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    600 results match your criteria AACN Advanced Critical Care[Journal]

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    Lung Disease and Genomics.
    AACN Adv Crit Care 2018 ;29(1):74-83
    Kenneth Wysocki is a Family Nurse Practitioner, Phoenix, AZ
    Research and application of genomic medicine in lung disease during the past century has clarified our understanding and focus on specific phenotypes, helping clinicians tailor treatment for individual patients. Cystic fibrosis and lung cancer have been researched extensively; specific genotypes have been instrumental in precision medicine to treat these lung diseases. Asthma and chronic obstructive pulmonary disease are more complex and heterogeneous in their pathogenesis, genotypic profile, and phenotypic expression, making treatment more difficult with increasing disease severity. Read More

    Genetics and Genomics of Acute Neurologic Disorders.
    AACN Adv Crit Care 2018 ;29(1):57-75
    Megan Maserati is a PhD student at University of Pittsburgh, Pittsburgh, Pennsylvania. Sheila A. Alexander is Associate Professor, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261
    Neurologic diseases and injuries are complex and multifactorial, making risk prediction, targeted treatment modalities, and outcome prognostication difficult and elusive. Genetics and genomics have affected clinical practice in many aspects in medicine, particularly cancer treatment. Advancements in knowledge of genetic and genomic variability in neurologic disease and injury are growing rapidly. Read More

    Cardiac Channelopathies: Recognition, Treatment, Management.
    AACN Adv Crit Care 2018 ;29(1):43-57
    Kathleen T. Hickey is Professor of Nursing, Columbia University Medical Center, 622 W 168th St, New York, NY 10032 Amir Elzomor is a premedical student at the Albert Dorman Honors College at the New Jersey Institute of Technology, Newark, New Jersey.
    The discovery of the human genome has ushered in a new era of molecular testing, advancing our knowledge and ability to identify cardiac channelopathies. Genetic variations can affect the opening and closing of the potassium, sodium, and calcium channels, resulting in arrhythmias and sudden death. Cardiac arrhythmias caused by disorders of ion channels are known as cardiac channelopathies. Read More

    Pharmacogenomics in Critical Care.
    AACN Adv Crit Care 2018 ;29(1):36-42
    Dennis Cheek is Abell-Hanger Professor of Gerontological Nursing, Texas Christian University, Harris College of Nursing and Health Sciences, 2800 West Bowie Street, Bass Building Room 2232, Fort Worth, TX 76129 Lynnette Howington is Assistant Professor of Professional Practice, Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas.
    Since the successful completion of the Human Genome Project in 2003, extensive genomic research has continued to alter pathophysiology at the molecular level. This research includes investigation of the specific receptors and metabolizing enzymes in drug pharmacodynamics and pharmacokinetics, specifically the cytochrome P450 system located primarily in the liver. In this article, pharmacogenomics and the role of the cytochrome P450 system in metabolism of various drugs are discussed. Read More

    Genomics and Precision Medicine: Implications for Critical Care.
    AACN Adv Crit Care 2018 ;29(1):28-35
    Christine Kessler is an Endocrinology Nurse Practitioner and Founder, Metabolic Medicine Associates, 6315 Vista Court, King George, VA 22485
    A new paradigm for disease diagnosis and treatment is emerging that will bring about changes in health care delivery in and out of the hospital setting. Over the past several decades, genomic medicine has been one of the fastest growing fields in acute and chronic health care. This quick growth has created a lag in genomics knowledge and preparation among nurses and health care providers. Read More

    Residual Neuromuscular Blockade in the Critical Care Setting.
    AACN Adv Crit Care 2018 ;29(1):15-24
    Nicole Stawicki is an Acute Care Nurse Practitioner, University of Illinois Hospital and Health Sciences System, 1740 W Taylor St, Chicago, IL 60612 Patty Gessner is a Critical Care Nurse Practitioner, Suburban Lung Associates, Elk Grove Village, Illinois.
    Residual neuromuscular blockade is a widespread challenge for providers in the acute care setting that, if left unrecognized or untreated, places patients at higher risk for morbidity and mortality. The condition is estimated to occur in 26% to 88% of patients undergoing general anesthesia. The role of the advanced practice nurse in the acute care setting is to facilitate a safe recovery process by identifying early signs of deterioration and supporting the patient until full muscular strength has returned. Read More

