American Journal of Critical Care最新文献_第8页

Clinical Pearls. 临床珍珠

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-09-01 DOI: 10.4037/ajcc2024782

Rhonda Board

引用次数: 0

Courage to Soar in Clinical Research. 临床研究中翱翔的勇气。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-09-01 DOI: 10.4037/ajcc2024935

Cindy L Munro, Lakshman Swamy

引用次数: 0

Individualized Numeric Rating Scale to Assess Pain in Critically Ill Children With Neurodevelopmental Disabilities. 评估神经发育障碍重症儿童疼痛的个性化数字评分量表

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024343

Shaneel Rowe, Kaitlin M Best

{"title":"Individualized Numeric Rating Scale to Assess Pain in Critically Ill Children With Neurodevelopmental Disabilities.","authors":"Shaneel Rowe, Kaitlin M Best","doi":"10.4037/ajcc2024343","DOIUrl":"10.4037/ajcc2024343","url":null,"abstract":"Background: Pain is a significant burden for children with neurodevelopmental disabilities but is difficult for clinicians to identify. No pain assessment tools for children with neurodevelopmental disabilities have been validated for use in pediatric intensive care units. The Individualized Numeric Rating Scale (INRS) is an adapted 0-to-10 rating that includes parents' input on their child's pain indicators.Objectives: To evaluate the reliability, validity, and feasibility and acceptability of use of the INRS for assessing pain in critically ill children with neurodevelopmental disabilities.Methods: This observational study enrolled critically ill patients with neurodevelopmental disabilities aged 3 to 17 years in 2 pediatric intensive care units at a children's hospital using a prospective repeated-measures cohort design. Structured parent interviews were used to populate each patient's INRS. Bedside nurses assessed pain using the INRS throughout the study. The research team completed independent INRS ratings using video clips. Participating parents and nurses completed feasibility and acceptability surveys. Psychometric properties of the INRS and survey responses were evaluated with appropriate statistical methods.Results: For 481 paired INRS pain ratings in 34 patients, interrater reliability between nurse and research team ratings was moderate (weighted κ = 0.56). Parents said that creating the INRS was easy, made them feel more involved in care, and helped them communicate with nurses.Conclusions: The INRS has adequate measurement properties for assessing pain in critically ill children with neurodevelopmental disabilities. It furthers goals of patient- and family-centered care but may have implementation barriers.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"280-288"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465594","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

Wide QRS Complex Rhythm in an Unresponsive Community-Based Patient. 一名反应迟钝的社区患者的宽 QRS 波群心律不齐。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024224

Sukardi Suba, Dillon J Dzikowicz, Mary G Carey, Michele M Pelter, Salah S Al-Zaiti

引用次数: 0

Caring for Children With Neurodevelopmental Disabilities in the Pediatric Intensive Care Unit. 在儿科重症监护室照顾有神经发育障碍的儿童。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024366

Cindy Cain

引用次数: 0

Climate Change and the Intensive Care Unit. 气候变化与重症监护室。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024761

Lakshman Swamy, Cindy L Munro

引用次数: 0

Effects of Natural Sound Therapy on Pain and Agitation Induced by Endotracheal Suctioning: A Real-World Study. 自然声音疗法对气管内抽吸引起的疼痛和躁动的影响：真实世界研究

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024570

Qianwen Ruan, Chuanxiong Li, Meihua Qiu, Linjun Wan, Tong Sun

{"title":"Effects of Natural Sound Therapy on Pain and Agitation Induced by Endotracheal Suctioning: A Real-World Study.","authors":"Qianwen Ruan, Chuanxiong Li, Meihua Qiu, Linjun Wan, Tong Sun","doi":"10.4037/ajcc2024570","DOIUrl":"10.4037/ajcc2024570","url":null,"abstract":"Background: Music therapy has been used as a complementary intervention to provide synergistic analgesia for various procedures.Objective: To evaluate the effects of natural sound therapy on pain intensity and agitation scores in intubated adult Chinese patients who received endotracheal suctioning in a critical care unit.Methods: A prospective, real-world, randomized, double-blind, controlled study was conducted from July 2021 through February 2022 among intubated surgical intensive care unit patients in a Chinese hospital. Patients were randomly assigned to a control group receiving conventional treatment or an intervention group receiving natural sound therapy plus conventional treatment (50 patients in each group). Patients' pain intensity and agitation levels were analyzed before, during, immediately after, 5 minutes after, and 15 minutes after completion of endotracheal suctioning. Pain intensity was assessed with the Critical-Care Pain Observation Tool (CPOT); agitation was assessed with the Richmond Agitation-Sedation Scale (RASS).Results: According to CPOT scores, patients in the intervention group had significant relief of pain intensity during, immediately after, and 5 minutes after endotracheal suctioning compared with patients in the control group (all P < .001). The RASS scores showed that agitation levels were significant lower in the intervention group than in the control group during (P = .002) and immediately after (P < .001) endotracheal suctioning.Conclusions: In this real-world study, natural sound therapy was part of a holistic bundle of interventions used to reduce pain and agitation in surgical intensive care unit patients during endotracheal suctioning.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"299-303"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465592","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

