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Am J Crit Care 2020 Jul;29(4):320-324

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

Am J Crit Care 2020 Jul;29(4):283-284

About the Author: Grant A. Pignatiello is a National Institutes of Health Clinical Research KL2 Scholar and an instructor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.

Am J Crit Care 2020 Jul;29(4):250

Am J Crit Care 2020 Jul;29(4):325-326

Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Am J Crit Care 2020 Jul;29(4):311-317

Babar Khan is an associate professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine; and a research scientist, Indiana University Center for Aging Research, Regenstrief Institute.

Background: Critical care patients with delirium are at an increased risk of functional decline and mortality long term.

Objective: To determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge.

Methods: A secondary data analysis of the Pharmacological Management of Delirium and Deprescribe randomized controlled trials. Read More

Am J Crit Care 2020 Jul;29(4):262-269

Matthew Bacchetta is an attending physician in the Department of Thoracic Surgery and co-director of the ECMO program at Vanderbilt University Medical Center.

Background: Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses.

Objectives: To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions.

Methods: An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Read More

Am J Crit Care 2020 Jul;29(4):e70-e80

María José Cabañero-Martínez is an associate professor, Nursing Department, University of Alicante, Spain.

Background: Pressure injuries are an important problem in hospital care. Detecting the population at risk for pressure injuries is the first step in any preventive strategy. Available tools such as the Norton and Braden scales do not take into account all of the relevant risk factors. Read More

Am J Crit Care 2020 Jul;29(4):271-282

Douglas White is director, Program in Ethics and Decision Making in Critical Illness, and vice chair, professor, and Endowed Chair for Ethics, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Background: Communication in the pediatric intensive care unit (PICU) between families and the health care team affects the family experience, caregiver psychological morbidity, and patient outcomes.

Objective: To test the feasibility of studying and implementing a PICU communication intervention called PICU Supports, and to assess families' and health care teams' perceptions of the intervention.

Methods: This study involved patients requiring more than 24 hours of PICU care. Read More

Am J Crit Care 2020 Jul;29(4):e81-e91

About the Authors: Renea L. Beckstrand and Karlen E. Luthy are professors and Janelle L. B. Macintosh is an associate professor at Brigham Young University College of Nursing, Provo, Utah.

Background: Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined.

Objective: To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Read More

Am J Crit Care 2020 Jul;29(4):292-300

About the Authors: Catherine Ford and Donna McCormick are clinical nurses; Katrien Derycke-Chapman, Judith Marshall, Jessica Mancarella, and Anne Chepulis are former clinical nurses in the cardiothoracic intensive care unit, Heart and Vascular Center, Yale New Haven Hospital, New Haven, Connecticut.

Background: Patients fast after cardiothoracic surgery because of concerns for nausea, vomiting, dysphagia, and aspiration pneumonia; fasting, however, causes thirst, a distressing symptom. To our knowledge, no studies exist to guide hydration practices in this population.

Objective: To determine the effect of early oral hydration on adverse events and thirst in patients after cardiothoracic surgery. Read More

Am J Crit Care 2020 Jul;29(4):301-310

Jan O. Friedrich is an intensivist in the Critical Care Department at St Michael's Hospital, a scientist at Li Ka Shing Knowledge Institute, and associate professor in the Interdepartmental Division of Critical Care, University of Toronto.

Background: Most intensive care patients require substitute decision makers (SDMs) to make decisions. The SDMs may prefer an active, shared, or passive decision-making role. Role incongruence is when preferred and actual roles differ. Read More

Am J Crit Care 2020 Jul;29(4):253-261

About the Author: Karen K. Giuliano is an associate professor, College of Nursing and Institute for Applied Life Sciences, University of Massachusetts, Amherst and a consulting nurse scientist, Center for Nursing Research and Advanced Practice, Orlando Health, Orlando, Florida.

In this presentation, I will share my unconventional journey, starting from my first job as a critical care staff nurse to my current role as tenure-track faculty at the University of Massachusetts Amherst, where I hold a joint position with the Institute for Applied Life Sciences and the College of Nursing. Throughout this journey, I have had many opportunities to participate in interdisciplinary clinical outcomes research and medical product development as a staff nurse, clinical nurse specialist, and project lead from the clinical, industry, and academic perspectives. While passionate about my central clinical research interests in technology innovation and its responsible use in critical and acute care, the foundation of my approach is dedicated to the values and lessons of my earliest experiences in critical care bedside nursing: supporting and preserving the dignity and humanity of person-centered patient care. Read More

Am J Crit Care 2020 Jul;29(4):285-291

Meredith MacKenzie Greenle is an assistant professor of nursing, M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania.

Background: Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units.

