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Am J Crit Care 2019 Mar;28(2):157-158

Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco, California. Teri M. Kozik is a nurse researcher at St Joseph's Medical Center, Stockton, California. Salah S. Al-Zaiti is an assistant professor at the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Am J Crit Care 2019 Mar;28(2):152-156

Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon.

Am J Crit Care 2019 Mar;28(2):149-151

Mary G. Carey is director, Clinical Nursing Research Center, and associate professor, School of Nursing Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York. Brandon W. Qualls is coordinator, Clinical Nursing Research Center, University of Rochester Medical Center. Colleen Burgoyne is a family nurse practitioner, University of Rochester Medical Center.

Background: Subjecting patients to stress has potentially detrimental effects on their physical and psychological recovery.

Objective: To identify stress-generating experiences that occur in an intensive care unit for patients after cardiac surgery.

Methods: A sample of 16 patients in a 14-bed cardiovascular intensive care unit at a university hospital in upstate New York completed a questionnaire (based on an established survey) asking them to rate 23 experiences on a Likert scale of 0 to 4. Read More

Am J Crit Care 2019 Mar;28(2):142-148

Brandon D. Gomes was an undergraduate honors student, College of Nursing, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, at the time of the study and is now a registered nurse in the critical care units, South-coast Hospitals Group, Fall River, Massachusetts. Ouida P. Dowd is a clinical assistant professor, College of Nursing, University of Massachusetts Dartmouth, and a critical care nurse. Kristen A. Sethares is a professor and PhD program director, College of Nursing, University of Massachusetts Dartmouth.

Background: Family-witnessed resuscitation is not consistently practiced in critical care despite the fact that it is recommended and research shows that it supports the emotional needs of families and patients and improves decision-making, care, and communication. Nurses support the idea of family-witnessed resuscitation but may not believe it should be standard practice.

Objectives: To examine the attitudes of American community hospital critical care nurses about family-witnessed resuscitation and to identify differences in attitudes between nurses who have and have not experienced it. Read More

Am J Crit Care 2019 Mar;28(2):136-141

Mayra Gonçalves Menegueti is a registered nurse, Department of Surgery and Anatomy, Division of Intensive Care Medicine, Ribeirão Preto Medical School, and an assistant professor, Ribeirão Preto Nursing School, University of São Paulo, Ribeirão Preto, Brazil. Thamiris Ricci de Araújo is a registered nurse and postgraduate student and Ana Maria Laus is an associate professor, Ribeirão Preto Nursing School, University of São Paulo. Olindo Assis Martins-Filho is head of the biomarker research group, Biomarkers Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Minas Gerais, Brazil. Anibal Basile-Filho is an associate professor and Maria Auxiliadora-Martins is an assistant professor, Division of Intensive Care Medicine, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo.

Background: Septic shock is one of the main causes of mortality in intensive care units worldwide. Nutritional support can affect the survival of patients with sepsis.

Objective: To evaluate whether resting energy expenditure, respiratory quotient, and oxygen consumption and carbon dioxide production (measured by indirect calorimetry) differ between critically ill patients with vs without sepsis. Read More

Am J Crit Care 2019 Mar;28(2):127-135

Annachiara Marra is an anesthesiologist, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, and Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy. Katarzyna Kotfis is an assistant professor, Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland. Annmarie Hosie is a postdoctoral research fellow, IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, Australia. Alasdair M. J. MacLullich is a professor, Edinburgh Delirium Research Group, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, Scotland. Pratik P. Pandharipande is a professor, Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, and Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center. E. Wesley Ely is a professor, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Center for Health Services Research, Department of Medicine, and Center for Quality Aging, Vanderbilt University Medical Center, and associate director for research, Geriatric Research, Education and Clinical Center (GRECC) Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, and CIBS Center, Vanderbilt University Medical Center. Brenda T. Pun is an advanced practice nurse, CIBS Center, Vanderbilt University Medical Center.

