1,229 results match your criteria Critical Care Nursing Quarterly [Journal]


Physician Engagement: A Key Concept in the Journey for Quality Improvement.

Crit Care Nurs Q 2019 Apr/Jun;42(2):215-219

Allegheny General Hospital, Pittsburgh, Pennsylvania.

In the 2001 Institute of Medicine report on patient outcomes in the United States, one of the key concepts was the importance of collaboration within the health care team by using quality improvement methodologies as a foundation and using data to drive change and improve patient outcomes and ultimately the health of the nation. Ensuring that all health care providers have a voice at the table on key initiatives has been a challenge to implement, especially when attempting to involve frontline staff including physicians and nurses. In regard to the particular organization to be discussed, it was important to have an understanding of what issues resonated with physicians and the health care team as a whole in order to successfully integrate their expertise into committee work and practice changes that were priorities for the organization. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201904000-0001
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000258DOI Listing
March 2019
20 Reads

Effect of Prehospital Blood Draws on Length of Stay for Chest Pain Patients in the Emergency Department: A Pilot Study.

Crit Care Nurs Q 2019 Apr/Jun;42(2):208-214

Sciamanda Total Health and Wellness, Erie, Pennsylvania (Dr DuCharme); Robert Morris University, Moon Township, Pennsylvania (Ms Macci Bires); and Emergency Department, Saint Vincent Hospital, Erie, Pennsylvania (Drs Montanye, Khan, DuCharme, and Carlson and Mr Linse).

This article provides research of cardiac biomarkers being drawn in the prehospital setting compared with the emergency department (ED) on intervals critical to the diagnosis of acute myocardial infarction. This is a retrospective chart review of patients brought to the ED of a single, urban teaching hospital by a single emergency medical service (EMS) agency with a chief complaint of "chest pain." We abstracted specific patient characteristics, intervals, positive troponin values, and rates of hemolysis from hospital records utilizing a custom data abstraction tool designed for this study through consensus of the authors. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000257DOI Listing

Educating Parents About Vitamin K in the Newborn Using Knowles' Theory of Adult Learning Principles as a Framework.

Crit Care Nurs Q 2019 Apr/Jun;42(2):205-207

Department of Nursing, University of North Carolina at Pembroke.

Parents must make an educated decision regarding vitamin K administration for their infant prior to birth. With an abundance of information available regarding this topic, the nurse needs to guide the parents through this process. Using Knowles' Theory of Adult Learning Principles as a framework can increase the parents' knowledge and assist the nurse in providing thorough information. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000256DOI Listing
March 2019
1 Read

Neonatal Blood Loss Risks.

Authors:
Lisa Fikac

Crit Care Nurs Q 2019 Apr/Jun;42(2):202-204

Neonatal Intensive Care Unit, Cape Fear Valley Health, Fayetteville, North Carolina.

There are many common risks for blood loss in the newborn infant. Blood loss can occur prenatally, intrapartally, and during the neonatal period. This article looks at the most common risks to be aware of in the newborn infant. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000255DOI Listing

Knowledge Deficit of Sickle Cell Trait Status: Can Nurses Help?

Authors:
Afua O Arhin

Crit Care Nurs Q 2019 Apr/Jun;42(2):198-201

School of Nursing, Fayetteville State University, Fayetteville, North Carolina.

Sickle cell disease and sickle cell trait are identified through universal newborn screening, which has been implemented in all hospitals across the United States since the 1970s. Yet, studies report that only 16% of Americans with sickle cell trait know their status. Despite these striking statistics, there appears to be no standardized methods for reporting positive sickle cell trait results of newborn screening to doctors or families of affected persons. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000254DOI Listing
March 2019
1 Read

Porphyria: A Rare, Complicated, and Misdiagnosed Disease.

Authors:
Kerstin Hudgins

Crit Care Nurs Q 2019 Apr/Jun;42(2):192-197

School of Nursing, Fayetteville State University, Fayetteville, North Carolina.

Diagnosis of porphyria is often difficult due to the range of symptoms, which are common in many other disorders, hence frequently leading to misdiagnosis. Attacks can be triggered through sunlight and contact with diverse substances, including medications. Signs are severe, appear quickly, and tend to last from days to weeks, affecting the skin, mentation, the digestive, cardiovascular, nervous, and muscular system. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000253DOI Listing

Blood Conservation: Exploring Alternatives to Blood Transfusions.

Crit Care Nurs Q 2019 Apr/Jun;42(2):187-191

School of Nursing, Fayetteville State University, Fayetteville, North Carolina (Ms Hudgins). Ms Carter is a telephone triage nurse at Cape Fear Valley Medical Center, Fayetteville, North Carolina.

The conservation of blood products and the use of alternatives to blood transfusion are the best practice. Patients treated with blood conservation techniques will have a reduced risk of blood-borne diseases and a reduced risk of human error that can occur during blood processing. The bedside nurse plays a vital role in educating the patient and the caregiver regarding risks, benefits, and alternatives. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000252DOI Listing
March 2019
2 Reads

Implementation of a Blood Conservation Initiative to Effectively Reduce Blood Transfusions in Cardiac Surgery Patients.

Authors:
Jeanne Lythgoe

Crit Care Nurs Q 2019 Apr/Jun;42(2):177-186

Frontier Nursing University, Hyden, Kentucky.

Perioperative and postoperative blood transfusions in cardiac surgery patients are associated with as much as a 16% increased risk of mortality and a significantly increased risk in morbid outcomes. At the project site, red blood cell transfusions in cardiac surgery patients undergoing isolated coronary artery bypass graft were above national benchmarks. The aim of the project was to reduce blood transfusions in cardiac surgery patients by 10% over 8 weeks. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000251DOI Listing

Blood Transfusion: Cost, Quality, and Other Considerations for the Surgical Management of the Critically Ill.

