American Journal of Critical Care最新文献_第2页

Clinical Pearls.

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-03-01 DOI: 10.4037/ajcc2025586

Rhonda Board

引用次数: 0

Mindfulness Bundle Toolkit's Impact on Nurse Burnout. 正念捆绑工具包对护士职业倦怠的影响。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-03-01 DOI: 10.4037/ajcc2025260

Gisele N Bazan, Tiffany Patterson, Kelsey Sawyer, Deborah Wambui Kamau, Michelle Bradberry, Cynthia Grissman, Sahar Mihandoust, Jamie K Roney Hernández, C Randall Stennett, JoAnn D Long

{"title":"Mindfulness Bundle Toolkit's Impact on Nurse Burnout.","authors":"Gisele N Bazan, Tiffany Patterson, Kelsey Sawyer, Deborah Wambui Kamau, Michelle Bradberry, Cynthia Grissman, Sahar Mihandoust, Jamie K Roney Hernández, C Randall Stennett, JoAnn D Long","doi":"10.4037/ajcc2025260","DOIUrl":"https://doi.org/10.4037/ajcc2025260","url":null,"abstract":"Background: Nurse burnout is a widespread problem affecting nurses' physical and mental health and patients' satisfaction. Nurses in intensive care units designated for patients with COVID-19 during the pandemic reported experiencing higher levels of emotional exhaustion, depersonalization, and stress and exhaustion and lower levels of personal accomplishment. The current literature does not have a solution to combat burnout.Objective: To test the effectiveness of a mindfulness bundle toolkit on burnout for nurses caring for patients with COVID-19.Methods: A quantitative quasi-experimental design was used. Participants were 52 frontline registered nurses caring for patients with COVID-19. A mindfulness bundle toolkit was provided with the goal of decreasing burnout in a 6-week period. Data were collected before intervention, immediately after intervention, and 6 weeks after intervention using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel, the Nursing Work Index-Revised, and the Stress/Arousal Adjective Checklist. Results The analysis indicated a statistically significant effect from the mindfulness bundle toolkit in 3 areas pertaining to burnout: emotional exhaustion (Wilks Λ = .66; F1,41 = 19.02; P = .001; η2 = .31), depersonalization (Wilks Λ = .70; F1,41 = 7.93; P = .007; η2 = .16), and stress (Wilks Λ = .81; F1,41 = 8.81; P = .005; η2 = .17).Conclusions: The results suggest that the use of a 6-week mindfulness bundle toolkit is an effective intervention to mitigate emotional exhaustion, depersonalization, and stress associated with burnout in critical care nurses caring for patients with COVID-19.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 2","pages":"119-126"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Cardiac Symptoms After Recent Orthopedic Surgery.

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-03-01 DOI: 10.4037/ajcc2025720

Sukardi Suba, Dillon J Dzikowicz, Cass Piper Sandoval, Michele M Pelter

引用次数: 0

Narrative Reflection in Critical Care. 重症监护中的叙事反思。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-03-01 DOI: 10.4037/ajcc2025712

Lakshman Swamy, Cindy L Munro

引用次数: 0

Calling Attention to the Practice of Acute and Critical Care Nursing. 呼吁关注急危重症护理实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-02-04 DOI: 10.4037/ajcc2025397

Michele C Balas, Kirsten E Hepburn, Martha A Q Curley

引用次数: 0

Correction. 修正。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2024270

引用次数: 0

Video Game Therapy in a Neurosciences Critical Care Unit: A Pilot Study. 神经科学重症监护病房的电子游戏治疗：一项试点研究。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025319

Megan Ziegler, Sowmya Kumble, Elizabeth K Zink, Nozomi Tahara, Isha Vora, Robert D Stevens, Mona N Bahouth

{"title":"Video Game Therapy in a Neurosciences Critical Care Unit: A Pilot Study.","authors":"Megan Ziegler, Sowmya Kumble, Elizabeth K Zink, Nozomi Tahara, Isha Vora, Robert D Stevens, Mona N Bahouth","doi":"10.4037/ajcc2025319","DOIUrl":"https://doi.org/10.4037/ajcc2025319","url":null,"abstract":"Background: Therapeutic activity after stroke is a component of early recovery strategies. Interactive video games have been shown to be safe as an adjunct rehabilitation therapy in the medical intensive care setting, but patients with neurologic disease were often excluded from those protocols.Objectives: To evaluate the feasibility and safety of individualized interactive video game therapy in critically ill neurologic patients.Methods: Adults admitted to the neurosciences critical care unit during the observation period were eligible for inclusion. Wii sports games with the potential to target common neurologic deficits were categorized by our interprofessional team. We collected information regarding the number of sessions attempted, time for setup, indications of use, patient/staff experience, and predefined safety events.Results: Twelve sessions were completed in 9 patients, mean (SD) age 48.6 (18.1) years, and sessions were led by nursing and therapy teams. Prescribed video game therapy sessions targeted the following recovery domains: coordination (70%), balance (50%), endurance (30%), cognition (30%), fine motor control (30%), neglect (20%), engagement in activity (10%), and vision (30%). On average, 4.7 minutes were spent for setup and 18.8 minutes were spent playing video games. No safety issues were identified. All patients indicated that they enjoyed participating in video game therapy.Conclusions: In this pilot study, prescriptive interactive video game therapy in early rehabilitation was feasible and safe in the neurosciences critical care setting. Video game therapy may be a valuable complement to existing rehabilitation for critically ill neurologic patients and warrants validation in a larger patient sample.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 1","pages":"60-66"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Use of Machine Learning Models to Predict Microaspiration Measured by Tracheal Pepsin A. 使用机器学习模型预测气管胃蛋白酶A测量的微吸。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025349