    Reflections on How We Teach Ethics: Moral Failure in Critical Care.
    AACN Adv Crit Care 2017 ;28(4):384-390
    Georgina Morley is a doctoral student, Centre for Ethics in Medicine, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. Jonathan Ives is Senior Lecturer, Biomedical Ethics and Law, Deputy Director Centre for Ethics in Medicine, School of Social and Community Medicine, University of Bristol, Room G.4a, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom

    Creating Healthy Work Environments for Second Victims of Adverse Events.
    AACN Adv Crit Care 2017 ;28(4):366-374
    Linda M. Tamburri is Clinical Nurse Specialist, Robert Wood Johnson University Hospital, One Robert Wood Johnson Place, New Brunswick, NJ 08901
    Adverse events may cause a patient serious harm or death; the patient becomes the first victim of these events. The health care providers who become traumatized by the events are the second victims. These second victims experience feelings such as guilt, shame, sadness, and grief, which can lead to profound personal and professional consequences. Read More

    Designing a Resilience Program for Critical Care Nurses.
    AACN Adv Crit Care 2017 ;28(4):359-365
    Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.
    Background: Workplace stress can affect job satisfaction, increase staff turnover and hospital costs, and reduce quality of patient care. Highly resilient nurses adapt to stress and use a variety of skills to cope effectively.

    Objective: To gain data on a mindfulness-based cognitive therapy resilience intervention for intensive care unit nurses to see if the intervention program would be feasible and acceptable. Read More

    Compassion Fatigue and the Healthy Work Environment.
    AACN Adv Crit Care 2017 ;28(4):351-358
    Lesly Kelly is Assistant Professor, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004 Michael Todd is Research Professor, Arizona State University, Phoenix, Arizona.
    Background: Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited.

    Objective: To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction. Read More

    Incivility and Professional Comportment in Critical Care Nurses.
    AACN Adv Crit Care 2017 ;28(4):345-350
    Kenneth John Oja is RN Clinical Research Program Director, Banner University Medical Center Phoenix, and Clinical Assistant Professor, University of Arizona College of Nursing, 1111 East McDowell Road, Phoenix, AZ 85006
    Background: Civility among critical care nurses is important for achieving positive patient outcomes. Professional comportment refers to nurse behaviors that are respectful, knowledgeable, deliberate, and compassionate.

    Objective: To examine the relationship between perceptions of nurse-to-nurse incivility and professional comportment among critical care nurses, and the extent to which nurse characteristics influence their perceptions. Read More

    Advanced Practice Registered Nurses on Therapeutic Hypothermia Response Teams.
    AACN Adv Crit Care 2017 ;28(4):332-341
    Jason Wannemacher is Pulmonary/Critical Care Nurse Practitioner in Dayton, Ohio, and at University of Michigan School of Nursing, 7056 Corporate Way, Centerville, OH 45459 Dana Tschannen is Clinical Associate Professor, Director of Post Master's DNP, Vice Chair of Academic Affairs-Systems, Populations & Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan. Kim Biery is Director of Quality Innovation, Miami Valley Hospital, Dayton, Ohio. Cynthia Arslanian-Engoren is Associate Dean, Faculty Affairs and Faculty Development, University of Michigan School of Nursing, Ann Arbor, Michigan.
    Background: Therapeutic hypothermia can improve neurological recovery after cardiac arrest when implemented quickly.

    Objective: To determine whether outcomes are improved among patients undergoing therapeutic hypothermia by adding advanced practice registered nurses to a therapeutic hypothermia response team.

    Methods: A pilot quality improvement project was conducted in a Midwest community teaching hospital using a retrospective chart review of all adult patients undergoing therapeutic hypothermia before and after the addition of advanced practice registered nurses to the therapeutic hypothermia response team. Read More

    Reversal Strategies for Newer Oral Anticoagulants.
    AACN Adv Crit Care 2017 ;28(4):322-331
    Adam J. Singer is Professor and Vice Chairman for Research, Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY 11794-8350 Susan Wilson is Associate Professor, Department of Neurology, and Adult Stroke Nurse Practitioner, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
    Nonvitamin K antagonist oral anticoagulants have advantages compared with warfarin, but both types of anticoagulants come with uncertainty about how best to manage life-threatening bleeding events, urgent surgeries, and invasive procedures. Nurse practitioners and physician assistants may need to manage such emergency situations in the critical care setting. Achieving hemostasis quickly is key, and efforts to do so have relied mainly on blood products. Read More