Delirium, one of the most common manifestations of acute brain dysfunction, is a serious complication in patients receiving care throughout the hospital and a strong predictor of worse outcome. Although delirium monitoring is advocated in numerous evidence-based guidelines as part of routine clinical care, it is still not widely and consistently performed at the bedside in different patient care settings. In a debate on delirium monitoring in hospitalized patients at the 7th American Delirium Society meeting in Nashville, Tennessee, June 2017, areas related to the feasibility, acceptability, and effectiveness of routine delirium monitoring of hospitalized patients were identified, and arguments both for (pro) and against (con) the practice were presented. Read More

Am J Crit Care 2019 Mar;28(2):126

Am J Crit Care 2019 Mar;28(2):117-123

Aluko A. Hope is an associate professor, Missiel Munoz is a research coordinator, and Michelle Ng Gong is a professor in the Department of Medicine, Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, New York. S. J. Hsieh is an associate professor in the Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Prehospital frailty has been associated with adverse hospital outcomes in critically ill adults. Although frailty assessment in intensive care units depends on patients' surrogates, frailty assessments by surrogates and researchers have not been compared.

Objectives: To compare agreement and validity between surrogates' and researchers' assessments of frailty in critically ill older adults. Read More

Am J Crit Care 2019 Mar;28(2):109-116

Sue Sendelbach (retired) was director of nursing research, Abbott Northwestern Hospital/Minneapolis Heart Institute/Allina Health, Minneapolis, Minnesota. Kristin E. Sandau is a professor of nursing, Bethel University, and a staff nurse, United Hospital/Allina Health, St Paul, Minnesota. Lisa Smith is a staff nurse in the cardiovascular laboratory, United Hospital/Allina Health. Steven Hanovich is an intensivist, United Hospital/Allina Health and information services medical director, Allina Health. Robert Kreiger is a senior scientific advisor, Courage/Kenny Center/Allina Health, Minneapolis, Minnesota. Marjorie Funk is Helen Porter Jayne and Martha Prosser Jayne Professor Emerita of Nursing, Yale University School of Nursing, West Haven, Connecticut.

Background: Although electrocardiographic monitoring is common in hospitalized patients, many patients receive unnecessary monitoring, contributing to patients' inconvenience, clinicians' alarm fatigue, and delayed admissions.

Objective: To evaluate the impact of implementation of an electronic order set based on the American Heart Association practice standards for electrocardiographic monitoring on the occurrence of appropriate monitoring.

Methods: The sample for this preintervention-to-postintervention quasi-experimental study consisted of 297 adult patients on medical, surgical, neurological, oncological, and orthopedic patient care units that used remote electrocardiographic monitoring in a 627-bed hospital in Minneapolis, Minnesota. Read More

Am J Crit Care 2019 Mar;28(2):101-108

Elisa Mattioli and Bienvenido Tabuzo Jr are both a clinical nurse III and Liberty Reyes is a clinical nurse II in the cardiac intensive care unit, Yale New Haven Hospital, New Haven, Connecticut. Prasama Sangkachand is a service line educator, Heart and Vascular Center, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital. Marjorie Funk is the Helen Porter Jayne and Martha Prosser Jayne Professor Emerita of Nursing, Yale School of Nursing, West Haven, Connecticut.

Background: Early mobilization of patients in the intensive care unit can be beneficial, but evidence is insufficient to indicate whether allowing patients with an indwelling pulmonary artery catheter to walk is safe.

Objective: To describe the physiological and emotional responses to ambulation in patients with heart failure and a pulmonary artery catheter.

Methods: This prospective, descriptive study included 19 patients with heart failure monitored with a pulmonary artery catheter in a cardiac intensive care unit. Read More

Am J Crit Care 2019 Mar;28(2):100

Am J Crit Care 2019 Mar;28(2):98-99

Nashville, Tennessee.

Am J Crit Care 2019 Mar;28(2):97-98

Greenfield Park, Canada.

Am J Crit Care 2019 Mar;28(2):96-97

Nashville, Tennessee.

Am J Crit Care 2019 Mar;28(2):96

New York, New York.

Am J Crit Care 2019 Mar;28(2):93-95

Cindy L. Munro is coeditor in chief of the American Journal of Critical Care. She is dean and professor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida. Aluko A. Hope is coeditor in chief of the American Journal of Critical Care. He is an associate professor at Albert Einstein College of Medicine and an intensivist and assistant bioethics consultant at Montefiore Medical Center, both in New York City.

