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Using Everyday Ethics to Address Bias and Racism in Clinical Care. 利用日常伦理来解决临床护理中的偏见和种族主义。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-03-15 DOI: 10.4037/aacnacc2022566
Shika Kalevor, M. Uveges, E. Meyer
{"title":"Using Everyday Ethics to Address Bias and Racism in Clinical Care.","authors":"Shika Kalevor, M. Uveges, E. Meyer","doi":"10.4037/aacnacc2022566","DOIUrl":"https://doi.org/10.4037/aacnacc2022566","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 1 1","pages":"111-118"},"PeriodicalIF":2.2,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48744635","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
Program Evaluation of an Early Nurse Intervention Team. 早期护理干预团队的项目评估。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-03-15 DOI: 10.4037/aacnacc2022521
Sarah Heitman, Deborah H. Allen, Jennifer Massengill, V. Orto, Julie A. Thompson, Staci S. Reynolds
{"title":"Program Evaluation of an Early Nurse Intervention Team.","authors":"Sarah Heitman, Deborah H. Allen, Jennifer Massengill, V. Orto, Julie A. Thompson, Staci S. Reynolds","doi":"10.4037/aacnacc2022521","DOIUrl":"https://doi.org/10.4037/aacnacc2022521","url":null,"abstract":"BACKGROUND\u0000Many hospitals have implemented early rapid response teams to improve detection of patients at risk for decline. However, formal evaluation of these programs is rare.\u0000\u0000\u0000OBJECTIVE\u0000To evaluate the Early Nurse Intervention Team program at a large community hospital in the southeastern United States.\u0000\u0000\u0000METHODS\u0000A retrospective evaluation was performed of unplanned intensive care unit transfers, hospital length of stay, length of stay index, ventilator days, and mortality in 2 patient groups: those with and those without an Early Nurse Intervention Team nurse present.\u0000\u0000\u0000RESULTS\u0000There was a marked decline in unplanned intensive care unit transfers as the Early Nurse Intervention Team nurse staffing increased. There were no significant interaction or main effects for length of stay, length of stay index, ventilator days, or mortality between the 2 groups.\u0000\u0000\u0000CONCLUSIONS\u0000This study showed a positive impact of implementation of an Early Nurse Intervention Team program, with significant savings given the cost of unplanned intensive care unit transfers.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 1 1","pages":"31-37"},"PeriodicalIF":2.2,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49005815","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
Targeted Temperature Management: A Program Evaluation. 目标温度管理：程序评估。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-03-15 DOI: 10.4037/aacnacc2022398
Hannah L. Kaylor, Clareen A Wiencek, Elizabeth Hundt
{"title":"Targeted Temperature Management: A Program Evaluation.","authors":"Hannah L. Kaylor, Clareen A Wiencek, Elizabeth Hundt","doi":"10.4037/aacnacc2022398","DOIUrl":"https://doi.org/10.4037/aacnacc2022398","url":null,"abstract":"In the United States, more than 350 000 cardiac arrests occur annually. The survival rate after an out-of-hospital cardiac arrest remains low. The majority of patients who have return of spontaneous circulation will die of complications of hypoxic-ischemic brain injury. Targeted temperature management is the only recommended neuroprotective measure for those who do not regain consciousness after return of spontaneous circulation. Despite current practices, a review of the literature revealed that evidence on the ideal time to achieve target temperature after return of spontaneous circulation remains equivocal. A program evaluation of a targeted temperature management program at an academic center was performed; the focus was on timing components of targeted temperature management. The program evaluation revealed that nurse-driven, evidence-based protocols can lead to optimal patient outcomes in this low-frequency, high-impact therapy.","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 1 1","pages":"38-52"},"PeriodicalIF":2.2,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46499794","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
Measuring and Evaluating Clinical Context in Implementation Science Research. 实施科学研究中临床情境的测量与评价。
IF 2.2
AACN Advanced Critical Care Pub Date : 2022-03-15 DOI: 10.4037/aacnacc2022664
Patricia C. Woltz, B. Granger, Staci S. Reynolds
