Critical care nurse最新文献

{"title":"The author responds.","authors":"Marci Ebberts","doi":"10.4037/ccn2025491","DOIUrl":"https://doi.org/10.4037/ccn2025491","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"10"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redesigning Intensive Care Unit Rounds to Improve Collaboration at a Military Hospital.","authors":"Kiffin R Smallegan, Samantha J Smith, Heather L Wilder, Gabriylle E Payne, Sorana Raiciulescu, Carolyn M Capps","doi":"10.4037/ccn2025757","DOIUrl":"https://doi.org/10.4037/ccn2025757","url":null,"abstract":"<p><strong>Background: </strong>Team communication is essential to delivering health care safely. Nurses in the adult intensive care unit at a large military treatment facility were not consistently present in daily patient rounds and stated that team communication could be improved. This clinical question was developed: among critical care staff members, how does a standardized daily rounding script, compared with current practice, impact interdisciplinary communication over a 36-week period?</p><p><strong>Review of evidence: </strong>Current literature includes 3 themes: rounds should be interdisciplinary; include the ABCDEF bundle (pain assessment, spontaneous awakening and breathing trials, analgesia and sedation choice, delirium assessment, early mobility, and family engagement); and use a standardized script. These elements can improve perceptions of collaboration in rounds.</p><p><strong>Implementation: </strong>An interdisciplinary rounding script was introduced across 2 adult intensive care units at a military hospital over 36 weeks. Before and after the intervention, the Collaboration and Satisfaction About Care Decisions survey was used to assess nurses' perceptions of collaboration; rounds were observed for key elements.</p><p><strong>Evaluation: </strong>After implementation, the mean survey score (both units combined) rose by 1.5 units, nurse presence at rounds increased by 21.6% (P = .01), nurse contributions to rounds increased by 31.1% (P = .001), all bundle elements were reviewed 18.9% more often (P = .07), a summary of care was given 53.6% more often (P < .001), and order read back was completed 69.8% more often (P < .001).</p><p><strong>Sustainability: </strong>Continued use of the script in the military treatment facility will require adapting it to practice changes and training new staff members on its use.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"16-26"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Critical Care Nursing: Benefits, Risks, and Ethical Considerations.","authors":"Annie George, Anne Griswold Peirce","doi":"10.4037/ccn2025746","DOIUrl":"https://doi.org/10.4037/ccn2025746","url":null,"abstract":"<p><strong>Background: </strong>The rapid evolution of artificial intelligence technologies, particularly in critical care nursing, presents opportunities and ethical challenges. Artificial intelligence has potential to enhance patient care and clinical decision-making, yet concerns regarding privacy, consent, bias, discrimination, and the dehumanization of care persist.</p><p><strong>Objective: </strong>To explore the intersection of artificial intelligence and ethics in nursing, with a focus on ethical implications for patient care and clinical decision-making.</p><p><strong>Methods: </strong>A comprehensive literature search was done for this narrative review to synthesize knowledge on artificial intelligence in nursing, incorporating insights from nursing, information technology, legal studies, and medicine.</p><p><strong>Results and discussion: </strong>Artificial intelligence technologies are reshaping nursing workflows and can improve health care outcomes. However, these technologies introduce complex ethical concerns, including the risk for bias, data privacy issues, and the potential for reduced human interaction in patient care. Critical care nurses are uniquely positioned to leverage artificial intelligence effectively while identifying and mitigating risks related to its use. The involvement of critical care nurses in the development and application of artificial intelligence technologies is essential to ensure the accuracy, safety, and fairness of these tools.</p><p><strong>Conclusion: </strong>Critical care nurses must advocate for the ethical integration of artificial intelligence in health care, ensuring alignment with core nursing values such as autonomy, beneficence, nonmaleficence, justice, and veracity. By actively participating in discussions, monitoring artificial intelligence tools, and providing feedback, nurses can help to ensure that artificial intelligence technologies enhance patient care while upholding the ethical principles fundamental to nursing practice.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"46-52"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Chlorhexidine-Coated Dialysis Catheter Caps to Reduce Central Venous Dialysis Catheter Infection Rates: A Quality Improvement Project.","authors":"Rosemary Olivier, Claudia Skinner, Todd Bloom, Dana Rutledge","doi":"10.4037/ccn2025293","DOIUrl":"https://doi.org/10.4037/ccn2025293","url":null,"abstract":"<p><strong>Background: </strong>Many patients with end-stage kidney disease begin dialysis therapy with central venous dialysis catheters, significantly increasing the risk of dialysis catheter-related bloodstream infection. Bloodstream infections are among the most severe harm events affecting patients receiving dialysis.