Objectives: To examine the relationship between exposure to the death or near death of a pediatric patient and compassion fatigue, specifically the outcomes of compassion satisfaction, burnout, and secondary traumatic stress. Read More

Am J Crit Care 2020 07;29(4):e92-e93

Alberto Lucchini is a nurse coordinator in the general intensive care unit, Ospedale San Gerardo, Monza, Italy.

Am J Crit Care 2020 Jul;29(4):318-319

Carolyn M. Reilly is an associate professor, Nell Hodgson Woodruff School of Nursing, Emory University.

Am J Crit Care 2020 Jul;29(4):246-248

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 2020 May;29(3):192-193

Grant A. Pignatiello is a National Institutes of Health Clinical Research KL2 Scholar and an instructor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.

Am J Crit Care 2020 May;29(3):194

Am J Crit Care 2020 May;29(3):168-169

Montreal, Canada.

Am J Crit Care 2020 May;29(3):168

Ankara, Turkey.

Am J Crit Care 2020 May;29(3):170

Am J Crit Care 2020 May;29(3):165-167

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 2020 May;29(3):e60-e69

Am J Crit Care 2020 May;29(3):237-238

Salah S. Al-Zaiti is an assistant professor and Ziad Faramand is a postdoctoral associate in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania. Teri M. Kozik is director of clinical research-academic affairs 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. Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Am J Crit Care 2020 May;29(3):226-232

Carmen Mabel Arroyo-Novoa and Milagros I. Figueroa-Ramos are professors at the University of Puerto Rico, Medical Sciences Campus, School of Nursing, San Juan, Puerto Rico. Kathleen A. Puntillo is a professor emeritus at the University of California, San Francisco, School of Nursing, San Francisco, California. Céline Gélinas is an associate professor in the Faculty of Medicine, Ingram School of Nursing, McGill University, and a nurse researcher at the Centre for Nursing Research and Lady Davis Institute, CIUSSS West-Central-Montreal, Jewish General Hospital, Montreal, Canada.

Background: The Critical-Care Pain Observation Tool (CPOT) is recommended for evaluating pain behaviors in patients in the intensive care unit who are unable to report pain. The source of the only published Spanish version of the CPOT does not verify that it underwent a formal translation process.

Objective: To describe the translation into Spanish and cultural adaptation of the original French version of the CPOT. Read More

Am J Crit Care 2020 May;29(3):233-236

Kandi M. Wise, J. Lynn Zinkan, and Carrie Norwood are educators and Stacy Gaither is director of research and simulation education for the Pediatric Simulation Center at Children's of Alabama (Department of Pediatrics, University of Alabama at Birmingham), Birmingham, Alabama. Chrystal Rutledge is co-medical director of the Pediatric Simulation Center at Children's of Alabama and an assistant professor of pediatrics at the University of Alabama at Birmingham. Nancy M. Tofil is medical director of the Pediatric Simulation Center at Children's of Alabama and professor of pediatrics, University of Alabama at Birmingham.

Background: Delayed or inadequate cardiopulmonary resuscitation during cardiopulmonary arrest is associated with adverse resuscitation outcomes in pediatric patients. Therefore, a "First Five Minutes" program was developed to train all inpatient acute care nurses in resuscitation skills. The program focused on steps to take during the first 5 minutes. Read More

Am J Crit Care 2020 May;29(3):221-225

Kerry A. Milner is an associate professor of nursing, Susan Goncalves is an assistant professor of nursing, and Suzanne Marmo is an assistant professor of social work at Sacred Heart University, Fairfield, Connecticut. Sheri Cosme is the director of accreditation, practice transition accreditation, and nursing skills competency programs at the American Nurses Credentialing Center, Silver Spring, Maryland.

Background: Evidence indicates that open visitation in adult intensive care units is a best practice for patient- and family-centered care, and nurses substantially influence such visitation patterns. However, it is unclear whether intensive care units in Magnet and Pathway to Excellence (MPE) facilities nationwide implement this in practice.

Objective: To describe current national visitation practices in adult intensive care units and determine whether they have changed since the last national study, which used data from 2008 to 2009. Read More

Am J Crit Care 2020 May;29(3):e52-e59

Armeen D. Poor is an assistant professor in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, NYC Health+Hospitals/Metropolitan, New York Medical College, New York, New York. Samuel O. Acquah is a professor and S Jean Hsieh is an associate professor in the Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Celia M. Wells is senior director, Department of Nursing; Maria V. Sevillano is a registered nurse in the Department of Wound, Ostomy and Continence Nursing; and Gary G. Oldenburg is director, Department of Respiratory Care Services, Mount Sinai Hospital, New York, New York. Christopher G. Strother is an associate professor in the Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai.