Annette Bourgault, Ilana Logvinov, Chang Liu, Rui Xie, Jan Powers, Mary Lou Sole

{"title":"Use of Machine Learning Models to Predict Microaspiration Measured by Tracheal Pepsin A.","authors":"Annette Bourgault, Ilana Logvinov, Chang Liu, Rui Xie, Jan Powers, Mary Lou Sole","doi":"10.4037/ajcc2025349","DOIUrl":"https://doi.org/10.4037/ajcc2025349","url":null,"abstract":"Background: Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator of microaspiration, was found in 39% of patients within 24 hours of enteral feeding. Tracheal pepsin A is a potential biomarker of enteral feeding intolerance.Objective: To identify predictors of microaspiration (tracheal or oral pepsin A). It was hypothesized that variables predicting the presence of tracheal pepsin A might be similar to predictors of enteral feeding intolerance.Methods: In this secondary analysis, machine learning models were fit for 283 adults receiving mechanical ventilation who had tracheal and oral aspirates obtained every 12 hours for up to 14 days. Pepsin A levels were measured using the proteolytic enzyme assay method, and values of 6.25 ng/mL or higher were classified as indicating microaspiration. Demographics, comorbidities, and variables associated with enteral feeding were analyzed with 3 machine learning models-random forest, XGBoost, and support vector machines with recursive feature elimination-using 5-fold cross-validation tuning.Results: Random forest for tracheal pepsin A was the best-performing model (area under the curve, 0.844 [95% CI, 0.792-0.897]; accuracy, 87.55%). The top 20 predictors of tracheal pepsin A were identified.Conclusion: Four predictor variables for tracheal pepsin A (microaspiration) are also reported predictors of enteral feeding intolerance, supporting the exploration of tracheal pepsin A as a potential biomarker of enteral feeding intolerance. Identification of predictor variables using machine learning models may facilitate treatment of patients at risk for enteral feeding intolerance.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 1","pages":"67-71"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Toward High Reliability and Enhanced Patient Experience: Creating a Culture Where Everybody Wins. 实现高可靠性和增强患者体验：创建一种人人共赢的文化。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025386

Richard H Savel

引用次数: 0

Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head And Neck Cancer. 头颈部癌症患者游离皮瓣手术后气管切开套环的固定方法

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-01-01 DOI: 10.4037/ajcc2025794

Pamela B DeGuzman, Michele N Cousins, Claiborne Miller-Davis, Sookyung Park

{"title":"Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head And Neck Cancer.","authors":"Pamela B DeGuzman, Michele N Cousins, Claiborne Miller-Davis, Sookyung Park","doi":"10.4037/ajcc2025794","DOIUrl":"https://doi.org/10.4037/ajcc2025794","url":null,"abstract":"Background: For patients with head and neck cancer who have undergone microvascular free flap surgery, securing a tracheostomy collar onto the neck using the traditional method (ie, with tracheostomy ties) is contraindicated because the ties may compress the newly vascularized tissue. However, no clear guidance exists for the use of other methods in these patients. Current techniques often use safety pins, which can cause injury to staff members.Objective: To identify 1 or more methods of securing a tracheostomy collar that would maximize patient mobility, minimize the risk of staff injury, and be easy to use.Methods: This pilot study had a descriptive design, with data collected from staff members caring for patients with head and neck cancer after microvascular free flap surgery. Three models of tracheostomy securement were evaluated, with each used for 10 postoperative patients with head and neck cancer (n = 30). Staff members rated each model on a 4-point Likert scale.Results: The overall median score of all models was 3.5. Model 2 (collar secured to tubular bandages using binder rings) was rated significantly higher than model 3 (collar secured to tubular bandages using tracheostomy ties) overall (P = .04) as well as for staying in place when the patient was mobile (P = .04) and for ease of changing out parts (P = .01).Conclusion: Several practical methods exist for securing a tracheostomy collar in patients with head and neck cancer who have undergone free flap surgery. These methods may be good alternatives to the use of safety pins.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 1","pages":"33-40"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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