Critical care nurse最新文献_第7页

Manual Prone Positioning in Adults: Reducing the Risk of Harm Through Evidence-Based Practices. 成人人工俯卧位：通过循证实践降低伤害风险。

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2023201

Lauren Morata, Kathleen Vollman, Jennifer Rechter, Jill Cox

引用次数: 0

The Anatomy and Physiology of True Collaboration. 真正协作的解剖学和生理学

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024167

Cindy Lefton

引用次数: 0

Measuring Intracranial Pressure. 测量颅内压。

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024495

Joan Walsh

引用次数: 0

Deimplementation of Gastric Residual Volume Monitoring to Enhance Patient Nutrition. 取消胃残余容积监测以增强患者营养。

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024937

Hannah E Landgrave

{"title":"Deimplementation of Gastric Residual Volume Monitoring to Enhance Patient Nutrition.","authors":"Hannah E Landgrave","doi":"10.4037/ccn2024937","DOIUrl":"10.4037/ccn2024937","url":null,"abstract":"Background: Routine gastric residual volume monitoring remains common in nursing practice. However, current evidence supports using a focused nursing assessment to identify signs and symptoms of enteral feeding intolerance such as abdominal pain, abdominal distension, and vomiting.Local problem: At the author's institution, nurses and other clinicians began reporting inconsistencies in gastric residual volume monitoring along with frequent interruptions in the delivery of enteral nutrition.Interventions: The quality improvement project included patients in the medical intensive care unit receiving enteral nutrition. Gastric residual volume monitoring was eliminated. Instead, enteral nutrition was suspended on the basis of signs and symptoms of enteral feeding intolerance. Multimodal education was provided to nurses, nurse practitioners, and physicians caring for these patients. Formative evaluation occurred via staff rounds, summative evaluation occurred through a staff survey, and nutritional adequacy was evaluated by tracking patient weight.Results: The 6-week project included 37 patients on the medical intensive care unit service. Of these patients, 28 gained weight; the mean change in weight was +6.2%. The practice change was well perceived by staff and is now an established part of care for any patient receiving enteral feedings at the study hospital.Conclusions: The deimplementation of routine gastric residual volume monitoring is supported by evidence. Use of a focused gastrointestinal nursing assessment to identify enteral feeding intolerance is safe, feasible, and effective and improves nutrition delivery and nurses' workflow.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 1","pages":"34-44"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697084","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 Relationship Between Rest Breaks and Professional Burnout Among Nurses. 护士休息时间与职业倦怠的关系。

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023177

Halle L Stutting

{"title":"The Relationship Between Rest Breaks and Professional Burnout Among Nurses.","authors":"Halle L Stutting","doi":"10.4037/ccn2023177","DOIUrl":"10.4037/ccn2023177","url":null,"abstract":"Background: Professional burnout is a well-studied phenomenon marked by feelings of depersonalization, emotional exhaustion, and decreased accomplishment. Affecting nearly half of all nurses, burnout presents a threat to health outcomes of the nurse, patient, organization, and society. Despite a growing literature on professional burnout, specific interventions that address key contributing factors have not been well described.Objective: The primary aim of this integrative literature review was to evaluate the relationship between rest breaks and professional burnout among registered nurses.Methods: A literature search was performed in the APA (American Psychological Association) PsycInfo, CINAHL (Cumulative Index of Nursing and Allied Health Literature), Cochrane Library, Embase, and PubMed databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a reporting guideline.Results: Five articles were selected for final synthesis; 1 was of \"high\" quality and 4 were of \"good\" quality. The literature showed that rest breaks were protective against professional burnout among registered nurses, especially when integrated with nursing management support, staffing support, and complementary strategies. Several threats to validity were identified as limitations among the articles selected for final synthesis.Conclusions: Rest breaks are effective in decreasing professional burnout among registered nurses, especially when combined with management support, staffing support, and complementary strategies. Future research should focus on a deeper evaluation of staffing support models, as well as identifying how nursing leaders can integrate complementary strategies across health care settings to reduce burnout.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"43 6","pages":"48-56"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458388","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

Clinical Inquiry 临床调查

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023264

Sara Knippa, M. Makic, Susan Coakley

引用次数: 0

Hypothermia for Neuroprotection in Adults After Cardiac Arrest. 低温对心脏骤停后成人神经保护的作用。

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023253

Adam S Cooper

引用次数: 0

Using a Fluid Resuscitation Algorithm to Reduce the Incidence of Abdominal Compartment Syndrome in the Burn Intensive Care Unit. 应用液体复苏算法降低烧伤重症监护病房腹膜隔室综合征的发生率。