Background: Prone position ventilation (PPV) is recommended for patients with severe acute respiratory distress syndrome, but it remains underused. Interprofessional simulation-based training for PPV has not been described.

Objectives: To evaluate the impact of a novel interprofessional simulation-based training program on providers' perception of and comfort with PPV and the program's ability to help identify unrecognized safety issues ("latent safety threats") before implementation. Read More

Am J Crit Care 2020 May;29(3):214-220

Jane Venis was a staff nurse in the intensive care unit at St Paul's Hospital, Vancouver, and is now a nursing faculty instructor at British Columbia Institute of Technology, Burnaby, British Columbia, Canada. Peter Dodek is a professor at the Centre for Health Evaluation and Outcome Sciences and Division of Critical Care, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.

Background: Identifying critically ill patients who have unmet needs for palliative care is the first step in integrating the palliative approach for patients and their families into intensive care units.

Objective: To explore how palliative care is addressed in an intensive care unit and to develop and test a screening tool for unmet needs that may be met through the palliative approach.

Methods: A mixed-methods study was conducted in the intensive care unit of a tertiary care hospital to explore the palliative approach. Read More

Am J Crit Care 2020 May;29(3):e44-e51

Maria L. Espinosa is a medical student at the University of Chicago Pritzker School of Medicine, Chicago, Illinois. Aaron M. Tannenbaum is a fellow at the Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; a resident in the Department of Medicine, University of Chicago; and a clinical ethics fellow at the MacLean Center for Clinical Medical Ethics, University of Chicago. Megha Kilaru is a research associate at the Center for Healthcare Delivery Science and Innovation, University of Chicago Medicine. Jennifer Stevens is a physician and director of the Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Mark Siegler is a physician in the Department of Medicine, University of Chicago, and founding director of the MacLean Center for Clinical Medical Ethics. Michael D. Howell is founder of the Center for Healthcare Delivery Science and Innovation, University of Chicago Medicine; a physician in the Department of Medicine, University of Chicago; and a principal scientist at Google AI, Google, LLC, Mountain View, California. William F. Parker is a physician in the Department of Medicine, University of Chicago, and a clinical ethics fellow at the MacLean Center for Clinical Medical Ethics.

Background: Bundled consent, the practice of obtaining anticipatory consent for a predefined set of intensive care unit procedures, increases the rate of informed consent conversations and incorporation of patients' wishes into medical decision-making without sacrificing patients' or surrogates' understanding. However, the adoption rate for this practice in academic and nonacademic centers in the United States is unknown.

Objective: To determine the national prevalence of use of bundled consent in adult intensive care units and opinions related to bundled consent. Read More

Am J Crit Care 2020 May;29(3):204-213

Jill Cox is an associate clinical professor at Rutgers University School of Nursing, Newark, New Jersey, and an advanced practice nurse and certified wound, ostomy, and continence nurse at Englewood Health, Englewood, New Jersey. Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Barnes-Jewish Hospital, St Louis, Missouri. Christy Jung is a research analyst in the Office of Institutional Research and Assessment, Rutgers University School of Nursing.

Background: Critically ill patients have a variety of unique risk factors for pressure injury. Identification of these risk factors is essential to prevent pressure injury in this population.

Objective: To identify factors predicting the development of pressure injury in critical care patients using a large data set from the PhysioNet MIMIC-III (Medical Information Mart for Intensive Care) clinical database. Read More

Am J Crit Care 2020 May;29(3):182-191

Jennifer Browne is an assistant professor at the University of the Incarnate Word Ila Faye Miller School of Nursing, San Antonio, Texas. Carrie Jo Braden is a professor at University of Texas Health San Antonio School of Nursing.

Background: Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood.

Objectives: The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. Read More

Am J Crit Care 2020 May;29(3):195-203

Priti P. Desai and Andrew S. Brimhall are associate professors, East Carolina University, Greenville, North Carolina. Samantha L. Flick is a certified child life specialist, Cardiac Center, Children's Hospital of Philadelphia, Pennsylvania. Susanne Knutsson is an associate professor, Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.

Background: Provision of developmentally appropriate support for child visitors in adult intensive care units (ICUs) would benefit patients and young visitors. Research on best practices for child visitation in adult ICUs is limited.

Objectives: To explore the perceptions and practices of nurses working in adult ICUs in the United States regarding child visitation and the role of child life specialists in this setting. Read More

Am J Crit Care 2020 May;29(3):174-181

Laura C. Myers was a fellow in the Division of Pulmonary/Critical Care Medicine and at the Edward P. Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts. Lisa Heard is a consultant at the Controlled Risk Insurance Company, Risk Management Foundation, and associate dean and an associate professor at the Massachusetts College of Pharmacy and Health Sciences School of Nursing, Boston, Massachusetts. Elizabeth Mort is chief quality officer, senior vice president for quality and safety, and a member of the internal medicine division at Massachusetts General Hospital.

