Dimensions of Critical Care Nursing最新文献

{"title":"Association of Symptoms and Mode of Transportation to Emergency Department in Patients With Acute Coronary Syndrome.","authors":"Leslie L Davis, Thomas P McCoy, Barbara Riegel, Sharon McKinley, Lynn V Doering, Debra K Moser","doi":"10.1097/DCC.0000000000000566","DOIUrl":"10.1097/DCC.0000000000000566","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute coronary syndrome (ACS) with symptoms matching their expectations of a heart attack are more likely to use emergency medical services (EMS) than not.</p><p><strong>Objective: </strong>To determine whether presenting symptom clusters are associated with EMS use in ACS patients and if EMS use or symptom clusters are associated with prehospital delay.</p><p><strong>Methods: </strong>This secondary analysis used data from the PROMOTION trial, a randomized clinical trial that enrolled 3522 subjects with a history of or at risk for ACS from 5 sites in the United States, Australia, and New Zealand. Subjects were randomized to usual care or an educational intervention to reduce prehospital delay. During the 2-year follow-up, subjects admitted for ACS were asked about symptoms, time of symptom onset, and mode of transportation to the hospital. Symptoms were grouped into classic ACS, pain symptoms, and stress symptoms clusters.</p><p><strong>Results: </strong>Of 3522 subjects enrolled, 331 sought care for ACS during follow-up; 278 had transportation mode documented; 121 (44%) arrived via EMS. Classic ACS plus pain symptoms (adjusted odds ratio [AOR], 2.66; P = .011), classic ACS plus stress symptoms (AOR, 2.61; P = .007), and classic ACS plus both pain and stress symptoms (AOR, 3.90; P = .012) were associated with higher odds of EMS use versus classic ACS symptoms alone. Emergency medical services use resulted in a 68.5-minute shorter median delay (P = .002) versus non-EMS use. Symptom clusters were not predictive of delay time in the adjusted model (P = .952).</p><p><strong>Discussion: </strong>Although chest symptoms were the most prevalent symptoms for most (85%), the combination of classic ACS symptoms with other symptom clusters was associated with higher EMS use. Further research is needed to determine whether a combination of symptom clusters helps patients correctly interpret ACS symptoms to better understand how symptom clusters influence EMS use.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"95-103"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660328","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}

{"title":"On Being a Scientist: A Guide to Responsible Conduct in Research: Third Edition.","authors":"Kathleen Ahern Gould","doi":"10.1097/DCC.0000000000000571","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000571","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"126-127"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9197512","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}

{"title":"Psychological Distress and COVID-19: Evidence-Based Interventions for Frontline Health Care Workers-A Literature Review.","authors":"Nancy Delassalle,&nbsp;Mary Cavaciuti","doi":"10.1097/DCC.0000000000000565","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000565","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic has had a serious impact on the psychological well-being of frontline health care workers. A variety of interventions have been offered to health care workers in their workplace that has them questioning which intervention would be most beneficial. The purpose of this review is to determine what evidence-based interventions would have an impact on alleviating COVID-19-related psychological distress.</p><p><strong>Methods: </strong>A search was conducted from multiple databases, including Pubmed, CINAHL, Joanna Briggs, and Cochrane, using the PRISMA framework. The search included COVID-19 as well as previous pandemics. Critical appraisal and synthesis of the 16 relevant sources of evidence were completed.</p><p><strong>Results: </strong>Based on the current evidence, one cannot conclude that any specific intervention is effective for pandemic-relate distress.</p><p><strong>Conclusion: </strong>The development, implementation, and scientific evaluation of evidence-based interventions to address the immediate, as well as the long-term, psychological effects of COVID-19 on the mental well-being of health care workers, are needed.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"53-62"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897118/pdf/dccn-42-53.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660327","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}

{"title":"Call for Manuscripts","authors":"","doi":"10.1097/01.dcc.0000919420.90633.e3","DOIUrl":"https://doi.org/10.1097/01.dcc.0000919420.90633.e3","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136173684","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}

{"title":"Resources for Effective Formatting of Academic and Professional Publications.","authors":"Kathleen Ahem Gould","doi":"10.1097/DCC.0000000000000574","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000574","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"124-125"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153138","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}

