Diagnostic Considerations of Venous Thromboembolic Disease
Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE). The clinical presentation of VTE is nonspecific and requires confirmatory testing. The most common diagnostic tool for DVT is duplex ultrasonography since it is a noninvasive test with high accuracy. Contrast venography is considered the gold standard modality to diagnose DVT, but it is an invasive test. Magnetic resonance venography and computed tomography venography are alternative diagnostic methods for DVT, which can be helpful in certain circumstances. Pulmonary embolism is commonly diagnosed by computed tomography pulmonar...
Source: Critical Care Nursing Quarterly - May 31, 2017 Category: Nursing Tags: Original Articles Source Type: research
Clinical Presentation and Risk Factors of Venous Thromboembolic Disease
Venous thromboembolism (VTE) has a wide range of clinical presentations. Deep venous thrombosis may occur in upper or lower extremities or in visceral veins. Extremity deep venous thrombosis usually manifests with unilateral painful swelling in the limb, while visceral deep venous thrombosis manifestations vary on the basis of the involved organ. Pulmonary embolism classically manifests with sudden pleuritic chest pain and unexplained dyspnea. Superficial thrombophlebitis usually presents with acute inflammation around a palpable thrombosed superficial vein. Risk factors of VTE are either inherited or acquired. The inherit...
Source: Critical Care Nursing Quarterly - May 31, 2017 Category: Nursing Tags: Original Articles Source Type: research
Pathogenesis and Epidemiology of Venous Thromboembolic Disease
Venous thromboembolism is the formation of a blood clot in the vein. It mainly consists of 2 life-threatening conditions—deep venous thrombosis and pulmonary embolism. Deep venous thrombosis is a potentially dangerous condition with grave sequelae, the worst of which is pulmonary embolism. Venous thromboembolism can also lead to multiple other conditions with significant morbidity and mortality that include extension of thrombi, pulmonary hypertension, recurrence, and postthrombotic syndrome. An update on the epidemiology, etiology, and pathogenesis of venous thromboembolism will be reviewed in this article. (Source: Cri...
Source: Critical Care Nursing Quarterly - May 31, 2017 Category: Nursing Tags: Original Articles Source Type: research
Introduction to the Anatomy and Physiology of Pulmonary Circulation
In the United States, venous thromboembolism is associated with high mortality and morbidity affecting as many as 900 000 people (1-2 per 1000) each year. Estimates suggest that 60 000 to 100 000 Americans die of deep venous thrombosis/pulmonary embolism and 10% to 30% die within 1 month of diagnosis, with sudden death being the first symptom in approximately 25% of population with pulmonary embolism. One-half of the patients with deep venous thrombosis will have postthrombotic syndrome, which includes swelling, pain, discoloration, and scaling in the affected limb. Approximately 33% of patients will have a recurrence with...