Am J Crit Care 2019 Jan;28(1):85-86

Salah S. Al-Zaiti is an assistant professor and Ziad Faramand is a postdoctoral associate at the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Teri M. Kozik is a nurse researcher at St Joseph's Medical Center, Stockton, California. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco, California. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Am J Crit Care 2019 Jan;28(1):81-84

Margaret Margretta is a nurse practitioner, Department of Transplant, Mayo Clinic, Jacksonville, Florida. Matthew Dennis is a certified neuroscience registered nurse, Department of Nursing, Mayo Clinic, Jacksonville. Diane C. McLaughlin is an acute care nurse practitioner, Department of Critical Care, Mayo Clinic, Jacksonville.

Background: Education opportunities for night shift nurses are limited compared with those for their day-shift counterparts. However, patients remain critically ill regardless of shift and require intensive nursing care at all hours. Overnight, this care is often provided with fewer resources. Read More

Am J Crit Care 2019 Jan;28(1):76-80

Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.

Acute respiratory distress syndrome is associated with long-term physical impairments. Although readmission is common, little is known about the impact of readmissions on the physical status of this population. The purpose of this study was to evaluate the association between hospital readmission, with or without an intensive care unit stay, and physical status in survivors of acute respiratory distress syndrome. Read More

Am J Crit Care 2019 Jan;28(1):64-75

Lisa-Mae S. Williams is operations director, telehealth and eICU, Baptist Health South Florida Telehealth Center, Coral Gables. Lynne S. Nemeth and Gayenell S. Magwood are professors and Emily Johnson is an assistant professor, College of Nursing, Medical University of South Carolina, Charleston. Donna Lee Armaignac is director of best practices, Baptist Health South Florida Telehealth Center, Coral Gables, Florida.

Background: Although telemedicine intensive care unit (tele-ICU) nurses are integral to the tele-ICU model of care, few studies have explored the influence of tele-ICU nursing interventions on preventing failure to rescue in critically ill patients.

Objective: To determine how tele-ICU nurses characterize their interventions to prevent failure to rescue.

Methods: This qualitative interpretive study recruited a purposive sample from 11 tele-ICU centers across the United States for structured open-ended interviews. Read More

Am J Crit Care 2019 Jan;28(1):56-63

Vinciya Pandian is an assistant professor in the Department of Acute and Chronic Care, Johns Hopkins School of Nursing, Baltimore, Maryland, and in the Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland. Mohit Datta is an assistant professor in the Department of Surgery, Palmetto Health USC, University of South Carolina, Columbia, South Carolina. Sajan Nakka is research assistant and Patricia M. Davidson is a dean and professor in the Department of Acute and Chronic Care, Johns Hopkins School of Nursing. Devi S. Tammineedi is a research assistant in the Department of Anesthesia and Critical Care Medicine, Johns Hopkins School of Medicine. Paul A. Nyquist is an associate professor in the departments of neurology, anesthesia/critical care medicine, neurosurgery, and general internal medicine, Johns Hopkins School of Medicine.

Background: Readmission for ventilator support in tracheostomy patients with primary brain injury is often attributed to failure of airway protection and aspiration pneumonia. Data regarding the incidence of intensive care unit readmissions and associated factors in these patients are limited.

Objectives: To determine the factors associated with intensive care unit readmission among tracheostomy patients with primary brain injury, as compared with tracheostomy patients without primary brain injury. Read More

Am J Crit Care 2019 Jan;28(1):48-55

Amanda J. Golino is a clinical nurse specialist, Catherine Christopher is director of physical medicine and rehabilitation, and Debra Stanger is the Magnet program director, Inova Loudoun Hospital, Leesburg, Virginia. Raymond Leone is director of medical music therapy, A Place to Be, Middleburg, Virginia. Audra Gollenberg is an associate professor of public health and Anthony Meadows is an associate professor of music therapy, Shenandoah University, Winchester, Virginia. Theresa M. Davis is clinical operations director of enVision eICU, INOVA Telemedicine, and Mary Ann Friesen is nursing research and evidence-based practice coordinator, Inova Health System, Falls Church, Virginia. Zhiwei Zhang is an associate professor and director of the Statistical Collaboratory, University of California, Riverside, California.

Background: Nonpharmacological interventions appear to benefit many patients and do not have the side effects commonly associated with medications. Music-based experiences may benefit critical care patients.