{"title":"Measuring and Evaluating Clinical Context in Implementation Science Research.","authors":"Patricia C. Woltz, B. Granger, Staci S. Reynolds","doi":"10.4037/aacnacc2022664","DOIUrl":"https://doi.org/10.4037/aacnacc2022664","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"33 1 1","pages":"103-110"},"PeriodicalIF":2.2,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43794263","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
Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment. 大手术后重症监护病房的使用与护士工作环境。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-12-15 DOI: 10.4037/aacnacc2021383
Anna Krupp, Karen B Lasater, Matthew D McHugh
{"title":"Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment.","authors":"Anna Krupp,&nbsp;Karen B Lasater,&nbsp;Matthew D McHugh","doi":"10.4037/aacnacc2021383","DOIUrl":"https://doi.org/10.4037/aacnacc2021383","url":null,"abstract":"<p><strong>Background: </strong>Across hospitals, there is wide variation in ICU utilization after surgery. However, it is unknown whether and to what extent the nurse work environment is associated with a patient's odds of admission to an intensive care unit.</p><p><strong>Purpose: </strong>To estimate the relationship between hospitals' nurse work environment and a patient's likelihood of ICU admission and mortality following surgery.</p><p><strong>Methods: </strong>A cross-sectional study of 269 764 adult surgical patients in 453 hospitals was conducted. Logistic regression models were used to estimate the effects of the work environment on the odds of patients' admission to the intensive care unit and mortality.</p><p><strong>Results: </strong>Patients in hospitals with good work environments had 16% lower odds of intensive care unit admission and 15% lower odds of mortality or intensive care unit admission than patients in hospitals with mixed or poor environments.</p><p><strong>Conclusions: </strong>Patients in hospitals with better nurse work environments were less likely to be admitted to an intensive care unit and less likely to die. Hospitals with better nurse work environments may be better equipped to provide postoperative patient care on lower acuity units.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 4","pages":"381-390"},"PeriodicalIF":2.2,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721523/pdf/nihms-1766327.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10714359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Novel Therapies in Oncology: An Individualized Approach. 肿瘤新疗法:个体化方法。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-09-15 DOI: 10.4037/aacnacc2021102
Stephanie Gregory, Margaret Kelley, Tanya Lalani
{"title":"Novel Therapies in Oncology: An Individualized Approach.","authors":"Stephanie Gregory,&nbsp;Margaret Kelley,&nbsp;Tanya Lalani","doi":"10.4037/aacnacc2021102","DOIUrl":"https://doi.org/10.4037/aacnacc2021102","url":null,"abstract":"<p><p>For decades, oncology treatments revolved around chemotherapeutic regimens that have been relatively nonspecific in their approach to cancer cell death. With advancements in genomics and personalized medicine, however, knowledge of the immune system has dramatically increased and methods for treating cancers have become much more individualized. With this increase in knowledge, vast arrays of novel therapies have entered the oncology realm. Nurses are expected to administer these therapies and ultimately manage the resulting toxicities and side effects. Such effects sometimes lead to severe illness, which may require intensive care unit admission. This article reviews novel therapies in oncology and nursing considerations pertaining to these treatment approaches as they relate to solid tumors.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 3","pages":"315-323"},"PeriodicalIF":2.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390639","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
Complex Oncologic Surgeries and Implications for the Intensive Care Unit Nurse. 复杂肿瘤手术及其对重症监护室护士的影响。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-09-15 DOI: 10.4037/aacnacc2021574
Michele L Weber, Roberta Kaplow
{"title":"Complex Oncologic Surgeries and Implications for the Intensive Care Unit Nurse.","authors":"Michele L Weber,&nbsp;Roberta Kaplow","doi":"10.4037/aacnacc2021574","DOIUrl":"https://doi.org/10.4037/aacnacc2021574","url":null,"abstract":"<p><p>There are many challenges in caring for the postsurgical patient in the intensive care unit. When the postsurgical patient has an active malignancy, this can make the intensive care unit care more challenging. Nutrition, infection, and the need for postoperative mechanical ventilatory support for the patient with cancer present challenges that may increase the patient's length of stay in the intensive care unit. Critical care nurses must be aware of these challenges as they provide care to this patient population.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 3","pages":"297-305"},"PeriodicalIF":2.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390641","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