Source: Critical Care Nursing Quarterly - May 31, 2017 Category: Nursing Tags: Original Articles Source Type: research
Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - May 31, 2017 Category: Nursing Tags: Foreword Source Type: research
Factors Influencing Weaning Older Adults From Mechanical Ventilation: An Integrative Review
This study aim was to describe the influences that affect weaning from mechanical ventilation among older adults in the intensive care unit (ICU). Adults older than 65 years comprised only 14.5% of the US population in 2014; however, they accounted up to 45% of all ICU admissions. As this population grows, the number of ICU admissions is expected to increase. One of the most common procedures for hospitalized adults 75 years and older is mechanical ventilation. An integrative review methodology was applied to analyze and synthesize primary research reports. A search for the articles was performed using the PubMed and Cumul...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Central Venous Access: The Missed Patient Safety Goal
Hospital-acquired conditions are conditions that never should happen to a patient while in the care of physicians, nurses, and the health care facility. Central line-associated bloodstream infections plague the nation's health care facilities. With increasing rates of infections being reported during hospitalization, hospital-acquired conditions, namely, infections, and more specifically central line-associated bloodstream infections, are now at the top of patient safety concerns and impact organization's reimbursement. Increased surveillance of infections by regulatory agencies and the implementation of value-based purcha...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Simple Strategies for Surviving the Night Shift
Without a doubt, working nights is stressful and can wreak havoc on your physical, mental, and emotional health. It is like fitting a square peg into a round hole; you are living on a schedule opposite from most of the world. Your internal rhythms are disrupted socially and biologically when you work nights. But it does not have to be as disruptive as we let it be. There are lifestyle strategies to better manage working nights; some are mental approaches and some are physical or behavioral tactics. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Improving Nurse Satisfaction With Open Visitation in an Adult Intensive Care Unit
The objective of this performance improvement project was to increase nurse satisfaction related to PFCC and create consistency across clinicians for visitation practices. The Unit Practice Council developed staff guidelines for family visitation that included scripting prompts the nurse could use when communicating with families. The adoption of staff guidelines for family visitation was helpful in creating a culture change toward PFCC. Nurses' overall mean stress level with PFCC decreased, and their perception of having difficulty in reducing patients' or families' anxieties also decreased. The development of guidelines ...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Implementing iRound: A Computer-Based Auditing Tool
Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo cu...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
An Analysis of the Prevalence of Depression Post–Myocardial Infarction
This article discusses the results of a research that was completed at a cardiology office using a retroactive medical record review that focused on outpatients with cardiac diseases. The primary aim of the study was to collect data using the Patient Health Questionnaire-9 (PHQ-9), a public domain screening tool. This research was intended to provide evidence that would support using the PHQ-9 as a standard depression screening tool for patients post–myocardial infarction. By recognizing the symptoms of depression, the patient would then be treated accordingly. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Improving Clinical Outcomes for Patients With Class III Heart Failure
The objective of the research study was to compare 30-day readmission rates of patients implanted with the CorVue capable ICD pacemaker with patients with congestive heart failure (CHF) with no implanted device. The aim of the research focused on the usefulness of intrathoracic impedance monitoring alerts in guiding empirical treatment of patients with CHF to prevent HF readmissions. Methodology included a retrospective medical chart review, comparing 30-day readmission events among patients with class III CHF who received home health intervention with similar patients implanted with the CorVue ICD. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Clinical Simulation Learning in Critical Care
Nurses are expected to master many skills, especially in critical care; thus, competency is crucial. Clinical educators must determine whether nurses who are new to the skill set have attained an acceptable level of achievement in performance; hence, are they capable of providing quality and safe patient care? Simulation learning is used in the hospital setting and largely in academic centers. Strategies include for the instructor to acquire an aspect of abilities and deficits as a basis upon which to create learning experiences that enable nurses to develop essential clinical competence. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Preparing the Family and Children for Surgery
The focus of this literature analysis is the concept of preparing the family and children for surgery. As posited in the literature, surgery causes stress and anxiety that have a negative impact on both parents and their children. Therefore, the need for health care professionals to facilitate positive preparation for surgery to minimize anxiety and enhance postoperative recovery is important. Preparing the family and children for surgery is discussed in depth under the following themes: Preoperative Anxiety in Children, the Impact of Preoperative Anxiety on the Pediatric Patients and Parents, Preoperative Psychological Pr...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
Nurses' Error Management in Critical Care Units: A Qualitative Study
Nursing errors are common in critical care units, and nurses are in the first line of confrontation. The purpose of this study was to explore the processes of managing nursing errors in critical care units in Iran and to develop a theoretical explanation of the phenomenon. This was a grounded theory study. We recruited a sample of 18 critical care nurses for the study. The sampling method was purposive and then changed to theoretical. The data were collected through in-depth interviews. For data analysis, we employed the constant comparative analysis technique. The core category of the study was “continuous situational a...
Source: Critical Care Nursing Quarterly - February 28, 2017 Category: Nursing Tags: Original Articles Source Type: research