Objective: To examine the effect of an active music therapy intervention on physiological parameters and self-reported pain and anxiety levels of patients in the intensive care unit. Read More

Am J Crit Care 2019 Jan;28(1):47

Am J Crit Care 2019 Jan;28(1):41-46

Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania.

Background: Thirst is a common, intense symptom reported by hospitalized patients. No studies indicate frequency of use of ice water and lip moisturizer with menthol to ameliorate thirst and dry mouth. In an audit of 30 intensive care unit patients at a 580-bed community teaching hospital, 66% reported dry mouth with higher thirst distress and intensity scores than in published studies. Read More

Am J Crit Care 2019 Jan;28(1):30-40

Annette M. Bourgault is an assistant professor and Laura Gonzalez is an associate clinical professor and simulation coordinator at University of Central Florida College of Nursing, Orlando, Florida. Bourgault is also a nurse scientist at Orlando Health, Orlando, Florida. Lillian Aguirre is a clinical nurse specialist in trauma and critical care at Orlando Regional Medical Center, Orlando, Florida. Joseph A. Ibrahim is trauma medical director at Orlando Health.

Background: Blind insertion of feeding tubes remains unsafe. Electromagnetic placement devices such as the CORTRAK Enteral Access System allow operators to interpret placement of feeding tubes in real time. However, pneumothoraces have been reported and inadequate user expertise is a concern. Read More

Am J Crit Care 2019 Jan;28(1):19-27

Stephanie A. Esses is a lead pediatric nurse practitioner in the pediatric intensive care unit, St Louis Children's Hospital, St Louis, Missouri. Ashley Rodemann is a social worker. Sara Small is a social worker and Mary E. Hart-man is an assistant professor, Department of Pediatrics, Washington University in St Louis, St Louis, Missouri.

Background: Targeted education to help parents and caregivers recognize the signs and symptoms of post-intensive care syndrome may increase their awareness and willingness to seek support during their child's admission. The optimal strategy for this education has not been established.

Methods: A pilot study to test 3 educational strategies for caregivers of pediatric intensive care unit patients. Read More

Am J Crit Care 2019 Jan;28(1):10-18

Sophia Wang is an assistant professor of clinical psychiatry, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, Duane Allen is an internal medicine resident, Department of Medicine, Indiana University School of Medicine. Anthony Perkins is a biostatistician, Division of Biostatistics, Indiana University, Indianapolis, Indiana. Patrick Monahan is a professor, Department of Biostatistics, Indiana University School of Medicine, and a research scientist, Indiana University Center of Aging Research, Regenstrief Institute, Indianapolis, Indiana. Sikandar Khan is an assistant professor of medicine, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine. Sue Lasiter is an associate professor, University of Missouri-Kansas City School of Nursing and Health Studies, Kansas City, Missouri. Malaz Boustani is a professor of medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, and a research scientist, Indiana University Center of Aging Research, Regenstrief Institute. Babar Khan is an associate professor of medicine, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, and a research scientist, Indiana University Center of Aging Research, Regenstrief Institute.

Background: Post-intensive care syndrome is defined as the long-term cognitive, physical, and psychological impairments due to critical illness.

Objective: To validate the self-report version of the Healthy Aging Brain Care Monitor as a clinical tool for detecting post-intensive care syndrome.

Methods: A total of 142 patients who survived a stay in an intensive care unit completed the Healthy Aging Brain Care Monitor Self-report and standardized assessments of cognition, psychological symptoms, and physical functioning. Read More

Am J Crit Care 2019 Jan;28(1)

Am J Crit Care 2019 Jan;28(1)

Portland, Oregon.

Am J Crit Care 2019 Jan;28(1)

Brooklyn, New York.

Am J Crit Care 2019 Jan;28(1):5-7

Aluko A. Hope is coeditor in chief of the American Journal of Critical Care. He is an associate professor at Albert Einstein College of Medicine and an intensivist and assistant bioethics consultant at Montefiore Medical Center, both in New York City.