Extracorporeal Membrane Oxygenation: Opportunities for Expanding Nurses' Roles. 体外膜氧合:扩大护士角色的机会。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-09-15 DOI: 10.4037/aacnacc2021862
Anna Peeler, Kelly T Gleason, Betty Ferrell, Vanessa Battista, Rachel Klinedinst, Sung-Min Cho, Patricia M Davidson
{"title":"Extracorporeal Membrane Oxygenation: Opportunities for Expanding Nurses' Roles.","authors":"Anna Peeler,&nbsp;Kelly T Gleason,&nbsp;Betty Ferrell,&nbsp;Vanessa Battista,&nbsp;Rachel Klinedinst,&nbsp;Sung-Min Cho,&nbsp;Patricia M Davidson","doi":"10.4037/aacnacc2021862","DOIUrl":"https://doi.org/10.4037/aacnacc2021862","url":null,"abstract":"","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 3","pages":"341-345"},"PeriodicalIF":2.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390633","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
Oncologic Surgical Care Using an Enhanced Recovery Approach. 使用增强恢复方法的肿瘤外科护理。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-09-15 DOI: 10.4037/aacnacc2021151
Lynne Brophy, Danette Birkhimer, Allison DeVilliers, Loletia Davis, Karen Meade, Valerie Pervo
{"title":"Oncologic Surgical Care Using an Enhanced Recovery Approach.","authors":"Lynne Brophy,&nbsp;Danette Birkhimer,&nbsp;Allison DeVilliers,&nbsp;Loletia Davis,&nbsp;Karen Meade,&nbsp;Valerie Pervo","doi":"10.4037/aacnacc2021151","DOIUrl":"https://doi.org/10.4037/aacnacc2021151","url":null,"abstract":"<p><p>Enhanced recovery programs are multimodal, evidence-based perioperative programs designed to improve a patient's functional recovery after surgery. Enhanced recovery programs promote standardized, multidisciplinary care throughout the perioperative course to improve patient outcomes, rather than focusing on surgical technique. It is important for nurses working in acute and critical care to be aware of the paradigm shift created by the trend toward the enhanced recovery approach. By learning more about facets of the approach, the nurse will be better prepared to adopt whatever aspects of enhanced recovery their institution implements for the surgical oncology population. An overview is provided of the potential components of enhanced recovery.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 3","pages":"286-296"},"PeriodicalIF":2.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390640","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
Oncologic Emergencies. 肿瘤紧急情况。
IF 2.2
AACN Advanced Critical Care Pub Date : 2021-09-15 DOI: 10.4037/aacnacc2021832
Ninotchka Brydges, Garry J Brydges
{"title":"Oncologic Emergencies.","authors":"Ninotchka Brydges,&nbsp;Garry J Brydges","doi":"10.4037/aacnacc2021832","DOIUrl":"https://doi.org/10.4037/aacnacc2021832","url":null,"abstract":"<p><p>A new cancer diagnosis is expected to affect approximately 1.9 million people in the United States in 2021. A small percentage of these patients will experience an emergent cancer-related complication. Oncologic emergencies may be encountered in emergency departments or require intensive care management. Patients newly diagnosed with cancer are more likely to present with emergencies related to the underlying malignancies. Oncologic emergencies can have various manifestations, ranging from mechanical obstruction due to tumor growth to metabolic derangements due to abnormal secretions from the tumor. Therefore, early identification and treatment of life-threatening oncologic events is critical. Although there are several different types of oncologic emergencies, this article focuses on metabolic emergencies (tumor lysis syndrome and cytoreductive hyperthermic intraperitoneal chemotherapy) and structural emergencies (increased intracranial pressure and vena cava thrombus). The purpose of this article is to provide acute care clinicians with an overview of selected oncologic emergencies and their evidence-based management.</p>","PeriodicalId":46461,"journal":{"name":"AACN Advanced Critical Care","volume":"32 3","pages":"306-314"},"PeriodicalIF":2.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390642","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
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