The Canadian journal of critical care nursing最新文献

{"title":"Implementation of a unique RRT model in a tertiary care centre in Western Canada.","authors":"Teddie Tanguay,&nbsp;Reagan Bartel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In early 2010, the Royal Alexandra Hospital (RAH) was the only tertiary hospital in Edmonton, Alberta, without a rapid response team (RRT). Once funding was obtained, the RAH RRT was developed with the mission of \"Helping you make it happen\" with the underlying philosophy that any call is a good call and the team is there to support care on the wards. The RAH RRT is unique, as it uses a registered nurse/respiratory therapist model rather than the physician model used by most tertiary centres. The RAH RRT provides consistent and efficient response to deteriorating patients and visitors to the hospital. The RRT does not replace the attending team, rather the team supports them to provide improved patient care and to escalate care if required. Other major centres in Alberta have heard about the success of the RAH model and are moving toward a similar model.</p>","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"28 1","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850280","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":"End-of-life care in the ICU: Supporting nurses to provide high-quality care.","authors":"Sarah Crowe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>ICU care has traditionally focused on curative treatment, but making the decision to withdraw life-sustaining therapies, the there is an increasing awareness of the key role palliative and barriers to providing good end-of-life care, factors that support comfort care play. Through a review of recent literature on end- good end-of-life care, and specific guidelinesfor the withdrawal of-life care and withdrawal of life-sustaining therapies in the of life-sustaining therapies. Using this information, a checklist to intensive care unit, four themes have emerged: the challenges of support end-of-life care by critical care nurses was created.</p>","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"28 1","pages":"30-33"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850279","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":"Nurses' experiences of providing care to bereaved families who experience unexpected death in intensive care units: A narrative overview.","authors":"Aalia Shariff,&nbsp;Joanne Olson,&nbsp;Anna Santos Salas,&nbsp;Lisa Cranley","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Death is a common occurrence in intensive care units (IC Us) and the complexity of care makes it difficult for nurses to find a balance between the patient's physical needs and the family's emotional needs, especially in circumstances of unexpected death. Cumulative or unresolved grief for families can have lasting negative repercussions. Nurses, therefore, need access to bereavement education in order to provide optimal- bereavement support.</p><p><strong>Purpose: </strong>The purpose of this review is to identify challenges and facilitators that nurses experience in delivering bereavement support during and after sudden or unexpected death in ICUs.</p><p><strong>Methods: </strong>A narrative overview was conducted based on a literature search using GINA HL, Medline, Psyclnfo, Scopus, and Pro quest databases, as well as grey literature, revealing 241 articles, 15 of which met inclusion criteria.</p><p><strong>Findings: </strong>Four themes surrounding bereavement support in the ICUs emerged: influence of hospital policies and organizational constraints; sign ~tl cance of time and trust; level of knowledge and support of staff and nurses' inner conflict, moral distress, and personal ways of coping.</p><p><strong>Conclusion: </strong>The availability of up-to-date literature in this area is limited. Further research could inform organizational poli- cies, nursing education, and nursing staff development to address existing barriers. With adequate resources, practical strate- gies could be implemented to provide bereavement support that ensures optimal bereavement outcomes for families experiencing sudden or unexpected death in ICUs.</p>","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"28 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850277","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":"A Survey of Nursing Staff’s Perspective Regarding Reasons for Medication Errors","authors":"M. Heidari, Salman Yadollahi, Z. Rafiee, M. Karimifard, Hedayatollah Lalehgani","doi":"10.5812/CCN.9305","DOIUrl":"https://doi.org/10.5812/CCN.9305","url":null,"abstract":"Background: Health care services are associated with risks for their recipients. Medication errors can lead to many negative consequences for the health care system, including prolonged hospital stay and increased cost per patient. The aim of this study was to investigate the nursing staff’s perspective regarding reasons for medication errors in Ayatollah Kashani hospital, Shahrekord, Iran. Methods: 207 nurses working in the ICUs of the hospital were selected by convenience sampling and their comments about effective factors in the incidence of medication errors were investigated by a researcher-made questionnaire. To examine the reliability and validity of the questionnaire, we offered