Am J Crit Care 2018 Nov;27(6):519-520

Ashlee Shields is a programmatic nurse specialist, Acute and Critical Cardiac Care, Children's Hospital of Pittsburgh of UPMC. Salah S. Al-Zaiti is an assistant professor at the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Teri M. Kozik is a nurse researcher at St Joseph's Medical Center, Stockton, California. Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco, California. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Am J Crit Care 2018 Nov;27(6):513-517

Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon. Catherine Crespo is the advanced cardiac life support director and simulation coordinator at the VA Portland Healthcare System.

Am J Crit Care 2018 Nov;27(6):508-512

Makayla Cordoza is a postdoctoral researcher at the Perelman School of Medicine, University of Pennsylvania, Philadelphia. Roger S. Ulrich is a professor of architecture at the Center for Healthcare Building Research, Chalmers University of Technology, Gothenburg, Sweden. Bette J. Manulik is the manager of Clinical Research, Legacy Research Institute, Portland, Oregon. Stuart K. Gardiner is an associate scientist at Devers Eye Institute Research Laboratories, Portland, Oregon. Paul S. Fitzpatrick is a research assistant, Legacy Research Institute. Teresia M. Hazen is a registered horticultural therapist and coordinator of therapeutic gardens, Legacy Health. Alar Mirka is the retired director of clinical research, Legacy Research Institute. R. Serene Perkins is the director of surgical and clinical research, Legacy Research Institute.

Background: Nurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood.

Objective: To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks. Read More

Am J Crit Care 2018 Nov;27(6):504-507

Cheng Minhua is a PhD candidate and Yu Wenkui is a professor at Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Gao Tao and Xi Fengchan are PhD candidates at Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University.

Background: Acute gastrointestinal injury is associated with significantly increased mortality in critically ill patients. However, markers for measuring acute gastrointestinal injury are neither sensitive nor specific.

Objective: To determine whether enzymes in digestive fluid are predictive of the severity of acute gastrointestinal injury. Read More

Am J Crit Care 2018 Nov;27(6):495-503

Evangelia Koutsioumpa is a physiotherapist, Athina Theochari is a nurse, and Dimitra Bagka and Efstratios Manoulakas are physicians, intensive care unit, University General Hospital of Larissa, Thessaly, Greece. Demosthenes Makris and Epaminondas Zakynthinos are professors, intensive care medicine, Stathis Stathakis is a physician, Anatomy Section, and Markos Sgantzos is a professor, anatomy and history of medicine, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.

Background: Critical illness polyneuropathy or myopathy is a severe disorder that may adversely affect patients in the intensive care unit, resulting in reduced mobilization, decline in muscle mass, and prolonged recovery periods.

Objective: To examine whether the application of trans-cutaneous electrical neuromuscular stimulation (TENMS) reduces the incidence or severity of myopathy related to critical illness in intensive care unit patients.

Methods: A total of 80 patients aged 18 years or older with an intensive care unit stay of 96 hours or more and receipt of mechanical ventilation for 96 hours or more were initially enrolled in a prospective, open-label randomized controlled trial in a university hospital. Read More

Am J Crit Care 2018 Nov;27(6):486-494

Dianne F. McKinley is a clinical nurse, Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia. Sharon B. Kinney is a nurse consultant, Department of Nursing Research, Royal Children's Hospital; and a senior lecturer, Departments of Nursing and Pediatrics, The University of Melbourne, Victoria. Beverley Copnell is an associate professor, School of Nursing and Midwifery, La Trobe University, Victoria. Frank Shann is a medical doctor, Intensive Care Unit, Royal Children's Hospital.

Background: Saline instillation is still used to assist in removal of secretions from endotracheal tubes in some pediatric intensive care units.

Objective: To compare the effect of using either no saline, quarter-normal (0.225%) saline, or normal (0. Read More

Am J Crit Care 2018 Nov;27(6):477-485

Jared A. Greenberg is an assistant professor and Robert A. Balk is a professor, Division of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, Illinois. Raj C. Shah is an associate professor, Center for Community Health Equity, Department of Family Medicine, and the Rush Alzheimer's Disease Center, Rush University Medical Center.

Background: Factors affecting the timing of ventilator liberation among patients requiring prolonged mechanical ventilation (≥21 consecutive days) are poorly understood. After tracheostomy placement, ventilator liberation typically involves daily reductions in ventilator support as patients regain the capacity to breathe independently.

