Critical care nurse最新文献_第9页

Screening for Alcohol Use Disorder and Management of Alcohol Withdrawal Syndrome in Critical Care Patients. 重症监护患者酒精使用障碍筛查和酒精戒断综合征管理。

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024423

Lindsay Mezzadri

{"title":"Screening for Alcohol Use Disorder and Management of Alcohol Withdrawal Syndrome in Critical Care Patients.","authors":"Lindsay Mezzadri","doi":"10.4037/ccn2024423","DOIUrl":"10.4037/ccn2024423","url":null,"abstract":"Background: Evidence-based research indicates that subjective questionnaires should be eliminated in screening for alcohol use disorder and management of alcohol withdrawal syndrome in critical care patients. However, transitioning clinicians away from these screening tools remains challenging.Objective: To improve screening for alcohol use disorder and management of alcohol withdrawal syndrome in the critical care setting by implementing an evidence-based alcohol use disorder screening tool and alcohol withdrawal syndrome protocol for critical care patients.Methods: The project site was a 17-bed adult medical intensive care unit in a large, southeastern US teaching hospital. Interventions consisted of the elimination of previously used tools such as the Clinical Institute Withdrawal Assessment for Alcohol-Revised and implementation of the Prediction of Alcohol Withdrawal Severity Scale for alcohol use disorder screening and the Richmond Agitation-Sedation Scale and symptom-triggered benzodiazepine administration for alcohol withdrawal syndrome management.Results: Alcohol use disorder screening among the critical care patient population increased by 49% from before to after the intervention. Of the patients at risk for withdrawal, 79% had an order for monitoring with the new intensive care unit alcohol withdrawal protocol in the postintervention group, compared with 35% who had an order for monitoring with the Clinical Institute Withdrawal Assessment for Alcohol-Revised in the preintervention group.Conclusion: The elimination of previously used tools and the implementation of the Prediction of Alcohol Withdrawal Severity Scale and the new intensive care unit alcohol withdrawal protocol improved alcohol use disorder screening and alcohol withdrawal syndrome management among critical care patients.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 1","pages":"46-54"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680815","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 Achieve Evidence-Based Practice in Nursing. 实现循证护理实践的策略。

IF 1.6 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024359

Steven Cuzmenco

引用次数: 0

Insulin Infusion Protocols for Blood Glucose Management in Critically Ill Patients: A Scoping Review. 用于重症患者血糖管理的胰岛素输注方案：范围综述。

IF 2 4区医学

Critical care nurse Pub Date : 2024-02-01 DOI: 10.4037/ccn2024427

Miao Huang, Ruiqi Yang, Dong Pang, Xiuni Gan

{"title":"Insulin Infusion Protocols for Blood Glucose Management in Critically Ill Patients: A Scoping Review.","authors":"Miao Huang, Ruiqi Yang, Dong Pang, Xiuni Gan","doi":"10.4037/ccn2024427","DOIUrl":"10.4037/ccn2024427","url":null,"abstract":"Background: Continuous insulin infusion is a method for maintaining blood glucose stability in critically ill patients with hyperglycemia. Many insulin infusion protocols have been applied in intensive care units. Understanding the content of these protocols can help clinical staff choose the most appropriate and convenient protocol and promote best practices in managing glucose levels in critically ill adult patients.Objective: To examine the types of insulin infusion therapies performed for blood glucose management in critically ill patients.Methods: For this scoping review, 3 Chinese-language and 8 English-language databases were searched for articles published from May 25, 2016, to October 25, 2022.Results: Twenty-one articles met the inclusion criteria. Twenty-one insulin infusion protocols were examined. Most of the insulin infusion protocols were paper protocols. Fourteen glucose management indicators were included in the 21 protocols. The glucose target range for all 21 protocols ranged from 70 to 180 mg/dL (3.9-10.0 mmol/L). Nurses were primarily responsible for protocol implementation in most protocol development processes. The roles of nurses differed in nurse-led insulin infusion protocols and non-nurse-led insulin infusion protocols.Discussion: This scoping review indicates an urgent need for more comprehensive glycemic control guidelines for patients receiving critical care. Because insulin infusion protocols are core aspects of blood glucose management guidelines, different population subgroups should also be considered.Conclusions: Nurse-led guidelines must be based on the best available evidence and should include other variables related to glucose management (eg, patient disease type, medication, and nutrition) in addition to insulin infusion.","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"44 1","pages":"21-32"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697085","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

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