{"title":"DCCN on the Web","authors":"","doi":"10.1097/01.dcc.0000919424.70057.c0","DOIUrl":"https://doi.org/10.1097/01.dcc.0000919424.70057.c0","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136173683","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}

{"title":"Spiritual Care in the Intensive Care Unit: Experiences of Dutch Intensive Care Unit Patients and Relatives.","authors":"Suzan Willemse,&nbsp;Wim Smeets,&nbsp;Evert van Leeuwen,&nbsp;Jeannette Heldens,&nbsp;Nelleke Ten Napel-Roos,&nbsp;Norbert Foudraine","doi":"10.1097/DCC.0000000000000570","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000570","url":null,"abstract":"<p><strong>Background/objective: </strong>To gain insight into both patients' and relatives' experiences with spiritual care (SC) in the intensive care unit (ICU).</p><p><strong>Methods: </strong>Method used was qualitative interviewing. This was a thematic, topic-centered, biographical, and narrative approach, using semistructured interviews with thematic analysis. A purposive sampling method was used to select a sample of ICU patients and ICU patients' relatives. An interview guide facilitated individual, semistructured interviews. The interview data were recorded by means of note-taking and audio-recording. Verbatim transcripts were compiled for analysis and interpretation.</p><p><strong>Results: </strong>All 12 participants-7 ICU patients and 5 family members of 5 other ICU patients-experienced ICU admission as an existential crisis. Participants would appreciate the signaling of their spiritual needs by ICU health care professionals (HCPs) at an early stage of ICU admission and subsequent SC provision by a spiritual caregiver. They regarded the spiritual caregiver as the preferred professional to address spiritual needs, navigate during their search for meaning and understanding, and provide SC training in signaling spiritual needs to ICU HCPs.</p><p><strong>Discussion: </strong>Early detection of existential crisis signals with ICU patients and relatives contributes to the mapping of spiritual and religious needs. Spiritual care training of ICU HCPs in signaling spiritual needs by ICU patients and relatives is recommended. Effective SC contributes to creating room for processing emotions, spiritual well-being, and satisfaction with integrated SC as part of daily ICU care.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"83-94"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655871","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}

{"title":"Sound and Light Levels in a General Intensive Care Unit Without Windows to Provide Natural Light.","authors":"Alberto Lucchini,&nbsp;Marco Giani,&nbsp;Katia Ferrari,&nbsp;Stefania Di Maria,&nbsp;Giulia Galimberti,&nbsp;Alessandra Zorz,&nbsp;Pasquale Iozzo,&nbsp;Stefano Elli,&nbsp;Roberto Fumagalli,&nbsp;Stefano Bambi","doi":"10.1097/DCC.0000000000000569","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000569","url":null,"abstract":"<p><strong>Background: </strong>Appropriate levels and patterns of sound and light in an intensive care room help to maintain the patient's normal physiological functions. High sound levels can disrupt the patient's normal sleep architecture, cause hearing deficits, and induce the onset of delirium. Intensive care unit patients frequently report poor sleep, partly due to the environment.</p><p><strong>Objectives: </strong>An observational pilot prospective study was designed to record sound pressure and light pollution levels in an Italian intensive care unit, without windows to provide natural light.</p><p><strong>Method: </strong>Sound levels were measured in decibel A (dBA) every 10 seconds. Sound data were analyzed for sound peak, defined as the number of times sound levels exceeded 45, 50, 60, 65, 70, 75, 80, and 85 dBA. Light measures were taken every 10 seconds on a continuous basis. Light data were analyzed for light \"peaks,\" defined as the number of times light levels exceeded 100, 200, 300, 400, and 500 lux.</p><p><strong>Results: </strong>The overall median sound level during the study period was equal to 54.60 (interquartile range [IQR], 51.70-57.70) dBA. The daytime median sound level was 56.00 (IQR, 53.00-59.50) dBA, and the nighttime median was 53.00 (IQR, 49.50-55.20) dBA (P < .001). The overall median light level was equal to 114 (IQR, 0-225) lux. The daytime median light level was 184 (IQR, 114-293) lux, and the nighttime median was 0 (IQR, 0-50) lux (P < .001). With respect to room lighting, rooms were observed to have \"no lights on\" 12.6% of daytime and 41% of nighttime.</p><p><strong>Discussion: </strong>The sound levels recorded in our sample demonstrated that peaks >45 dBA during daytime and nighttime are, respectively, equal to 99.9% and 98.6% of all readings. The Environmental Protection Agency/World Health Organization recommended thresholds for both day (45 dBA) and night (35 dBA). Sound levels reached \"toxic levels\" when sound-generating activities were performed by nurses and physicians.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"115-123"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153136","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}