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023162

Jasmine Peters, Paul Won, Julie Herrera, T Justin Gillenwater, Haig A Yenikomshian

{"title":"Using a Fluid Resuscitation Algorithm to Reduce the Incidence of Abdominal Compartment Syndrome in the Burn Intensive Care Unit.","authors":"Jasmine Peters, Paul Won, Julie Herrera, T Justin Gillenwater, Haig A Yenikomshian","doi":"10.4037/ccn2023162","DOIUrl":"10.4037/ccn2023162","url":null,"abstract":"Background: Patients with large burns must be carefully resuscitated to balance adequate tissue perfusion with the risk of end-organ damage. One devastating complication of overresuscitation is abdominal compartment syndrome. Reducing the volume of fluids given during resuscitation may reduce the incidence of abdominal compartment syndrome and improve outcomes.Objective: To determine whether decreasing fluid resuscitation volume in a burn center reduced the incidence of abdominal compartment syndrome.Methods: This retrospective cohort study involved all patients with severe burns (total body surface area ≥20%) who were admitted to a burn intensive care unit over 4 years (n = 166). Primary outcomes were required fluid volume, whether differences in the patient characteristics measured affected outcomes, rate of abdominal compartment syndrome, and incidence of abdominal hypertension. After the first 2 years, the Parkland fluid resuscitation algorithm was modified to decrease the volume goal, and patients were assessed for the incidence of abdominal compartment syndrome and related complications such as kidney failure, abdominal hypertension, and ventilator days.Results: A total of 16% of patients resuscitated using the Parkland equation experienced abdominal compartment syndrome compared with 10% of patients resuscitated using the modified algorithm, a difference of 6 percentage points (P = .39). Average volume administered was 11.8 L using the Parkland formula and 9.4 L using the modified algorithm (P = .03).Conclusion: Despite a significant decrease in the amount of fluid administered, no significant difference was found in incidence of abdominal compartment syndrome or urine output. Matched prospective studies are needed to improve resuscitation care for patients with large burns.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"43 6","pages":"58-66"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458390","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

Historical Letters to the Editor Mirror Current Issues in Nursing. 给编辑的历史信件反映了护理中的当前问题。

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023950

Annette M Bourgault

引用次数: 0

Nursing Management of a Patient With Fulminant Myocarditis and Electrical Storm Receiving ECMO: A Case Report. 暴发性心肌炎合并电风暴患者行ECMO的护理管理1例报告。

IF 1.6 4区医学

Critical care nurse Pub Date : 2023-12-01 DOI: 10.4037/ccn2023112

Xiaoxiao Wu, Xiaoyan Wang, Jinmei Luo, Fang Tian, Jin Bian

{"title":"Nursing Management of a Patient With Fulminant Myocarditis and Electrical Storm Receiving ECMO: A Case Report.","authors":"Xiaoxiao Wu, Xiaoyan Wang, Jinmei Luo, Fang Tian, Jin Bian","doi":"10.4037/ccn2023112","DOIUrl":"10.4037/ccn2023112","url":null,"abstract":"Introduction: Fulminant myocarditis is a devastating disease with significant mortality and complications. The care of patients with fulminant myocarditis is rarely reported.Clinical findings: A 17-year-old female patient was admitted to the emergency department with dizziness, amaurosis fugax, and chest tightness. Initial assessment revealed elevated levels of troponin T (4.753 ng/mL), troponin I (49.540 ng/mL), creatine kinase (1306 U/L), creatine kinase-MB isoenzymes (75.71 ng/mL), lactate dehydrogenase (509 U/L), and N-terminal pro-B-type natriuretic peptide (6345 pg/mL). The patient had recurrent ventricular tachycardia and failed to maintain a sinus rhythm after multiple electrical cardioversions.Diagnosis: Echocardiography revealed a left ventricular ejection fraction of 34%. Magnetic resonance imaging results confirmed the diagnosis of myocarditis.Interventions: The patient received extracorporeal membrane oxygenation for 6 days, intra-aortic balloon pump support for 7 days, and mechanical ventilation for 5 days. Norepinephrine and dopamine were used to keep circulation stable, lidocaine and amiodarone were used to control heart rate, and glucocorticoids and immunoglobulins were used to modulate immunity.Outcomes: The patient was discharged after 23 days. A month after discharge, echocardiography showed that the ejection fraction was 60%. The patient reported complete resolution of signs and symptoms of fulminant myocarditis at follow-up assessment.Conclusion: This case report presents the activities of bedside nurses in caring for a patient with fulminant myocarditis and broadens the literature describing nursing interventions for patients with fulminant myocarditis.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"43 6","pages":"22-33"},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458386","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