it to 5 nursing experts and necessary corrections were made based on the comments. The reliability of the questionnaire was also investigated by Cronbach’s alpha coefficient that gave the value of 85%. The first section of the questionnaire consisted of questions about demographic characteristics and the second section investigated the reasons for medication errors in nursing-related area, workplace-related area, director of nursing-related area, and drug-related area. For each item, there were four choices, i.e. none, little, moderate, and much and therefore, the level of importance scored between 0 and 3. The data were analyzed by SPSS 17. Results: In this study, the most important reasons for medication errors were related to workload-induced fatigue (mean: 2.37) in the nurses-related area, high labor-intensity in department (mean: 2.32) in the workplace-related area, insufficient nursing staff proportional to the number of patients in department (mean: 2.41) in the director of nursing-related area, and drug name confusion in the drug-related area (mean: 2.04). Conclusions: The officials of health care systems should focus on the effective processes in reducing medication errors including appropriate training of the staff and holding in-service training sessions about drug information as well as appropriate planning for employment of adequate workforce.","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82441554","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":"Comparison of the Effects of Aromatherapy with Rose and Lavender on Physiological Parameters of Patients Undergoing Open Heart Surgery: A Clinical Trial","authors":"S. Ghasemi, H. B. Darzi, A. Ebadi","doi":"10.5812/CCN.10029","DOIUrl":"https://doi.org/10.5812/CCN.10029","url":null,"abstract":"Background: Complementary therapies are cost-effective and non-invasive methods, aimed at increasing comfort in stressful situations. The aim of this study was to compare the effects of aromatherapy with rose and lavender fragrances on the physiological parameters of patients undergoing open heart surgery. Methods: This randomized, controlled, clinical study was performed on 160 patients, undergoing open heart surgery in 2015. The patients were randomly allocated to 4 groups: 2 intervention groups, 1 control group, and 1 placebo group. After transferring the patients from the operating room to the cardiovascular intensive care unit (ICU), the vital signs were documented in all the groups with the patient’s first inspiratory effort, using a monitoring device. In the intervention group, after the patient’s first inspiratory effort, a cotton cloth, impregnated with 3 drops of rose and lavender fragrances, was attached to the patient’s endotracheal tube. In the placebo group, intervention was performed with a cotton cloth impregnated with water. In the control group, no intervention was applied. Afterwards, the patients’ vital signs were controlled and documented every 30 minutes until the endotracheal tube was extracted. Following endotracheal tube extraction, the vital signs were documented every 15 minutes for 1 hour. For data analysis, descriptive and inferential statistics were calculated, using SPSS version 23. Results: The results of the present study indicated that aromatherapy with rose and lavender fragrances does not cause any significant difference in the physiological indicators. The decline in systolic blood pressure within the first 15, 45, and 60 minutes following endotracheal tube extraction was significantly different among the groups. However, although the difference was statistically significant, it was not of clinical importance. Conclusions: Considering the positive effects of aromatherapy on hemodynamic indicators, this method can be applied as an effective complementary treatment.","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86319121","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":"Glycemic Control in Intensive Care Unit: A Proposal for the Safe Application in the Post-Surgical Patient","authors":"C. Tacconi, A. Schiavon","doi":"10.5812/CCN.10132","DOIUrl":"https://doi.org/10.5812/CCN.10132","url":null,"abstract":"Objectives: This study is to propose recommendations regarding glycemic control in intensive care in the post surgical patient. Methods: It was carried out as a literature review using the following search terms: post anesthesia nursing, hypoglycemia, hyperglycemia, intensive care units, glycemic control. Results: Within each article, outcomes of patients undergoing continuous treatment with insulin infusion were examined in addition to the percentage of patients who fell in hypoglycemia or hyperglycemia. Conclusions: Given the risks of hypoglycaemia, the authors recommend: Start early infusion at a constant supply of glucose; the start of continuous infusion of insulin to the overrun of 180 mg/dL; the use of solutions for infusion at a concentration of 1 unit mL, and glucose monitoring every 2 hours","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81585763","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 Meaning of Emergency Care in the Iranian Nursing Profession","authors":"H. Mahmoudi, Eesa Mohmmadi, A. Ebadi","doi":"10.5812/CCN.10073","DOIUrl":"https://doi.org/10.5812/CCN.10073","url":null,"abstract":"Background: An emergency department (ED) has