    Intravenous -Acetylcysteine for Acetaminophen Toxicity.
    AACN Adv Crit Care 2017 ;28(4):305-310
    Alyssa N. Fixl is Critical Care Clinical Pharmacist, Department of Pharmacy Services, St Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA 18015 Robert M. Woods is Emergency Medicine/ICU Clinical Pharmacist, Department of Pharmacy Services, St Joseph's Hospital, Tampa, Florida. Katelyn Dervay is Pharmacotherapy Specialist Emergency Medicine, Director, Postgraduate Year 2 Emergency Medicine Residency, Department of Pharmacy Services, Tampa General Hospital, Tampa, Florida.

    Adiposity and the Role of Neuroendocrine Hormones in Energy Balance.
    AACN Adv Crit Care 2017 ;28(3):284-288
    Heather Roff is Critical Care Clinical Nurse Specialist, Donor Network West, 12667 Alcosta Boulevard #500, San Ramon, CA 94583 Colette Jappy is Clinical Nurse Specialist, Kaiser Permanente, Redwood City, CA
    Obesity is a worldwide health concern and, given the risk for developing associated co-morbidities that increase mortality, obesity has health implications for individuals and populations. Obesity involves multifactorial regulatory mechanisms, and recognition of these mechanisms will enhance the care critical care nurses provide to their patients. This article reviews the general physiological mechanisms of energy storage and the regulation of adiposity related to key neuroendocrine hormones. Read More

    Managing Care of Critically Ill Bariatric Patients.
    AACN Adv Crit Care 2017 ;28(3):275-283
    Cheryl Holsworth is Senior Specialist Bariatric Surgery, Sharp Memorial Hospital, San Diego, California. Susan Gallagher is Senior Clinical Advisor, Celebration Institute Inc, 8790 Skyline Lane, Conroe, TX 77302
    Nearly 160 million Americans are overweight, obese, or morbidly obese. Morbid obesity and its numerous comorbidities are threats to a person's health. Moreover, hospitalized individuals living with adiposity-based chronic conditions are at risk for certain immobility hazards. Read More

    Comprehensive Care for Bariatric Surgery Patients.
    AACN Adv Crit Care 2017 ;28(3):263-274
    Aura Petcu is Nurse Practitioner, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Mail Code UHS 8W, Portland, OR 97239
    Obesity is a worldwide epidemic, and those suffering from obesity have increased morbidity and mortality rates. There are various causes of obesity and many treatment options for patients suffering from obesity, including nonsurgical treatments. However, bariatric surgery is often the best choice for optimal weight loss and the attenuation of comorbidities. Read More

    Weight Bias and Psychosocial Implications for Acute Care of Patients With Obesity.
    AACN Adv Crit Care 2017 ;28(3):254-262
    Rachel Smigelski-Theiss is Clinical Nurse Specialist, Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813 Malisa Gampong is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii. Jill Kurasaki is Nurse Manager, Queen's Medical Center, Honolulu, Hawaii.
    Obesity is a complex medical condition that has psychosocial and physiological implications for those suffering from the disease. Factors contributing to obesity such as depression, childhood experiences, and the physical environment should be recognized and addressed. Weight bias and stigmatization by health care providers and bedside clinicians negatively affect patients with obesity, hindering those patients from receiving appropriate care. Read More

    Pursuing the Clinical Track Faculty Role: From Clinical Expert to Educator.
    AACN Adv Crit Care 2017 ;28(3):243-249
    Raymond R. Blush III is Clinical Assistant Professor at University of Michigan School of Nursing, Room 2304, 400 SNB North Ingalls, Ann Arbor, MI 48109 Heidi L. Mason is Clinical Instructor, University of Michigan School of Nursing, Ann Arbor, Michigan. Nicole M. Timmerman is Lecturer, University of Michigan School of Nursing, Ann Arbor, Michigan.

