Critical care nurse最新文献_第2页

Using the Modified Minnesota Detoxification Scale to Evaluate Alcohol Withdrawal Syndrome: An Integrative Review.

IF 2 4区医学

Critical care nurse Pub Date : 2025-04-01 DOI: 10.4037/ccn2025568

Torri Trojand, Jaclynn Morgan, Charles J Shamoun

{"title":"Using the Modified Minnesota Detoxification Scale to Evaluate Alcohol Withdrawal Syndrome: An Integrative Review.","authors":"Torri Trojand, Jaclynn Morgan, Charles J Shamoun","doi":"10.4037/ccn2025568","DOIUrl":"10.4037/ccn2025568","url":null,"abstract":"Background: Alcohol use disorder in the United States is increasing. Alcohol is the second most commonly abused drug worldwide, resulting in acute hospitalizations related to alcohol use and alcohol withdrawal syndrome. Management of alcohol withdrawal syndrome relies on screening tools to determine the need for treatment. The most commonly used tool is the Clinical Institute Withdrawal Assessment for Alcohol Scale-Revised (CIWA-Ar), which has not been validated for use in critical care units.Objective: To evaluate whether the modified Minnesota Detoxification Scale (mMINDS) is more effective than the CIWA-Ar for evaluating acute withdrawal symptoms in patients in intensive care units.Methods: This integrative review used the framework of Whittemore and Knafl. The literature was searched for studies related to mMINDS, neurocritical care, and critical care.Results: Nine articles were included in the review. The review revealed 3 outcomes: nurses preferred the mMINDS over the CIWA-Ar, assessments with the mMINDS tool was more accurate for patients with CIWA-Ar scores greater than 10, and patient outcomes were improved with use of the mMINDS. The mMINDS is preferred over the CIWA-Ar for managing alcohol withdrawal syndrome in patients in intensive care units because it is associated with shorter stays, less benzodiazepine use, and a decrease in delirium tremens.Conclusion: The findings regarding mMINDS can apply to both critical care and non-critical care settings. The mMINDS is preferred by nurses and results in more positive patient outcomes. The mMINDS is effective and should be used in critical care areas.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 2","pages":"60-68"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751530","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}

引用次数: 0

A Rapid-Cycle Intervention to Enhance Patient and Family Satisfaction in the Intensive Care Unit.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025564

Heather Pena, Jason Stokes, Lauren Zulueta, Mavis Awuku, Kathryn Bergamesca, Joanna Do, Timothy Espersen, Rebecca Fleetwood, Jenna Knors, Tonda Thomas, Alec Tobey, Julie A Thompson, Bradi B Granger

{"title":"A Rapid-Cycle Intervention to Enhance Patient and Family Satisfaction in the Intensive Care Unit.","authors":"Heather Pena, Jason Stokes, Lauren Zulueta, Mavis Awuku, Kathryn Bergamesca, Joanna Do, Timothy Espersen, Rebecca Fleetwood, Jenna Knors, Tonda Thomas, Alec Tobey, Julie A Thompson, Bradi B Granger","doi":"10.4037/ccn2025564","DOIUrl":"https://doi.org/10.4037/ccn2025564","url":null,"abstract":"Background: Patient and family satisfaction with care in intensive care units is not reflected in Hospital Consumer Assessment of Healthcare Providers and Systems surveys. Gaps may be unknown.Local problem: In a cardiothoracic intensive care unit, patient satisfaction scores were not assessed and gaps could not be addressed. The primary aim was to obtain baseline data on patient and family satisfaction. The secondary aim was to improve identified gaps in satisfaction.Methods: A preintervention-postintervention, 2-cycle quality improvement project and a 12-month sustainability assessment were conducted to evaluate patient and family satisfaction in a cardiothoracic intensive care unit in a large academic health system from August 2022 to August 2023. The Nursing Intensive Care Satisfaction Scale was used to measure patients' satisfaction and the European Quality Questionnaire was used to measure family members' satisfaction with intensive care unit nursing care. Standardized scripting, processes for patient and family engagement during rounds, and structured communication were used to enhance patient and family engagement.Results: At baseline (47 patients, 35 family members), overall patient and family satisfaction was high (mean [SD] satisfaction scores: patients, 87.6 [19.3]; family members, 94.6 [9.7]; P = .06). After intervention cycle 2, family members (n = 50) had high mean satisfaction scores on the Information Needs sub-scale of the European Quality Questionnaire. Family participation in rounds improved from 18.5% of rounds at baseline to 76.5% after intervention cycle 2 and was 61.5% at 12 months.Conclusion: Strategies that engage family members in rounds improve communication and satisfaction.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 1","pages":"61-68"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074338","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}

