary Approach to Equipment Use in Pediatric Patient Mobilization
Research has shown that patients who are mechanically ventilated or immobile for greater than 7 days are at increased risk for deconditioning and muscle atrophy. Immobility impacts length of stay as well as patients' ability to return to their prior level of function. As part of the safe patient-handling initiative created at Michigan Medicine, a special team of nurses and therapists was assembled to adapt an adult mobility framework for the pediatric population. The pediatric mobility model determines each patient's specific mobility “phase” based on detailed criteria. Clinical staff can then implement strategies aime...
Source: Critical Care Nursing Quarterly - June 1, 2018 Category: Nursing Tags: Original Articles Source Type: research
Development of Medical Criteria for Mobilizing a Pediatric Patient in the PICU
Physical activity in acute and critical care has been recognized as a successful method of improving patient outcomes. Challenges lie, however, in mobilizing pediatric critically ill patients and establishing consensus among health care providers about the safety and feasibility. The challenge of mobilizing pediatric patients is balancing developmental level, functional ability, and level of acuity; therefore, a mobility guideline was developed for use in the pediatric intensive care unit (PICU). The unique population and challenges in the PICU led to the development of a PICU-specific set of medical criteria within a PICU...
Source: Critical Care Nursing Quarterly - June 1, 2018 Category: Nursing Tags: Original Articles Source Type: research
