Critical care nurse最新文献

{"title":"Corrections.","authors":"","doi":"10.4037/ccn2026213","DOIUrl":"10.4037/ccn2026213","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"5"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136749","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":"Removing a Pulmonary Artery Catheter.","authors":"Elizabeth Bridges","doi":"10.4037/ccn2026682","DOIUrl":"https://doi.org/10.4037/ccn2026682","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"70-72"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136808","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":"Venovenous Extracorporeal Membrane Oxygenation After Lung Transplant: A Case Report.","authors":"Alexandra Miller, Vanessa Okolie","doi":"10.4037/ccn2026765","DOIUrl":"10.4037/ccn2026765","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membrane oxygenation is an invasive form of mechanical therapy for patients requiring circulatory or respiratory support. Venovenous extracorporeal membrane oxygenation supports patients' lungs by oxygenating the blood, replacing pulmonary gas exchange function, and allowing a failing lung to recover. This supportive therapy can be used to treat patients with acute rejection following a lung transplant.</p><p><strong>Clinical findings: </strong>A 59-year-old White man was admitted for bilateral orthotopic lung transplant and was nearing the time of discharge home after the procedure. However, acute decompensation on postoperative day 17 prolonged the patient's hospitalization.</p><p><strong>Diagnosis: </strong>The patient received a diagnosis of antibody-mediated rejection.</p><p><strong>Intervention: </strong>The patient completed antibody-mediated rejection treatment and underwent cannulation for venovenous extracorporeal membrane oxygenation. The extracorporeal membrane oxygenation cannulation was later changed to a venovenous-venous configuration to manage ongoing hypoxemia.</p><p><strong>Outcomes: </strong>Postoperative complications related to the diagnosis of acute rejection resulted in prolonged hospitalization. The patient was transferred out of the intensive care unit on postoperative day 93. He was discharged home when he was hemodynamically stable.</p><p><strong>Conclusion: </strong>Acute rejection occurs in nearly one-third of patients after lung transplant, highlighting the need for accurate patient diagnosis. This case report discusses the treatment of antibody-mediated rejection, demonstrates how venovenous extracorporeal membrane oxygenation can be used to support a patient with acute rejection following a lung transplant, and highlights the crucial role of critical care nurses in treating patients receiving extracorporeal membrane oxygenation.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"51-56"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136831","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":"Trust as Meaningful Recognition in Critical Care Nursing.","authors":"Jeanette Drake, Adrianna L Watson","doi":"10.4037/ccn2026975","DOIUrl":"https://doi.org/10.4037/ccn2026975","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"8-9"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136814","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":"Reducing Pressure Injuries Due to Noninvasive Ventilation Masks in the Pediatric Intensive Care Unit: An Interprofessional Approach.","authors":"Brenna Saltzman, Lindsay Fayram, Mandi Houston, Elyse Laures","doi":"10.4037/ccn2026322","DOIUrl":"10.4037/ccn2026322","url":null,"abstract":"<p><strong>Background: </strong>Medical devices are common causes of health care-associated pressure injuries in pediatric patients. Noninvasive ventilation masks are among the most frequently used medical devices that result in injury. Unique pediatric facial anatomy, limited noninvasive ventilation mask sizes, and lack of pediatric-specific guidelines all contribute to injury.</p><p><strong>Local problem: </strong>In 2021, the local pediatric intensive care unit reported that 66% of stage 2 or greater health care-associated pressure injuries were facial injuries related to noninvasive ventilation masks. An evidence-based practice project was conducted to prevent noninvasive ventilation mask-related pressure injuries in the pediatric intensive care unit.</p><p><strong>Methods: </strong>An evidence-based bundle specific to the local pediatric intensive care unit was developed in accordance with the Iowa Model-Revised through interprofessional collaboration. Process and outcome data were collected to evaluate bundle implementation. Data included knowledge, attitude, and behavior indicators and health care-associated pressure injury outcome data.</p><p><strong>Results: </strong>The number of health care-associated pressure injuries related to noninvasive ventilation masks decreased from 6 in 2021 to 0 in 2022 after bundle implementation in October 2022. Postimplementation survey data showed that unit staff members' knowledge improved and behaviors to prevent health care-associated pressure injuries increased after implementation of the practice change.</p><p><strong>Conclusion: </strong>An evidence-based practice approach guided development of a localized practice change. Bundle use and interprofessional team collaboration reduced pressure injuries related to noninvasive ventilation masks in the pediatric intensive care unit.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"57-64"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136805","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":"Technology for Bedside Nurses: Launch of a New Department.","authors":"Annette M Bourgault","doi":"10.4037/ccn2026549","DOIUrl":"https://doi.org/10.4037/ccn2026549","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"4"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136847","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":"Introducing Technology for Bedside Nurses: A New Department for Critical Care Practice.","authors":"Jenny G Alderden, Carl Goforth","doi":"10.4037/ccn2026785","DOIUrl":"https://doi.org/10.4037/ccn2026785","url":null,"abstract":"","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"73-75"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136734","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":"Impact of Empowerment of Nursing Unit Council in a Medical Critical Care Unit on Ventilator-Associated Events and Ventilator Days.","authors":"Laura K Gilmore, Chondra Russ","doi":"10.4037/ccn2026189","DOIUrl":"10.4037/ccn2026189","url":null,"abstract":"<p><strong>Background: </strong>Mechanical ventilation increases patients' risk for ventilator-associated events. Nursing unit councils can help mitigate these events through shared governance.