引用次数: 0

The Authors Respond.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025736

Athanasios Tsiouris

引用次数: 0

Prone Positioning in a Pregnant Woman With Severe Acute Respiratory Distress Syndrome: A Case Report.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025831

Jiahao Xu, Fangjie Fu, Qianrong Ding, Bo Wang, Peng Ji

{"title":"Prone Positioning in a Pregnant Woman With Severe Acute Respiratory Distress Syndrome: A Case Report.","authors":"Jiahao Xu, Fangjie Fu, Qianrong Ding, Bo Wang, Peng Ji","doi":"10.4037/ccn2025831","DOIUrl":"https://doi.org/10.4037/ccn2025831","url":null,"abstract":"Introduction: Prone ventilation is a standard treatment for acute respiratory distress syndrome, and its clinical benefits are well established. However, implementing prone positioning safely and effectively is challenging in patients who are pregnant, have intra-abdominal hypertension, or are in other high-risk groups.Clinical findings and diagnosis: A patient in the third trimester of pregnancy (28 weeks and 6 days of gestation) developed a body temperature of 39 °C and severe respiratory distress. She was transferred to the intensive care unit, received noninvasive ventilation, and ultimately underwent endotracheal intubation. Because her oxygenation index remained below 100, she received a diagnosis of severe acute respiratory distress syndrome.Interventions: The patient was safely placed in the prone position with a swim ring while receiving venovenous extracorporeal membrane oxygenation. During this period, her intra-abdominal pressure did not increase significantly.Outcomes: The fetus was delivered by cesarean birth, and the patient was transferred to the general ward after extubation.Conclusion: This case report describes the use of prone positioning in a pregnant patient. The report offers critical care nurses insights into the clinical management of patients who are pregnant or have intra-abdominal hypertension.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 1","pages":"29-35"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074113","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}

引用次数: 0

Reducing Hospital-Acquired Pressure Injuries in a Cardiothoracic Intensive Care Unit.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025980

Sunday Caldwell

{"title":"Reducing Hospital-Acquired Pressure Injuries in a Cardiothoracic Intensive Care Unit.","authors":"Sunday Caldwell","doi":"10.4037/ccn2025980","DOIUrl":"https://doi.org/10.4037/ccn2025980","url":null,"abstract":"Background: Hospital-acquired pressure injuries are a significant patient safety concern. The Centers for Medicare & Medicaid Services tracks hospital-acquired pressure injuries as a patient safety indicator. Health care organizations with higher-than-expected rates may incur penalties.Local problem: The pressure injury prevalence rate in a cardiothoracic intensive care unit was above the National Database of Nursing Quality Indicators benchmark. The current standard of care-use of the Braden scale for pressure injury risk assessment and the SKIN (surface, keep turning, incontinence care, and nutrition) care bundle-may not adequately address the needs of the intensive care unit population. In addition, cardiac patients present a special challenge because of their disease process and the mechanical support devices used to treat patients in cardiogenic shock, which place them at risk for the development of hospital-acquired pressure injuries.Methods: A performance improvement project was carried out in the cardiothoracic intensive care unit to reduce the prevalence and incidence of hospital-acquired pressure injuries. A preintervention convenience cohort was compared with a postintervention cohort. The intervention consisted of use of the Cubbin-Jackson scale, an intensive care unit-specific risk-assessment tool, with linked interventions to prevent pressure injuries.Results: The preintervention and postintervention cohorts consisted of 102 patients each. The pressure injury prevalence and incidence rates decreased by 67.84% and 36.43%, respectively, from before to after the intervention.Conclusion: The use of an intensive care unit-specific risk-assessment tool with linked interventions to prevent pressure injury can help reduce hospital-acquired pressure injuries in an intensive care unit.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 1","pages":"12-20"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074114","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}

引用次数: 0

Training in Cardiac Surgical Resuscitation.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025457

Sondra Jill Ley

引用次数: 0

Integrating Artificial Intelligence Into Critical Care Nursing: Next Steps.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025194

