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AACN Advanced Critical Care最新文献

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Pressure Injury Risk Assessment and Prevention in Patients With COVID-19 in the Intensive Care Unit. 重症监护室新冠肺炎患者压力损伤风险评估和预防。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022335
J. Alderden, S. Kennerly, Jill N. Cox, T. Yap
{"title":"Pressure Injury Risk Assessment and Prevention in Patients With COVID-19 in the Intensive Care Unit.","authors":"J. Alderden, S. Kennerly, Jill N. Cox, T. Yap","doi":"10.4037/aacnacc2022335","DOIUrl":"https://doi.org/10.4037/aacnacc2022335","url":null,"abstract":"BACKGROUND\u0000Patients critically ill with COVID-19 are at risk for hospital-acquired pressure injury, including device-related pressure injury.\u0000\u0000\u0000METHODS\u0000Braden Scale predictive validity was compared between patients with and without COVID-19, and a logistic regression model was developed to identify risk factors for device-related pressure injury.\u0000\u0000\u0000RESULTS\u0000A total of 1920 patients were included in the study sample, including 407 with COVID-19. Among the latter group, at least 1 hospital-acquired pressure injury developed in each of 120 patients (29%); of those, device-related pressure injury developed in 55 patients (46%). The Braden Scale score area under the receiver operating characteristic curve was 0.72 in patients without COVID-19 and 0.71 in patients with COVID-19, indicating fair to poor discrimination.\u0000\u0000\u0000CONCLUSIONS\u0000Fragile skin and prone positioning during mechanical ventilatory support were risk factors for device-related pressure injury. Clinicians may consider incorporating factors not included in the Braden Scale (eg, oxygenation and perfusion) in routine risk assessment and should maintain vigilance in their efforts to protect patients with COVID-19 from device-related pressure injury.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"173-185"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44333021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Analgesia and Sedation in Critically Ill Patients With Burns. 危重烧伤患者的镇痛和镇静。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022588
P. Weaver, Rochelle Brual, David Blair
{"title":"Analgesia and Sedation in Critically Ill Patients With Burns.","authors":"P. Weaver, Rochelle Brual, David Blair","doi":"10.4037/aacnacc2022588","DOIUrl":"https://doi.org/10.4037/aacnacc2022588","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"125-129"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42447857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primer on Artificial Intelligence Used in Electronic Health Records. 电子健康记录中使用的人工智能入门。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022390
L. Harrington
{"title":"Primer on Artificial Intelligence Used in Electronic Health Records.","authors":"L. Harrington","doi":"10.4037/aacnacc2022390","DOIUrl":"https://doi.org/10.4037/aacnacc2022390","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"130-133"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44770112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards. 使用AACN的健康工作环境标准提高护理质量的医院路线图。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022632
N. Blake, R. Sandoval, Ria Sangalang, Jamenica Reyes, Kelli Anderson, Debra Hunt
{"title":"A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards.","authors":"N. Blake, R. Sandoval, Ria Sangalang, Jamenica Reyes, Kelli Anderson, Debra Hunt","doi":"10.4037/aacnacc2022632","DOIUrl":"https://doi.org/10.4037/aacnacc2022632","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"208-211"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45026597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Beyond Burnout and Resilience: The Disillusionment Phase of COVID-19. 超越倦怠和恢复力:COVID-19的幻灭阶段。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022248
Perry M Gee, Marla J Weston, Tom Harshman, Lesly A Kelly
{"title":"Beyond Burnout and Resilience: The Disillusionment Phase of COVID-19.","authors":"Perry M Gee,&nbsp;Marla J Weston,&nbsp;Tom Harshman,&nbsp;Lesly A Kelly","doi":"10.4037/aacnacc2022248","DOIUrl":"https://doi.org/10.4037/aacnacc2022248","url":null,"abstract":"<p><p>In caring for patients during the COVID-19 pandemic, nurses are experiencing a crisis of emotional highs and lows that will have lasting implications for their professional and personal well-being. As a result, much attention has been focused on nurse burnout, but the range of nurses' experiences is more nuanced, complicated, and profound. With the recognition that the nursing workforce was already experiencing burnout before the pandemic, this article explores how individuals respond to disasters and the detrimental effects of the repeated surges of critically ill patients, which have led nurses to experience an extended period of disillusionment that includes secondary traumatic stress, cumulative grief, and moral distress. This article describes the range of psychological responses to the COVID-19 pandemic so that nurse leaders can better identify resources and interventions to support nurses.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2","pages":"134-142"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39642733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Threats to Skin Integrity in the Critically Ill Patient. 危重病人皮肤完整性的威胁。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022200
R. Bryant
{"title":"Threats to Skin Integrity in the Critically Ill Patient.","authors":"R. Bryant","doi":"10.4037/aacnacc2022200","DOIUrl":"https://doi.org/10.4037/aacnacc2022200","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"163-164"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47204957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differentiation of Lower Extremity Skin Changes in the Intensive Care Setting. 重症监护环境下下肢皮肤变化的鉴别。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022737