</p><p><strong>Local problem: </strong>In 2023, the dialysis catheter-related central line [catheter]-associated bloodstream infection (CLABSI) rate at an acute care medical center in southern California was thrice the national benchmark. This quality improvement project aimed to decrease this rate by adding chlorhexidine-coated dialysis catheter caps to standard care.</p><p><strong>Methods: </strong>Using the Knowledge to Action model, the medical center made a dialysis catheter-related CLABSI reduction practice change. Preimplementation and postimplementation monthly aggregate data were collected for dialysis catheter-related CLABSIs, central venous dialysis catheter days, and dialysis catheter-related infection rates. One-on-one dialysis staff simulation training and process compliance audits ensured intervention fidelity. The intervention was replacement of nonchlorhexidine dialysis catheter caps with chlorhexidine-coated dialysis catheter caps for patients with central venous dialysis catheters.</p><p><strong>Results: </strong>An 8-week preimplementation period included 119 patients, 561 dialysis therapies, 934 central dialysis catheter days, and 2 dialysis catheter-related CLABSIs (2.14 infections per 1000 catheter days). An 8-week postimplementation period included 128 patients, 583 dialysis therapies, 897 central dialysis catheter days, and 0 dialysis catheter-related CLABSIs; no dialysis catheter-related CLABSIs occurred during postimplementation sustainability assessment (24 weeks total).</p><p><strong>Conclusions: </strong>Use of chlorhexidine-coated dialysis catheter caps led to clinically significant results among patients receiving dialysis with central catheters at an acute care medical center.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"53-62"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversation Is Critical: Teaching Critical Care Nurses a Framework for Peer Feedback.","authors":"Ellen M Alvarez, Amber Capone, Jennifer Papi, Kathleen Luckner","doi":"10.4037/ccn2025624","DOIUrl":"https://doi.org/10.4037/ccn2025624","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"88-91"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Safety Concerns With Replacing Central Venous Catheters With Midline Cathers.","authors":"Barb Nickel, Tricia Kleidon, Marlene Steinheiser, Lisa Gorski, Lynn Hadaway, Victor Daniel Rosenthal","doi":"10.4037/ccn2025432","DOIUrl":"https://doi.org/10.4037/ccn2025432","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"10-12"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Authors Respond.","authors":"Michael Mazzeffi","doi":"10.4037/ccn2025946","DOIUrl":"https://doi.org/10.4037/ccn2025946","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"13-14"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multimodal Approach to Transform Culture by Implementing AACN's Healthy Work Environment Standards.","authors":"Nancy Blake","doi":"10.4037/ccn2025911","DOIUrl":"https://doi.org/10.4037/ccn2025911","url":null,"abstract":"<p><strong>Background: </strong>Organizational culture and work environment are important factors in retaining staff members and achieving good patient outcomes. The COVID-19 pandemic exacerbated existing challenges for nurses and the health care organizations employing them.</p><p><strong>Local problem: </strong>Following the COVID-19 pandemic, the nursing staff turnover rate at Los Angeles General Medical Center in Los Angeles, California, reached 20.62%, an all-time high. A quality improvement project was initiated to improve the organization's culture in order to increase retention and improve other nurse-sensitive indicators.</p><p><strong>Methods: </strong>The quality improvement project was intended to implement as many as possible of the 6 healthy work environment standards established by the American Association of Critical-Care Nurses (AACN): Effective Communication, True Collaboration, Appropriate Staffing, Authentic Leadership, Meaningful Recognition, and Shared Decision-Making. Key elements of the project were the implementation of professional shared governance, a new graduate transition to practice program, a mobile application to improve communication, a grant-funded project to decrease burnout, the AACN Clinical Scene Investigator Academy, a leadership development program, and a new staffing and scheduling system.</p><p><strong>Results: </strong>The quality improvement program resulted in improved patient outcomes, reduced nurse turnover, an increased rate of nurse certification, a higher proportion of nurses educated at the bachelor of science in nursing level or higher, and decreased overall costs.</p><p><strong>Conclusion: </strong>Implementation of a quality improvement program focusing on the 6 AACN healthy work environment standards can improve the nursing work environment.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"e1-e9"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrections.","authors":"","doi":"10.4037/ccn2025750","DOIUrl":"https://doi.org/10.4037/ccn2025750","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"7"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerns With Recommendation to Use Midline Catheters for Vasopressor Administration.","authors":"Molly Moyer","doi":"10.4037/ccn2025200","DOIUrl":"https://doi.org/10.4037/ccn2025200","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"13"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}