</p><p><strong>Local problem: </strong>The medical critical care unit at the project site faced challenges in outperforming benchmarks, increasing ventilator days, and consistently adhering the ICU Liberation Bundle. This project aimed to reintroduce effective practices and enhance nurse empowerment to reduce ventilator-associated events and improve patient outcomes.</p><p><strong>Methods: </strong>Led by a clinical nurse specialist and the medical critical care nursing unit council, the quality improvement project focused on the spontaneous awakening and breathing trials element of the ICU Liberation Bundle. Multifaceted interventions included education, data literacy training, compliance monitoring, and root cause analysis of ventilator-associated events. The Council Health Survey was distributed before and after the intervention to evaluate the nursing unit council's feelings of empowerment.</p><p><strong>Results: </strong>In the preintervention period, 23 patient charts were audited and in the intervention period, 34 patient charts were audited. Before the intervention, 15 nurses completed the Council Health Survey, and after the intervention, 9 nurses completed it. The intervention took place during 8 weeks. Ventilator-associated events decreased by 33.3% and the ventilator-associated event rate per 1000 ventilator days decreased by 29.9%; however, these changes were not significant (P = .70). Spontaneous awakening trial compliance increased from 75.7% to 83.0% (P = .39) and spontaneous breathing trial compliance decreased from 88.4% to 70.4% (P = .10); neither change was significant. Council Health Survey overall scores dropped 9.8%; subscale scores did not significantly change (P values ranged from .10 to .81).</p><p><strong>Conclusion: </strong>The ICU Liberation Bundle has been shown to improve patient outcomes. Future initiatives should focus on sustaining a comprehensive approach to reducing ventilator-associated events.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"16-23"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136709","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":"Dietitian-Led Feeding Tube Placement: Reducing Nursing Workload and Enhancing Patient Safety in the Intensive Care Unit.","authors":"Meagan Davis, Jamie Grandic","doi":"10.4037/ccn2026599","DOIUrl":"10.4037/ccn2026599","url":null,"abstract":"<p><strong>Background: </strong>As a result of the COVID-19 pandemic, health care systems nationally are adopting innovative strategies to streamline nursing care while optimizing outcomes. Concurrently, registered dietitian nutritionists are seeking opportunities to maximize their professional contribution and underscore their value as part of the interprofessional health care team. Implementing a feeding tube placement program led by registered dietitian nutritionists, rather than nurses, might enhance patient safety and enable dietitians to practice at an expert level while affording nurses more time for other patient care responsibilities.</p><p><strong>Local problem: </strong>In a 5-hospital health system, the COVID-19 pandemic worsened nursing shortages and increased nurse workloads and burnout. High volumes of patients with respiratory compromise increased the demand for postpyloric feeding tube placement. Challenges included unreliable placement methods and the need for bedside procedures due to transport restrictions. This situation prompted the creation of a registered dietitian nutritionist-led program for bedside feeding tube placement.</p><p><strong>Methods: </strong>An electromagnetic sensor-guided feeding tube placement program was implemented in phases across the health system after a successful pilot. This process included development of a feeding tube placement practice guideline, electronic health record updates, superuser training, competency development, and system-wide education.</p><p><strong>Results: </strong>One year after implementation, the program has saved more than 350 nursing hours. The number of radiographs has been reduced by 20% and the incidence of ventilator-associated pneumonia has been reduced by 67%, with no lung placements.</p><p><strong>Conclusion: </strong>Enabling registered dietitian nutritionists to lead feeding tube placement is an effective strategy for optimizing patient care and safety while reducing nursing workload.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"24-34"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136788","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":"Orientation of New Graduate Nurses to Acute and Critical Care: Reimagining the Preceptor Role.","authors":"Carrie McDermott, Philip J Haun, Elisabeth Robinson, Lillian Russo","doi":"10.4037/ccn2026912","DOIUrl":"10.4037/ccn2026912","url":null,"abstract":"<p><strong>Background: </strong>Hospitals and health systems experienced unprecedented levels of nurse turnover during the COVID-19 pandemic, increasing the need for new graduate nurses in the postpandemic workforce.</p><p><strong>Local problem: </strong>With a growing shortage of qualified preceptors, a redesign of the preceptor role was proposed. Clustering new graduate nurses into small groups of 2 to 5 allows for increasing the number of new graduate nurses onboarded with a limited number of preceptors.</p><p><strong>Methods: </strong>A group-orientation model was used to assign a preceptor dedicated to orientation and unburdened with patient assignment to a small group of new graduate nurses. New graduate nurses stayed within the group for the first phase of onboarding, from 4 to 8 weeks, then transitioned to 1:1 supervision with a preceptor for the last phase of orientation.</p><p><strong>Results: </strong>Preceptor and new graduate nurse satisfaction increased. New graduate nurse retention also increased by 3 percentage points compared with new graduate nurses oriented with the traditional model over the same period. The cost of preceptor salaries in the first 15 months of the group-orientation program was approximately $10 000 per new graduate nurse.</p><p><strong>Discussion: </strong>The group-orientation model appears to be financially viable, with favorable impact on new graduate nurse retention.</p><p><strong>Conclusion: </strong>A group-orientation model for onboarding new graduate nurses may be a useful approach to accelerate onboarding, enhance satisfaction, and decrease turnover. The cost of providing group orientation may be offset by cost savings seen when new graduate nurse retention increases.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"46 3","pages":"43-50"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136732","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}