K. Bauer
{"title":"Differentiation of Lower Extremity Skin Changes in the Intensive Care Setting.","authors":"K. Bauer","doi":"10.4037/aacnacc2022737","DOIUrl":"https://doi.org/10.4037/aacnacc2022737","url":null,"abstract":"Digital and lower extremity skin changes often signify critical underlying disorders. Patients in the intensive care unit also frequently have hemodynamic instability requiring the use of vasoactive medications, which may lead to various presentations of limb ischemia; preexisting conditions increase these patients' risk for arterial embolization. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds, where they cause arterial occlusion, ischemia, and, potentially, infarction; the 2 most common sequelae are stroke and lower limb ischemia. Emboli also arise from atherosclerotic plaques. Other conditions can also cause skin color changes in this vulnerable population. Prompt recognition and differentiation of lower extremity skin changes can result in improved patient outcomes. A thorough literature search was conducted to differentiate the primary causes of lower extremity and digital skin changes in the critically ill patient and outline diagnostic and management techniques.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"196-207"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Time to Hemostasis After Trauma and Transfusion by Patient Blood Type. 创伤后止血时间和按患者血型输血。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022432
Justin L Miller, Hallie Harper, Hannah Jane McCarty, Peng Li, Allison R. Jones
{"title":"Time to Hemostasis After Trauma and Transfusion by Patient Blood Type.","authors":"Justin L Miller, Hallie Harper, Hannah Jane McCarty, Peng Li, Allison R. Jones","doi":"10.4037/aacnacc2022432","DOIUrl":"https://doi.org/10.4037/aacnacc2022432","url":null,"abstract":"BACKGROUND\u0000Although evidence supports an increased risk of mortality after major trauma among patients with type O blood, the relationship between patient blood type and clinical outcomes aside from mortality has not been fully elucidated.\u0000\u0000\u0000OBJECTIVE\u0000To examine the relationship between patient blood type and time to hemostasis after trauma and massive transfusion.\u0000\u0000\u0000METHODS\u0000A secondary analysis of the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial was performed (N = 544). Blood type was dichotomized into type O versus non-type O. It was hypothesized that patients with non-type O blood would achieve hemostasis more quickly owing to the theoretical presence of increased clotting factors. Bivariate analysis and multiple Cox regression were conducted to test this assumption.\u0000\u0000\u0000RESULTS\u0000No significant difference was found in time to hemostasis between patients with type O blood and those with non-type O blood. However, mechanism of injury, diastolic blood pressure, and international normalized ratio affected the time to hemostasis in these trauma patients.\u0000\u0000\u0000CONCLUSION\u0000This study showed no significant difference in time to hemostasis by blood type.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"154-161"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43112172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Silent Hypoxia in COVID-19 Pneumonia: State of Knowledge, Pathophysiology, Mechanisms, and Management. COVID-19肺炎的无症状性缺氧:知识状况、病理生理学、机制和管理。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022448
Ruff Joseph Macale Cajanding
{"title":"Silent Hypoxia in COVID-19 Pneumonia: State of Knowledge, Pathophysiology, Mechanisms, and Management.","authors":"Ruff Joseph Macale Cajanding","doi":"10.4037/aacnacc2022448","DOIUrl":"https://doi.org/10.4037/aacnacc2022448","url":null,"abstract":"<p><p>Patients with COVID-19 often present with life-threatening hypoxemia without dyspnea or signs of respiratory distress. Termed silent or happy hypoxia, it has puzzled clinicians and challenged and defied our understanding of normal respiratory physiology. A range of host- and pathogen-related factors appears to contribute to its development, including SARS-CoV-2's ability to produce different COVID-19 phenotypes; induce endothelial damage and elicit a vascular distress response; invade cells of the central nervous system and disrupt normal interoception and response; and modulate transcription factors involved in hypoxic responses. Because hypoxemia in COVID-19 is associated with increased mortality risk and poorer survival, early detection and prompt treatment is essential to prevent potential complications. Interventions to prevent hypoxemia and improve oxygen delivery to the blood and the tissues include home pulse-oximetry monitoring, optimization of patient positioning, judicious use of supplemental oxygen, breathing control exercises, and timely and appropriate use of ventilatory modalities and adjuncts.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2","pages":"143-153"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39746485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids. 通过现场临床调查推进护理科学：设计问题金字塔。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-06-15 DOI: 10.4037/aacnacc2022750
B. Granger, Anna Mall, Staci S. Reynolds
{"title":"Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.","authors":"B. Granger, Anna Mall, Staci S. Reynolds","doi":"10.4037/aacnacc2022750","DOIUrl":"https://doi.org/10.4037/aacnacc2022750","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 2 1","pages":"212-219"},"PeriodicalIF":2.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44020034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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