Critical care nurse最新文献_第3页

Enhancing Critical Care Through a Military, Trauma, and Disaster Nursing Lens. 从军事、创伤和灾难护理角度加强重症护理。

IF 2 4区医学

Critical care nurse Pub Date : 2024-10-01 DOI: 10.4037/ccn2024990

Carl Goforth, Annette M Bourgault, Nestor Neil A Peig, Tara Sacco

引用次数: 0

Nursing Care After Endobronchial Valve Placement: Optimizing Patient Recovery and Outcomes. 支气管内瓣膜置入术后的护理：优化患者康复和疗效。

IF 2 4区医学

Critical care nurse Pub Date : 2024-10-01 DOI: 10.4037/ccn2024247

Michael Gabrilovich, Meredith Padilla

引用次数: 0

The Imperative of Proactivity. 积极主动的必要性

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024687

Tara L Sacco

引用次数: 0

Reducing Central Line-Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach. 以护士为主导的多管齐下方法减少中心静脉相关血流感染。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024493

Linda M Hoke, Gracy C Mathen, Ellen Beckett

{"title":"Reducing Central Line-Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach.","authors":"Linda M Hoke, Gracy C Mathen, Ellen Beckett","doi":"10.4037/ccn2024493","DOIUrl":"https://doi.org/10.4037/ccn2024493","url":null,"abstract":"Background: Despite implementation of central catheter bundles, central line [catheter]-associated bloodstream infections (CLABSIs) remain a preventable hospital-acquired infection.Local problem: A new population of patients with pulmonary artery catheters was introduced to the cardiac progressive care unit, increasing central catheter days, device use, and CLABSI rate.Methods: A quality improvement project was conducted. Nursing staff implemented a standardized central catheter rounding process 3 days a week to critically assess all central catheter dressings, deter-mine the necessity of each central catheter, and educate patients on the importance of keeping central catheter dressings clean, dry, and intact. Data were collected during central catheter rounds for each patient, entered in an electronic survey tool via mobile devices, and analyzed.Results: From July 2019 through June 2022, a total of 2692 rounds were conducted for 707 individual patients with 3064 central catheters. Main interventions were dressing management, monitoring insertion site bleeding that extended beyond edges of the chlorhexidine gluconate pad, treating patients' allergies to products, and maintaining sustainability within the unit. Central catheter rounds decreased the CLABSI rate from 1.86 to 0.0 despite the continued increase in central catheter days.Conclusions: Central catheter dressing assessment, intervention, and education help reduce CLABSIs. Central catheter rounds are an important adjunct to the CLABSI bundle. A central catheter dressing management algorithm helps nurses decide when to change a dressing and which type of dressing to use.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 4","pages":"27-36"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859252","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

Conservative Treatment of Mesenteric and Hepatic Portal Venous Gas Caused by Gut-Derived Infection After Ileostomy: A Case Report. 回肠造口术后肠系膜和肝门静脉气体由肠道感染引起的保守治疗：病例报告。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024512

Qiuping Jiang, Pan Sun, Cuiyun Xie, Hongmei Hua

{"title":"Conservative Treatment of Mesenteric and Hepatic Portal Venous Gas Caused by Gut-Derived Infection After Ileostomy: A Case Report.","authors":"Qiuping Jiang, Pan Sun, Cuiyun Xie, Hongmei Hua","doi":"10.4037/ccn2024512","DOIUrl":"https://doi.org/10.4037/ccn2024512","url":null,"abstract":"Introduction: Hepatic portal venous gas is an extremely rare symptom of gas accumulation in the portal venous system. This disease has an acute onset, a rapid progression, and an extremely high mortality rate. This report describes a patient with mesenteric and hepatic portal venous gas caused by intestinal microbiota disturbance-induced gut-derived infection after ileostomy. The patient recovered and was discharged after conservative treatment. Nursing management of patients with mesenteric and hepatic portal venous gas is discussed.Clinical findings: A 76-year-old patient developed septic shock, paralytic intestinal obstruction, and mesenteric and hepatic portal venous gas after undergoing ileostomy.Diagnosis: Mesenteric and hepatic portal venous gas was diagnosed on the basis of abdominal contrast-enhanced computed tomography findings.Interventions: The treatment plan included early control of infection, early identification and nursing care of gut-derived infection caused by intestinal microbiota disturbance, early identification of paralytic intestinal obstruction, relief of intestinal obstruction and prevention of intestinal ischemia, and early nutritional support.Outcomes: On day 18 of hospitalization, the patient was transferred to the general ward and resumed eating, producing gas, and defecating. His abdominal signs and infection indicator levels were normal. On day 27, the patient was discharged home.Conclusion: This case provides an in-depth understanding of the care of patients with mesenteric and hepatic portal venous gas and emphasizes the important role of bedside nurses in evaluating and treating these patients. This report may help nurses care for similar patients.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 4","pages":"37-46"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859297","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