Nurses' Understanding and Practice of Minimal Stimulation in the Pediatric Intensive Care Unit. 儿科重症监护室护士对最小刺激的理解和实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024104

Shelley Burcie, Angelica Morris, Virginia Young, Zara Sajwani-Merchant, Lindsey Patton

{"title":"Nurses' Understanding and Practice of Minimal Stimulation in the Pediatric Intensive Care Unit.","authors":"Shelley Burcie, Angelica Morris, Virginia Young, Zara Sajwani-Merchant, Lindsey Patton","doi":"10.4037/ajcc2024104","DOIUrl":"https://doi.org/10.4037/ajcc2024104","url":null,"abstract":"Background: Pediatric patients receiving neurologic and neurosurgical critical care undergo many procedures that result in stimulation of the sympathetic nervous system, which increases their risk of poor outcomes. Nurses typically implement a variety of interventions to minimize such stimulation; however, minimal stimulation has not been specifically defined in the literature or described as a standardized bundle of care.Objective: To examine pediatric intensive care unit nurses' interpretation and practice of minimal stimulation in patients with neurologic and neurosurgical conditions and specifically to triangulate nurses' descriptions of this practice with related findings in the literature.Methods: This was a qualitative, descriptive, exploratory study that used naturalistic inquiry.Results: A total of 13 pediatric intensive care unit nurses participated in the study. Three primary themes were identified regarding minimal stimulation: (1) new knowledge and practice, (2) communication, and (3) impact of minimal stimulation.Conclusions: The findings of this study help to establish a working definition of the nursing practice of minimal stimulation and provide a basis for future research. More detailed study is needed on the concept of a standardized minimal stimulation bundle and its impact on patient outcomes.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"272-279"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465596","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

Discussion Guide for the Botsch Article. 博茨文章讨论指南。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024321

Grant A Pignatiello

引用次数: 0

Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential. 医院心电监护：好的、不太好的和尚未开发的潜力。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024781

Michele M Pelter

{"title":"Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential.","authors":"Michele M Pelter","doi":"10.4037/ajcc2024781","DOIUrl":"https://doi.org/10.4037/ajcc2024781","url":null,"abstract":"Continuous electrocardiographic (ECG) monitoring was first introduced into hospitals in the 1960s, initially into critical care, as bedside monitors, and eventually into step-down units with telemetry capabilities. Although the initial use was rather simplistic (ie, heart rate and rhythm assessment), the capabilities of these devices and associated physiologic (vital sign) monitors have expanded considerably. Current bedside monitors now include sophisticated ECG software designed to identify myocardial ischemia (ie, ST-segment monitoring), QT-interval prolongation, and a myriad of other cardiac arrhythmia types. Physiologic monitoring has had similar advances from noninvasive assessment of core vital signs (blood pressure, respiratory rate, oxygen saturation) to invasive monitoring including arterial blood pressure, temperature, central venous pressure, intracranial pressure, carbon dioxide, and many others. The benefit of these monitoring devices is that continuous and real-time information is displayed and can be configured to alarm to alert nurses to a change in a patient's condition. I think it is fair to say that critical and high-acuity care nurses see these devices as having a positive impact in patient care. However, this enthusiasm has been somewhat dampened in the past decade by research highlighting the shortcomings and unanticipated consequences of these devices, namely alarm and alert fatigue. In this article, which is associated with the American Association of Critical-Care Nurses' Distinguished Research Lecture, I describe my 36-year journey from a clinical nurse to nurse scientist and the trajectory of my program of research focused primarily on ECG and physiologic monitoring. Specifically, I discuss the good, the not so good, and the untapped potential of these monitoring systems in clinical care. I also describe my experiences with community-based research in patients with acute coronary syndrome and/or heart failure.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"247-259"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465593","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