    Pharmacologic Management of Alcohol Withdrawal Syndrome in Intensive Care Units.
    AACN Adv Crit Care 2017 ;28(3):233-238
    Beatrice Adams is Critical Care Clinical Pharmacist, Medical and Burn Intensive Care Unit, Department of Pharmacy Services, Tampa General Hospital, PO Box 1289, Tampa, FL 33601 Kevin Ferguson is Critical Care Clinical Pharmacist, Medical Intensive Care Unit, Department of Pharmacy Services, Tampa General Hospital, Tampa, Florida.

    Atrioventricular Reentrant Tachycardia.
    AACN Adv Crit Care 2017 ;28(2):223-228
    Karen M. Marzlin is Cardiology APRN, Aultman Hospital, Canton, Ohio, and Business Owner/Author/Educator/Consultant, Key Choice/Cardiovascular Nursing Education Associates, 4565 Venus Rd, Uniontown, OH 44685 Cynthia Webner is Business Owner/Author/Educator/Consultant, Key Choice/Cardiovascular Nursing Education Associates, North Canton, Ohio.

    Creating Clinical Research Protocols in Advanced Practice: Part IV, Designing Research to Fit Practice.
    AACN Adv Crit Care 2017 ;28(2):210-217
    Myra Ellis is Clinical Nurse IV, Cardiothoracic Intensive Care Unit, Duke University Hospital, Durham, NC 27710 Lynn McGugan is Advanced Practice Nurse, Duke University Hospital, Durham, North Carolina. Jill Engel is Associate Vice President of Heart Operations, Nursing and Patient Care Services, Duke University Health System, Durham, North Carolina. Bradi B. Granger is Director, Duke Heart Center Nursing Research Program, and Professor, Duke University School of Nursing, Durham, North Carolina.

    Implementing Family-Centered Care Through Facilitated Sensemaking.
    AACN Adv Crit Care 2017 ;28(2):200-209
    Judy E. Davidson is Evidence-Based Practice and Research Nurse Liaison, University of California, San Diego Health, 200 W Arbor Drive 8929, San Diego, CA 92103 Sidney Zisook is Distinguished Professor, Department of Psychiatry, University of California, San Diego, and San Diego Veteran's Administration Health Care System, San Diego, California.
    The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. Read More

    Innovation and Technology: Electronic Intensive Care Unit Diaries.
    AACN Adv Crit Care 2017 ;28(2):191-199
    Elizabeth A. Scruth is Clinical Practice Consultant, Clinical Effectiveness Team, Regional Quality and Regulatory Services, Kaiser Permanente, 1950 Franklin Street, 14th Floor, Oakland, CA 94612 Nazanin Oveisi is Senior User Experience Design Lead, Amazon Web Services, Seattle, Washington. Vincent Liu is Research Scientist I, Division of Research Critical Care, Kaiser Permanente Northern California, Santa Clara, California.
    Hospitalization in the intensive care unit can be a stressful time for patients and their family members. Patients' family members often have difficulty processing all of the information that is given to them. Therefore, an intensive care unit diary can serve as a conduit for synthesizing information, maintaining connection with patients, and maintaining a connection with family members outside the intensive care unit. Read More

    Measuring Outcomes of an Intensive Care Unit Family Diary Program.
    AACN Adv Crit Care 2017 ;28(2):179-190
    Truong-Giang Huynh is ICU Assistant Nurse Manager, Jacobs Medical Center, University of California, San Diego Health, 9300 Campus Point Drive, La Jolla, CA 92037 Miranda Covalesky is Clinical Nurse II, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Samantha Sinclair is Clinical Nurse II, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Heather Gunter is Clinical Nurse III, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California. Tamara Norton is Clinical Nurse III, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California. Alice Chen is Clinical Nurse III, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Cassia Yi is Critical Care Clinical Nurse Specialist, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California.
    Patients discharged from intensive care units are at risk of short- and long-term physical, cognitive, and emotional symptoms known as post-intensive care syndrome. Family members of intensive care unit patients are at risk of similar symptoms known as post-intensive care syndrome-family. Both syndromes are common, and strategies to reduce risk factors should be employed. Read More