{"title":"The Effect of Abdominal Massage on Discharge and Ventilator-Associated Pneumonia in Enterally Fed Patients Connected to Mechanical Ventilation: A Randomized Controlled Study.","authors":"Vesile Eskici İlgin,&nbsp;Nadiye Özer","doi":"10.1097/DCC.0000000000000572","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000572","url":null,"abstract":"<p><strong>Purpose: </strong>The present research was conducted to reveal the impact of abdominal massage on enteral nutrition-induced ventilator-associated pneumonia and the gastrointestinal system in mechanically ventilated patients.</p><p><strong>Materials and methods: </strong>The present research is a prospective, randomized, controlled clinical trial. This study was completed with 63 patients (31 in the experimental group and 32 in the control group). Data collection was performed using a patient information form, a patient follow-up form, and the Bristol Stool Scale. After patients were under mechanical ventilation for 48 hours, the data collection tools were filled out twice a day for 3 days by visiting the mechanical ventilation patients. The experimental group received 15 minutes of abdominal massage twice a day before nursing care was delivered in the morning and the evening.</p><p><strong>Results: </strong>According to the intergroup evaluations, the experimental group had lower gastric residual volume and abdominal distension, types of stool closer to normal, and higher defecation frequency. Differences between the groups were statistically significant (P < .05). In accordance with the intragroup evaluations, the experimental group had lower gastric residual volume, abdominal distension, and ventilator-associated pneumonia. The difference between the groups was revealed to be statistically significant (P < .05).</p><p><strong>Conclusion: </strong>Abdominal massage reduces ventilator-associated pneumonia development to a statistically significant degree. Furthermore, it decreases gastric residual volume and abdominal distension, causes stools to be closer to the normal/ideal stool, increases defecation frequency, and regulates bowel movements and excretion (P < .05).</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"104-114"},"PeriodicalIF":1.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153137","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}

{"title":"Assessment of Clinical Reasoning While Attending Critical Care Postsimulation Reflective Learning Conversation: A Scoping Review.","authors":"Emad Almomani, Jacqueline Sullivan, Jisha Samuel, Ahmed Maabreh, Natalie Pattison, Guillaume Alinier","doi":"10.1097/DCC.0000000000000567","DOIUrl":"10.1097/DCC.0000000000000567","url":null,"abstract":"<p><strong>Background: </strong>The critical care environment is characterized with a high level of workload, complexity, and risk of committing practice mistakes. To avoid clinical errors, health care professionals should be competent with effective clinical reasoning skills. To develop effective clinical reasoning skills, health care professionals should get the chance to practice and be exposed to different patient experiences. To minimize safety risks to patients and health care professionals, clinical reasoning with a focus on reflective learning conversation opportunities can be practiced in simulated settings.</p><p><strong>Objectives: </strong>To explore the most valid and reliable tools to assess clinical reasoning while attending adult critical care-related simulation-based courses in which reflective learning conversations are used.</p><p><strong>Methods: </strong>A scoping review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. Eight electronic databases were searched, and full-text review was completed for 26 articles.</p><p><strong>Results: </strong>The search resulted in no studies conducted to measure clinical reasoning while attending adult critical care-related, simulation-based courses in which the reflective learning conversation method was embedded.</p><p><strong>Discussion: </strong>This highlights the need to evaluate current available clinical reasoning tools or develop new tools within the context of adult critical care simulation where reflective learning forms a key part of the simulation procedures.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"42 2","pages":"63-82"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9197513","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}