Background: Medical malpractice data can be used to improve patient safety.

Objective: To describe the types of harm events involving nurses that lead to malpractice claims and to compare claims among intensive care units (ICUs), emergency departments, and operating rooms.

Methods: Malpractice claims closed between 2007 and 2016 were extracted from a national database. Read More

Am J Crit Care 2020 Jul;29(4):270

Am J Crit Care 2020 03;29(2):130-131

Grant A. Pignatiello is a National Institutes of Health Clinical Research KL2 Scholar and an instructor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleve-land, Ohio.

Am J Crit Care 2020 03;29(2):150-154

Rochelle Flayter is senior director, Trauma Services, Southern Colorado Region, UCHealth Memorial Hospital.

Am J Crit Care 2020 03;29(2):103

Am J Crit Care 2020 03;29(2):87-88

St Louis, Missouri.

Am J Crit Care 2020 03;29(2):88

Mobile, Alabama.

Am J Crit Care 2020 Mar;29(2):89

Am J Crit Care 2020 03;29(2):84-86

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 2020 03;29(2):155-156

Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.

Am J Crit Care 2020 03;29(2):e39-e43

Babar A. Khan is an associate professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, and IU Center for Aging Research, Regenstrief Institute, Indianapolis, Indiana.

Background: The effect of delirium on physical function in patients undergoing noncardiac thoracic surgery has not been well described and may differ from that in other surgical populations.

Objective: To determine the effects of delirium on muscle strength and functional independence. The primary end point was change in Medical Research Council sum score (MRC-SS) by delirium status. Read More

Am J Crit Care 2020 03;29(2):140-144

Sandra L. Kane-Gill is a professor of pharmacy, critical care medicine, and clinical translational sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.

Background: Patient-reported outcomes are essential to understand the relationship between patients' perception of sedation and clinicians' assessments of sedation.

Objectives: To evaluate the association between sedation and agitation indexes and patient-reported outcomes of sedation and analgesia.

Methods: This prospective, single-center, observational study included adult patients who were continuously sedated for at least 24 hours in a medical or surgical/ trauma intensive care unit. Read More

Am J Crit Care 2020 03;29(2):145-149

Joseph M. Price is a principal consultant at JPriceAnalytics LLC, Brentwood, Tennessee.

Background: Professional quality of life is the quality a person feels in relation to work. For critical care nurses, it is composed of compassion satisfaction and compassion fatigue. Professional quality of life is affected by work environment. Read More

Am J Crit Care 2020 03;29(2):122-129

Peter M. Dodek is a scientist at the Centre for Health Evaluation and Outcome Sciences and a physician at the Division of Critical Care Medicine, University of British Columbia.

Background: Pain, agitation, and delirium are associated with negative outcomes in critically ill patients. Reducing variation in pain, agitation, and delirium management among institutions could improve care.

Objectives: To define opportunities to improve pain, agitation, and delirium management in intensive care units in British Columbia, Canada. Read More

Am J Crit Care 2020 03;29(2):e19-e30

Lawrence J. Fabrey was the chief psychometrician at the time of the study, Certification, PSI Services, Glendale, California.

Background: Standards for advanced practice registered nurse (APRN) licensure in the United States require certification programs to analyze practice in order to document the knowledge and skills necessary for entry-level adult-gerontology acute care nurse practitioners (AGACNPs) and wellness-through-acute-care clinical nurse specialists (AGCNSs). The practice analysis done every 5 years by the AACN Certification Corporation provides research data for use in establishing test plans for certification of APRNs.

Objectives: To describe the development of a survey to collect information on the current practice of AGACNPs and AGCNSs, and to compare the results from practitioners in the 2 roles. Read More

Am J Crit Care 2020 03;29(2):e31-e38

Babar A. Khan is an associate professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, and a scientist, Center for Aging Research, Indiana University.

Background: Management of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention.

Objectives: To determine the feasibility and acceptability of personalized music (PM), slow-tempo music (STM), and attention control (AC) in patients receiving mechanical ventilation in an intensive care unit, and to estimate the effect of music on delirium. Read More

Am J Crit Care 2020 03;29(2):132-139

Robert B. Banzett is an associate professor, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.

Background: Dyspnea (breathing discomfort) is commonly experienced by critically ill patients and at this time is not routinely assessed and documented. Intensive care unit nurses at the study institution recently instituted routine assessment and documentation of dyspnea in all patients able to report using a numeric scale ranging from 0 to 10.

Objective: To assess nurses' perceptions of the utility of routine dyspnea measurement, patients' comprehension of assessment questions, and the impact on nursing practice and to gather nurses' suggestions for improvement. Read More