    Sleep in the Intensive Care Unit in a Model of Family-Centered Care.
    AACN Adv Crit Care 2017 ;28(2):171-178
    Robert L. Owens is Assistant Professor of Medicine, University of California San Diego, Division of Pulmonary, Critical Care, and Sleep Medicine, La Jolla, CA 92037 Truong-Giang Huynh is ICU Assistant Nurse Manager, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Giora Netzer is Associate Professor of Medicine and Epidemiology, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
    The desire for families to be physically present to support their loved ones in the intensive care unit, and guidelines in favor of this open visitation approach, require that clinicians consider both patient and family sleep. This article reviews the causes of poor sleep for patients and their family members in the intensive care unit as well as the expected changes in cognition and emotion that can result from sleep deprivation. Measures are proposed to improve the intensive care unit environment to promote family sleep. Read More

    Factors Influencing Active Family Engagement in Care Among Critical Care Nurses.
    AACN Adv Crit Care 2017 ;28(2):160-170
    Breanna Hetland is Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH Ronald Hickman is Associate Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Natalie McAndrew is Clinical Nurse Specialist, Medical Intensive Care Unit, The Medical College of Wisconsin-Froedtert Hospital, Milwaukee, Wisconsin. Barbara Daly is Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
    Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. Read More

    Promoting Patient- and Family-Centered Care in the Intensive Care Unit: A Dissemination Project.
    AACN Adv Crit Care 2017 ;28(2):155-159
    Ruth Kleinpell is Director, Center for Clinical Research and Scholarship, Rush University Medical Center, and Professor, Rush University College of Nursing, 600 South Paulina Avenue, Suite 1080, Chicago, IL 60612 Timothy G. Buchman is Director, Emory Critical Care Center, and Professor, Emory University School of Medicine, Atlanta, Georgia. Lori Harmon is Director of Quality, Society of Critical Care Medicine, Mount Prospect, Illinois. Melissa Nielsen is Communication Manager, Society of Critical Care Medicine, Mount Prospect, Illinois.
    Awareness of patient-centered and family-centered care research can assist clinicians to promote patient and family engagement in the intensive care unit. Project Dispatch (Disseminating Patient-Centered Outcomes Research to Healthcare Professionals) was developed to disseminate patient- and family-centered care research and encourage its application in clinical practice. The 3-year project involved the development of an interactive website platform, online educational programming, social media channels, a podcast and webcast series, and electronic and print media. Read More

    Implementing Intensive Care Unit Family-Centered Care: Resources to Identify and Address Gaps.
    AACN Adv Crit Care 2017 ;28(2):148-154
    David Y. Hwang is Assistant Professor of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, P.O. Box 208018, New Haven, CT 06520 Robert El-Kareh is Associate Professor of Medicine, Divisions of Biomedical Informatics and Hospital Medicine, University of California, San Diego Health, La Jolla, California. Judy E. Davidson is Evidence-Based Practice and Research Nurse Liaison, University of California, San Diego Health, San Diego, California.
    During creation of the 2017 Society of Critical Care Medicine Guidelines for Family-Centered Care in the Intensive Care Unit, 2 implementation tools were developed to assist intensive care unit clinicians in incorporating the new recommendations into local practice: a gap analysis tool and a work tools document. The gap analysis tool helps intensive care unit teams rapidly develop unit- or organization-specific recommendations to enhance family-centered care and assess local barriers to implementation. The work tools document identifies readily available and tested resources that may further assist with action planning for change. Read More

    Implementing the SCCM Family-Centered Care Guidelines in Critical Care Nursing Practice.
    AACN Adv Crit Care 2017 ;28(2):138-147
    Maureen Coombs is Professor, Clinical Nursing, The Graduate School of Nursing Midwifery and Health, Victoria University, Wellington, New Zealand Kathleen A. Puntillo is Professor Emeritus and Research Scientist, Department of Physiological Nursing, University of California, San Francisco, California. Linda S. Franck is Jack and Elaine Koehn Endowed Chair in Pediatric Nursing, Department of Family Health Care Nursing, University of California, San Francisco, California. Elizabeth A. Scruth is Clinical Practice Consultant, Regional Quality and Regulatory Services, Kaiser Permanente, Oakland, California. Maurene A. Harvey is a Critical Care Educator and Consultant, Lake Tahoe, Nevada. Sandra M. Swoboda is Research Program Coordinator/Simulation Educator, Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Maryland. Judy E. Davidson is Evidence-Based Practice and Research Nurse Liaison, University of California San Diego Health, San Diego, California.
    Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice. Read More

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