Intensive Care Unit Sleep Promotion Bundle: Impact on Sleep Quality, Delirium, and Other Patient Outcomes. 重症监护病房睡眠促进捆绑包：对睡眠质量、谵妄和其他患者预后的影响。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024972

Nicole M Gorecki, Marilyn A Prasun

{"title":"Intensive Care Unit Sleep Promotion Bundle: Impact on Sleep Quality, Delirium, and Other Patient Outcomes.","authors":"Nicole M Gorecki, Marilyn A Prasun","doi":"10.4037/ccn2024972","DOIUrl":"https://doi.org/10.4037/ccn2024972","url":null,"abstract":"Background: High-quality sleep is important for optimal patient recovery. Sleep deprivation during hospitalization may lead to poor patient outcomes.Objective: To examine whether implementation of a sleep promotion bundle in the intensive care unit affects rates of delirium and agitation, restraint use, and length of stay.Methods: An evidence-based sleep promotion bundle was developed and implemented in 2 intensive care units in a 1025-bed level I trauma teaching hospital. Deidentified data from the electronic health record were obtained for patients hospitalized before and during the intervention. Data included scores on the Confusion Assessment Method for the Intensive Care Unit, Richmond Agitation-Sedation Scale, and Glasgow Coma Scale; restraint use; and hospital and intensive care unit length of stay.Results: A total of 137 patients during the preintervention period and 149 patients during the intervention period were hospitalized in the intensive care units and met inclusion criteria. A 9-percentage-point decrease in the incidence of delirium from before to during the intervention was found, although it was not statistically significant (P = .07). Significant reductions were found in both intensive care unit (P = .04) and hospital (P = .03) length of stay. A significant decrease was found in Richmond Agitation-Sedation Scale high scores for patients requiring mechanical ventilation (P = .03). No significant differences were found in Richmond Agitation-Sedation Scale low scores, Glasgow Coma Scale scores, or restraint use.Conclusions: Critical care nurses are in an optimal position to implement evidence-based sleep promotion measures. Further research on sleep promotion bundles is needed.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 4","pages":"11-18"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859251","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

Strategies to Improve Sleep Quality in Intensive Care Unit Patients. 改善重症监护病房患者睡眠质量的策略。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024368

Melita Peršolja, Anet Rožnik

{"title":"Strategies to Improve Sleep Quality in Intensive Care Unit Patients.","authors":"Melita Peršolja, Anet Rožnik","doi":"10.4037/ccn2024368","DOIUrl":"10.4037/ccn2024368","url":null,"abstract":"Background: Patients in intensive care units are exposed to many factors that can negatively affect the quality of their sleep.Objective: To describe the latest findings regarding sleep quality improvement in intensive care unit patients.Methods: An integrative literature review was conducted in the CINAHL, PubMed, Cochrane Library, and MEDLINE databases in April and May 2023. The following keywords were used: intensive care units, promotion, sleep quality, and sleep. The Critical Appraisal Skills Programme tool was used to assess the quality of individual studies.Results: Of 159 articles identified, 10 were included in the final analysis. The findings were grouped into 4 thematic categories: consequences of poor sleep quality, factors affecting sleep quality, pharmacologic ways to improve sleep quality, and nonpharmacologic ways to improve sleep quality.Discussion: Various pharmacologic and nonpharmacologic treatments are used in clinical settings. Nonpharmacologic interventions include sleep masks, earplugs, reductions in alarm volume, and reductions in nighttime interventions. Relaxation techniques include aromatherapy, music therapy, and acupressure.Conclusions: The most effective way to improve sleep for intensive care unit patients is to use a combination of pharmacologic and nonpharmacologic interventions. Among the latter, the use of earplugs and sleep masks is simplest.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 4","pages":"47-56"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859254","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

Device Day: Promoting High-Quality Care With Low-Fidelity Simulation. 设备日：通过低仿真模拟促进高质量护理。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024396

Rachael Alexis Jividen, Jessica M Elliott, Karen S Distelhorst

引用次数: 0

High-Level Burnout in Physicians and Nurses Working in Adult Intensive Care Units. 在成人重症监护病房工作的医生和护士的高水平职业倦怠。

IF 2 4区医学

Critical care nurse Pub Date : 2024-08-01 DOI: 10.4037/ccn2024113

Adam S Cooper

引用次数: 0

The Practice of Clamping a Chest Tube Before Removal. 拔出胸管前夹紧胸管的做法。