multiple patients with a wide variety of conditions that receive care simultane-","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90702770","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":"Effect of Nurses’ Awareness on Myocardial Infarction Pain Management","authors":"F. Ziba, F. Shirazi","doi":"10.5812/CCN.10020","DOIUrl":"https://doi.org/10.5812/CCN.10020","url":null,"abstract":"Background: Awareness of healthcare providers (especially nurses) about common medical problems is an important issue in realizing the significant effects of pain physiology. Pain management in myocardial infarction is a major responsibility of nurses, which can be accomplished through care provision for patients. Nurses’ age, type of employment, and other factors such as work experience have great impacts on the efficacy of pain management and the related parameters. Objectives: To determine the level of nurses’ awareness about pain management in myocardial infarction as a critical care issue, based on the clinical data. Methods: This descriptive cross sectional study was carried out in teaching hospitals, affiliated to Shahid Beheshti University of Medical Sciences. In this study, 200 nurses were selected as the participants. The data collection tool was a questionnaire consisting of 2 parts. The demographic and awareness sections of the questionnaire consisted of 10 modules of the Faculty of Medicine. The selection criterion was defined to identify the validity and reliability of actual care implementation. Each nurse was evaluated in the morning, afternoon, and evening shifts in a live response manner to determine the level of care provision. It took 20 minutes to complete the questionnaire. Dishonesty in responding to the questionnaire (predefined) was controlled and eliminated. For data analysis, statistical tests including independent t test were performed, using SPSS version 21. Results: Based on the findings, the nurses’ knowledge (skills and expertise) about myocardial infarction pain management had a significant relationship with their consciousness, type of employment (P = 0.022), and sex (P = 0.024). Conclusions: The results showed that sex and type of employment play effective roles in myocardial infarction pain management.","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81933283","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":"Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score in Measuring Level of Consciousness and Outcome in Patients Receiving Sedation Under Mechanical Ventilation","authors":"Aliakbar Keykha, H. Askari, A. Navidian, Bibi Mahdie Khodadadi Hosseini","doi":"10.5812/CCN.10160","DOIUrl":"https://doi.org/10.5812/CCN.10160","url":null,"abstract":"Background: Determining the level of consciousness is one of the main responsibilities of nurses in intensive care unit (ICUs). Scales used to determine the level of consciousness should be less affected by the injection of analgesics and sedatives and should provide proper vision of the patient’s status. Objectives: This study was conducted to assess the ability of two tools including Glasgow coma scale (GCS) and full outline of unresponsiveness (FOUR) score in measuring the level of consciousness and outcome in patients receiving sedation under mechanical","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72706944","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 Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study","authors":"Leila Safaeepour, J. Nouri, S. Moradian, S. Ghiasi","doi":"10.5812/CCN.10655","DOIUrl":"https://doi.org/10.5812/CCN.10655","url":null,"abstract":"Background: The use of nonpharmacological methods has been emphasized in the recent years. These methods are used to decrease the duration of weaning from mechanical ventilation after coronary artery bypass graft (CABG) surgery. Objectives: The present study aimed at determining the effect of family-centered care on the duration of weaning from mechanical ventilation in patients undergoing CABG. Methods: This clinical trial study was conducted in Jamaran Heart Subspecialty hospital in Tehran in 2016. Initially, convenient sampling method and random allocation were used by quaternary blocks to allocate patients into 2 groups of experimental and control, with 35 participants in each group. In the intervention group, the patients’ family member chosen by the patient was entered into the ward during the weaning process. Patient’s entrance time to the ward to extubation time was considered as the duration of weaning from mechanical ventilation in the 2 groups. Results: Duration of weaning in the experimental group was 97 minutes less than the control group; in other words, the weaning duration of those in the control group was 1.4 times greater than those in the experimental group. This difference was statistically significant between the 2 groups (P = 0.05). Conclusions: Family-centered care reduced the duration of weaning from mechanical ventilator in patients undergoing coronary artery surgery, which can remarkably decrease complications due to ventilation with positive pressure in these patients.","PeriodicalId":91413,"journal":{"name":"The Canadian journal of critical care nursing","volume":"319 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77133370","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}