Objectives: To determine the association between ventilator requirements on the day after tracheostomy placement and subsequent weaning duration. Read More

Am J Crit Care 2018 Nov;27(6):471-476

Jenny Alderden is an assistant professor, School of Nursing, Boise State University, Boise, Idaho, and an adjunct assistant professor, College of Nursing, University of Utah, Salt Lake City, Utah. Yunchuan (Lucy) Zhao is an assistant professor, School of Nursing, Boise State University. Yingying Zhang and Yue Zhang are biostatisticians, Study Design and Biostatistics Center, Center for Clinical and Translational Science, University of Utah. Donna Thomas is director of wound nursing, University of Utah Hospital, Salt Lake City, Utah. Ryan Butcher is a senior data architect, Biomedical Informatics Team, Center for Clinical and Translational Science, University of Utah. Mollie Rebecca Cummins is a professor, College of Nursing, University of Utah.

Background: Approximately half of hospital-acquired pressure injuries identified among critical care patients are stage 1. Although stage 1 injuries are common, outcomes associated with them among critical care patients have not been examined.

Objectives: To examine the outcomes of stage 1 pressure injuries among critical care patients and to identify factors associated with worsening of pressure injuries. Read More

Am J Crit Care 2018 Nov;27(6):461-468

Jenny Alderden is an assistant professor, School of Nursing, Boise State University, Boise, Idaho, and an adjunct assistant professor, College of Nursing, University of Utah, Salt Lake City, Utah. Ginette Alyce Pepper is a professor, and Andrew Wilson is a clinical assistant professor, College of Nursing, University of Utah. Joanne D. Whitney is a professor, College of Nursing, University of Washington, Seattle, Washington. Stephanie Richardson is a professor, Rocky Mountain University of the Health Professions, Provo, Utah. Ryan Butcher is a senior data architect, Biomedical Informatics Team, Center for Clinical and Translational Science, University of Utah. Yeonjung Jo is a doctoral (PhD) student in population health science, College of Nursing, University of Utah. Mollie Rebecca Cummins is a professor, College of Nursing, University of Utah.

Background: Hospital-acquired pressure injuries are a serious problem among critical care patients. Some can be prevented by using measures such as specialty beds, which are not feasible for every patient because of costs. However, decisions about which patient would benefit most from a specialty bed are difficult because results of existing tools to determine risk for pressure injury indicate that most critical care patients are at high risk. Read More

Am J Crit Care 2018 Nov;27(6):454-460

William P. Tidwell is a clinical pharmacist, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Tonya L. Thomas is a clinical pharmacist, Department of Pharmacy, Saint Thomas West Hospital, Nashville, Tennessee. Angus J. Webber is a hospitalist, Saint Thomas West Hospital, Nashville. Jonathon D. Pouliot is an assistant professor, College of Pharmacy and Health Sciences, Lipscomb University, Nashville, Tennessee, and a clinical pharmacist, Department of Pharmacy, Saint Thomas West Hospital, Nashville. Angelo E. Canonico is an associate professor, College of Medicine, University of Tennessee Health Sciences Center, Nashville, and a pulmonologist intensivist, Saint Thomas Medical Group, Nashville.

Background: Benzodiazepine-based therapy for alcohol withdrawal is associated with agitation and respiratory depression. Treatment can be complicated by a need for adjunctive therapy to control these symptoms and in patients requiring mechanical ventilation. Strong evidence for the effectiveness of alternative treatment modalities is lacking, despite the availability of promising pharmacological agents such as phenobarbital. Read More

Am J Crit Care 2018 Nov;27(6):445-453

Anna E. Buehler is a medical student, University of California San Diego School of Medicine, San Diego, California, and a research assistant, Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Isabella V. Ciuffetelli is a medical student, McGovern Medical School, University of Texas, Houston, Texas. Aaron M. Delman is a general surgery resident, University of Cincinnati School of Medicine, Cincinnati, Ohio. Saida A. Kent is a medical student, University of Kentucky College of Medicine, Lexington, Kentucky. Dominique F. Bayard is an attending physician, Pulmonary and Critical Care of Atlanta, Atlanta, Georgia. Elizabeth Cooney is director of research operations, PAIR Center, University of Pennsylvania. Scott D. Halpern is director, PAIR Center; senior fellow, Leonard Davis Institute of Health Economics; professor, Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine; attending physician, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine; and professor, Department of Medical Ethics and Health Policy, University of Pennsylvania. Michael E. Detsky is affiliated faculty, PAIR Center; attending physician, Sinai Health System, Toronto, Ontario, Canada; and an assistant professor of medicine, University of Toronto, Toronto, Ontario, Canada.