Carl Goforth, Jenny Alderden

引用次数: 0

Nursing Tales From the Bedside: The Impact of Peer-Supported Storytelling on Nurse Resilience.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025871

Lisa Romberger, David B Simmons

引用次数: 0

Ambulation Protocol for Adult Patients Receiving Extracorporeal Membrane Oxygenation: A Quality Improvement Initiative.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025452

Valentina Obreja, Taline Marcarian, Pamela S Miller

{"title":"Ambulation Protocol for Adult Patients Receiving Extracorporeal Membrane Oxygenation: A Quality Improvement Initiative.","authors":"Valentina Obreja, Taline Marcarian, Pamela S Miller","doi":"10.4037/ccn2025452","DOIUrl":"https://doi.org/10.4037/ccn2025452","url":null,"abstract":"Background: For patients receiving extracorporeal membrane oxygenation, early mobility decreases mechanical ventilation time, delirium incidence, and length of intensive care unit stay and improves physical functioning. Individual centers use institutional guidelines to develop ambulation protocols. Local Problem A quality improvement initiative was used to evaluate an ambulation protocol for adult intensive care unit patients receiving extracorporeal membrane oxygenation.Methods: Adult patients receiving extracorporeal membrane oxygenation who walked according to the protocol were compared with a historical control group of patients who walked without the protocol. Data analysis included descriptive statistics and independent t tests. Outcomes included adverse safety events, number of patients and ambulation sessions, standing and ambulation time, and distance.Results: From January to March 2021, 13 of 46 patients receiving extracorporeal membrane oxygenation (28%) walked according to the protocol. In the control group, 14 of 147 patients (10%) walked in 2019; 21 of 144 patients (15%) walked in 2020. Some characteristics of the control group (hospitalized before the COVID-19 pandemic) differed from those of the protocol group (hospitalized during the pandemic). Mean number of ambulation sessions was not significantly different between groups (protocol group, 10; control group, 9). Differences in mean standing time (protocol group, 121.23 minutes; control group, 210.80 minutes), ambulation time (protocol group, 11.77 minutes; control group, 198.70 minutes), and ambulation distance were not significant.Conclusions: Standing time, ambulation time, and distance were not significantly different between the groups. The extracorporeal membrane oxygenation ambulation protocol demonstrated clinical significance by increasing the number of patients walking.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 1","pages":"52-60"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074339","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}

引用次数: 0

Improving Communication and Workflow Among Advanced Practice Providers and Nurses on Night Shift in an Intensive Care Unit.

IF 2 4区医学

Critical care nurse Pub Date : 2025-02-01 DOI: 10.4037/ccn2025358

Chelsey A D Massey, Margaret J Selph, Sheryl Mitchell

{"title":"Improving Communication and Workflow Among Advanced Practice Providers and Nurses on Night Shift in an Intensive Care Unit.","authors":"Chelsey A D Massey, Margaret J Selph, Sheryl Mitchell","doi":"10.4037/ccn2025358","DOIUrl":"https://doi.org/10.4037/ccn2025358","url":null,"abstract":"Background: In critical care settings during night shift, the number of staff members is reduced and a designated time for structured patient care discussions is often absent. The absence of organized collaboration and shared decision-making strains professional relationships.Local problem: In a 21-bed cardiovascular intensive care unit, advanced practice providers were frequently interrupted by night shift nurses to discuss nonurgent clinical matters while engaged in patient care activities.Methods: This quality improvement project used a preintervention-postintervention design. Surveys were distributed to advanced practice providers and nurses to determine perceptions of communication. All advanced practice providers and nurses working night shift in the cardiovascular intensive care unit were included. Nightly bedside rounds for advanced practice providers and nurses using a goal sheet to improve communication were implemented in the cardiovascular intensive care unit. Preintervention and postintervention scores on survey subscales (perceptions of collaboration, workflow, and communication) were examined with analysis of variance for both groups.Results: Mean scores increased after the intervention for both advanced practice providers and nurses. Scores for perception of collaboration significantly increased for both advanced practice providers and nurses (both P = .01). The score for perception of workflow significantly increased for nurses (P < .001) but not for advanced practice providers. Scores for perception of communication did not significantly change for either group.Conclusion: Implementation of bedside rounds using a goal sheet for advanced practice providers and nurses working night shift in the cardiovascular intensive care unit improved perceptions of collaboration and workflow.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 1","pages":"36-51"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073520","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}

引用次数: 0