Anticoagulation Considerations in Liver Disease
Coagulopathy of liver disease is a complex pathology that may result in thrombosis and/or bleeding complications. Routine laboratory values are not always reflective of the degree of these risks. Additionally, prophylaxis and treatment of venous thromboembolism in patients with cirrhosis require careful evaluation when selecting and monitoring drug therapy for these indications. Therefore, this article aims to provide insight regarding coagulopathy of liver disease, influence on laboratory values, and anticoagulant therapy considerations for critical care nurses assuming care for patients with cirrhosis. (Source: Critical ...
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Original Articles Source Type: research
Review of Anticoagulation in Continuous Renal Replacement Therapy
Continuous renal replacement therapy is an important, yet challenging, treatment of critically ill patients with kidney dysfunction. Clotting within the dialysis filter or circuit leads to time off therapy and impaired delivery of prescribed treatment. Anticoagulation can be used to prevent this complication; however, doing so introduces risk for unintended complications such as bleeding or metabolic derangements in patients who are already critically ill. A thorough understanding of indications, therapeutic options, and monitoring principles is necessary for safe and effective use of this strategy. This review provides cl...
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Original Articles Source Type: research
Hemostatic Management in Extracorporeal Membrane Oxygenation
The use of extracorporeal membrane oxygenation (ECMO) for acute cardiac and/or respiratory failure has grown exponentially in the past several decades. Systemic anticoagulation is a fundamental element of caring for ECMO patients. Hemostatic management during ECMO walks a fine line to balance the risk of safe and effective anticoagulant delivery to mitigate thromboembolic complications and minimizing hemorrhagic sequelae. This review discusses the pharmacology, monitoring parameters, and special considerations for anticoagulation in patients requiring ECMO. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Original Articles Source Type: research
Perioperative Anticoagulation Management
Management of anticoagulation in individuals undergoing operative procedures is a complex situation. Each case should be assessed individually with proper risk assessment, monitoring, and plan for perioperative and postoperative anticoagulation. Clinical evidence for the management of these patients is relatively scarce, and clinicians are often assessing each individual case with minimal guidance. This review provides nurses with a summary of available literature on the assessment, laboratory monitoring, timing of adjusting anticoagulation, and bridging prior to procedures. In addition to general perioperative anticoagula...
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Original Articles Source Type: research
Anticoagulation Monitoring in the Intensive Care Unit
Patients with critical illness often display variable hypo- and hypercoagulable sequalae requiring intense monitoring and anticoagulation pharmacotherapy to prevent or treat inappropriate clot formation. It is imperative to understand the various stages of the clotting cascade and where each pharmacotherapy agent exerts its therapeutic effect. Common coagulation tests are utilized to monitor the areas of the clotting cascade and the effects that anticoagulant pharmacotherapy exhibits. Many novel coagulation tests are also in development. The purpose of this narrative review is to evaluate commonly utilized coagulation test...