Background: Information about a critically ill patient's prognosis is important to the shared decision-making process. The factors that physicians and nurses consider when generating their prognoses are not well understood.

Objective: To explore the factors that intensive care unit clinicians consider when prognosticating for their patients. Read More

Am J Crit Care 2018 Nov;27(6):444

Am J Crit Care 2018 Nov;27(6):443

Durham, North Carolina.

Am J Crit Care 2018 Nov;27(6):442-443

Englewood, New Jersey.

Am J Crit Care 2018 Nov;27(6):438-440

Richard H. Savel is coeditor in chief of the American Journal of Critical Care. He is director, Adult Critical Care Services, Maimonides Medical Center and professor of clinical medicine and neurology, SUNY Down state College of Medicine, both in New York City. Cindy L. Munro is coeditor in chief of the American Journal of Critical Care. She is dean and professor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida.

Am J Crit Care 2018 Sep;27(5):429-430

Teri M. Kozik is a nurse researcher at St Joseph's Medical Center, Stockton, California. Jacquie M. DeMellow is a PhD candidate at Betty Irene Moore School of Nursing, University of California, Davis. Salah S. Al-Zaiti is an assistant professor at the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York. Michele M. Pelter is an assistant professor at the Department of Physiological Nursing, University of California, San Francisco, California.

Am J Crit Care 2018 Sep;27(5):418-427

Christa Schorr is a clinical nurse scientist, Cooper Research Institute, Cooper University Hospital, and an associate professor of medicine, Cooper Medical School of Rowan University, Camden, New Jersey. Krystal Hunter is a statistician II, Cooper Research Institute, Cooper University Hospital, and an assistant professor of medicine, Cooper Medical School of Rowan University. Patti Rager Zuzelo is a clinical professor of nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania.

Background: Quality improvement efforts in sepsis management have increased patients' survival rates. Many sepsis survivors experience sequelae leading to unplanned hospital readmissions and subsequent mortality, especially when survivors delay seeking medical attention because they do not recognize the signs and symptoms of recurrent sepsis. Thus, increasing knowledge of sepsis among patients and caregivers before initial hospital discharge is essential. Read More

Am J Crit Care 2018 Sep;27(5):410-416

Nhu N. Tran is a clinical research nurse III, Department of Cardiothoracic Surgery, Children's Hospital Los Angeles, Los Angeles, California. Ram Kumar is an assistant professor of surgery, Keck School of Medicine, University of Southern California, Los Angeles, California. Felicia S. Hodge is a professor and Paul M. Macey is an associate professor, School of Nursing, University of California, Los Angeles.

Background: Congenital heart disease (CHD) is a leading birth defect in the United States, affecting about 40 000 neonates each year. Despite efforts to prevent developmental delays, many children with CHD have neurological deficits that last into adulthood, influencing employability, self-care, and quality of life.

Objective: To determine if neonates with CHD have impaired cerebral autoregulation and poorer neurodevelopmental outcomes compared with healthy controls. Read More

Am J Crit Care 2018 Sep;27(5):398-406

All authors are affiliated with the University of Alabama at Birmingham (UAB), Birmingham, Alabama. R. Scott Kopf is a nurse practitioner for pulmonary and critical care, UAB Hospital. Penni I. Watts is an assistant professor and director of clinical simulation, UAB School of Nursing. Eileen S. Meyer is a nurse practitioner and assistant director of advanced practice providers, UAB Hospital. Jacqueline A. Moss is a professor and associate dean for technology and innovation, UAB School of Nursing.

Background: Nearly one-third of new-graduate nurse practitioners report undergoing no formal orientation process, and postcertification orientation processes vary. A validated curriculum would address the need for structured training to enhance new graduates' practice transition.

Methods: A competency-based practice transition curriculum for intensive care unit nurse practitioners was created using a literature review and expert panels. Read More