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Original Articles Source Type: research
Foreword
No abstract available (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - February 25, 2022 Category: Nursing Tags: Foreword Source Type: research
Factors Influencing University Students' Acceptance to Undertake the COVID-19 Vaccine in Jordan
This article reports study findings regarding factors that influence university students' decision of acceptability to the COVID-19 vaccine in Jordan. Results highlight the continued need for clear and consistent information about the vaccine by health care decision-makers and university administrations. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
Evaluating the Feasibility and Efficacy of a Pediatric Intensive Care Unit Diary
As the progress of critical care medicine has improved the survival rate of critically ill patients, comorbidities and long-term health care have attracted people's attention. The terms “post–intensive care syndrome” (PICS) and “PICS-family” (PICS-F) have been used in non-neurocritical care populations, which are characterized by the cognitive, psychiatric, and physical sequelae associated with intensive care hospitalization of survivors and their families. An intensive care unit (ICU) diary authored by the patient's family members may alleviate the psychological distress of the patient and his or her family. Thi...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
Development, Implementation, and Evaluation of an Early Mobility Protocol in a Regional Level II Trauma Center
The purpose of this project was to develop and evaluate a collaborative nursing/therapist protocol for early mobility in a medical-surgical intensive care unit (MICU) in a regional level II trauma center. Data for patients in the MICU were compared for the periods August 3, 2015-August 2, 2016, and August 3, 2014-August 2, 2015. Semistructured interviews were conducted with 10 nurses and 1 therapist. Average MICU length of stay decreased from 3.81 to 3.50 days (P = .057). Mean time in mobility chairs did not change (0.12 days vs 0.11 days, P = .389). Mean number of days to first documented level 2-5 activity decreased sign...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
The Effect of Early Mobilization on Respiratory Parameters of Mechanically Ventilated Patients With Respiratory Failure
This article reports the results of a study of a randomized clinical trial of intensive care unit patients receiving mechanical ventilation. The findings of this study confirmed that a 4-step protocol for early mobilization can improve Pao2, O2 saturation, Pao2/Fio2 (fraction of inspired oxygen) ratio, and pulmonary compliance. The value of interdisciplinary collaboration supporting early mobilization was confirmed. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
The Attitude of Iranian Critical Care Nurses Toward Euthanasia: A Multicenter Cross-sectional Study
Today, one of the major ethical challenges facing the world's health care system, and in particular nurses in the intensive care unit, is euthanasia or death out of pity. The aim of this study was to investigate the attitude of Iranian nurses in the intensive care unit toward euthanasia. This was an analytical cross-sectional study using census sampling. The data collection tool was the Euthanasia Attitude Scale. A total of 206 nurses working in the intensive care unit in 4 hospitals in the Mazandaran province of Iran were included in this study. The mean of total Euthanasia Attitude Scale score in intensive care unit nurs...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
A New Patient Acuity Tool to Support Equitable Patient Assignments in a Progressive Care Unit
Making fair and equitable staffing decisions and patient assignments created complexities and undue nursing dissatisfaction on a 20-bed progressive care unit. Common themes shared by the nursing staff included inadequate staffing ratios, increased workload, and unease for patient safety. On the basis of these concerns, a unit-based needs assessment provided insight into what perceived and actual barriers exist preventing nurses from providing excellent care. Information gathered helped determine what could be done to overcome some barriers, and performing a comprehensive unit profile assessment allowed for better insight i...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
A Quality Improvement Initiative to Evaluate the Effectiveness of the ABCDEF Bundle on Sepsis Outcomes
Sepsis affects 1.7 million Americans annually and often requires an intensive care unit (ICU) stay. Survivors of ICU can experience long-term negative effects. This quality improvement initiative was designed to increase compliance with ABCDEF bundle elements and improve clinical outcomes. A significant improvement was seen in the completion of spontaneous awakening and breathing trials (P = .002), delirium assessment (P = .041), and early mobility (P = .000), which was associated with a reduction in mortality and 30-day readmission rates. Findings were consistent with other research that demonstrated an improvement in car...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
The Effect of the Nursing Care Based on the Roy Adaptation Model on the Level of the Quality of Life and Fatigue in the Patients Undergoing Coronary Artery Bypass Graft Surgery
This article reports the findings of a study designed to investigate the effectiveness of the Roy Adaptation Model, as it relates to improvements in nursing care outcomes for patients undergoing coronary bypass graft surgery. Results revealed that the implementation of a training program based on this model enhanced staff education and led to decreases in the level of fatigue and improved the quality of life for this group of patients. (Source: Critical Care Nursing Quarterly)
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
Emergency Department Initiative to Improve Sepsis Core Measure Compliance: A Hospital Network Approach
The topic of sepsis has been realized among the last 20 years. A majority of patients with sepsis enter the health system through the emergency department, and health professionals need to provide evidence-based care. Within the health system, interdepartmental teams were formed with the purpose to set a system-wide standard to meet the evidence-based practice standards for sepsis. Participants were recruited from every department that was involved with the care delivery of emergency department patients with sepsis. The team developed a team charter to state the group objectives. A gap analysis was completed to set group p...
Source: Critical Care Nursing Quarterly - November 29, 2021 Category: Nursing Tags: Original Articles Source Type: research