Crit Care Nurs Q 2019 Apr/Jun;42(2):173-176

Cape Fear Valley Hospital, Heart & Vascular Center, Fayetteville, North Carolina.

This article explores the average overall costs of blood transfusion for critically ill surgical patients and in particular explores the evidence supporting reduction of transfusion as part of guideline-based care in cardiothoracic surgical patients. Average cost data compiled from various sources are presented and quality and outcome considerations in blood transfusion in the critically ill are reviewed. Multiple strategies that have a high level of evidence to support their use in this population are noted. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000250DOI Listing

Hemorrhage Control: Lessons Learned From the Battlefield Use of Hemostatic Agents That Can Be Applied in a Hospital Setting.

Authors:
Herman A Allison

Crit Care Nurs Q 2019 Apr/Jun;42(2):165-172

SR-AHEC Family Practice Clinic, Fayetteville, North Carolina.

Uncontrolled blood loss is a major cause of preventable death worldwide. A severe injury can occur anywhere at any time. Controlling blood loss is an important issue for patient care in the hospital setting. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000249DOI Listing
March 2019
2 Reads

Management of Chronic Hypertension Following Intracerebral Hemorrhage.

Crit Care Nurs Q 2019 Apr/Jun;42(2):148-164

Department of Clinical Pharmacy and Translational Science, University of Tennessee College of Pharmacy, Memphis (Dr Van Matre); Pharmacy Services, University of Kentucky HealthCare, Lexington (Dr Cook); Department of Pharmacy, Methodist University Hospital, Memphis, Tennessee (Dr Shah); and Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus (Drs Rydz and Smetana).

Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000248DOI Listing

Acute Management of Hypertension Following Intracerebral Hemorrhage.

Crit Care Nurs Q 2019 Apr/Jun;42(2):129-147

Department of Pharmacy, Methodist University Hospital, Memphis, Tennessee (Drs Haller and Jones); Department of Pharmacy, The Ohio State University Wexner Medical Center; Columbus (Drs Wiss, May, and Smetana); and Department of Clinical Pharmacy, Neurology and Neurosurgery, University of Tennessee Health Sciences Center, Memphis (Dr Jones).

Intracerebral hemorrhage (ICH) is responsible for approximately 15% of strokes annually in the United States, with nearly 1 in 3 of these patients dying without ever leaving the hospital. Because this disproportionate mortality risk has been stagnant for nearly 3 decades, a main area of research has been focused on the optimal strategies to reduce mortality and improve functional outcomes. The acute hypertensive response following ICH has been shown to facilitate ICH expansion and is a strong predictor of mortality. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000247DOI Listing

Foreword.

Authors:
Kerstin Hudgins

Crit Care Nurs Q 2019 Apr/Jun;42(2):127-128

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000259DOI Listing
February 2019

Prevention of Pressure Injury by Using Silicone Foam Dressings: Experience at a University Hospital in Hong Kong.

Crit Care Nurs Q 2019 Jan/Mar;42(1):117-126

Departments of Surgery (Ms Lee), Adult Intensive Care Unit (Messrs Lai and Chan), Neurosurgery (Ms Boo), Cardiothoracic Surgery (Ms Hui), and Orthopedic & Traumatology (Mr Kwong), Queen Mary Hospital, Pok Fu Lam, Hong Kong; and Department of Medicine, Tung Wah Hospital, Sheung Wan, Hong Kong (Ms Wan).

Pressure injury is a serious problem and is common in critical care units. Over the last decade, there is new evidence suggesting that the use of multilayered silicone foam dressing as preventive measures can decrease the incidence and prevalence rate of hospital-acquired pressure injury. The purpose of this study was to investigate the clinical efficacy of this dressing in reducing sacral and coccygeal pressure injury incidence rate as compared with standard preventive interventions in critical care settings. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000245DOI Listing
March 2019
12 Reads

Effect of Interventional Educational Programs on Intensive Care Nurses' Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Postclinical Trial.

Crit Care Nurs Q 2019 Jan/Mar;42(1):106-116

Student Research Committee (Mr Ahmadi), Clinical Care Research Center (Mr Bagheri-Saweh and Dr Valiee), Social Determinants of Health Research Center, Research Institute for Health Development (Dr Nouri), and Salahuddin Ayyubi Hospital (Mr Mohamadamini), Kurdistan University of Medical Sciences, Sanandaj, Iran.

The article reports results of an educational program designed to modify negative attitudes of intensive care nurses regarding the use of physical restraints. Findings revealed that increased knowledge about appropriate utilization of various types of restraints positively impacted perceptions, attitudes, and patient care practices. Authors also explore restraint use in several countries and identify variations in use of restraining methods. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000244DOI Listing
March 2019
4 Reads

Case Study Investigation Decreases Burnout While Improving Interprofessional Teamwork, Nurse Satisfaction, and Patient Safety.

Crit Care Nurs Q 2019 Jan/Mar;42(1):96-105

Jacobs Medical Center Medical/Surgical Intensive Care Unit (Mss Hellyar and Yeaman and Drs Madani and Kerr), Intensive Care Unit (Ms O'Connor), and Education Development and Research (Dr Davidson), University of California San Diego Health.

Prevention of burnout is a national imperative, and blame-free investigations of clinical events are advocated. Reflective inquiry techniques are helpful in processing adverse events while minimizing blame. The purpose of this project was to develop an interprofessional peer review program (Case Study Investigation) to process emotions, improve teamwork, and optimize patient outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000243DOI Listing
March 2019
42 Reads

Effect of Intensive Care Unit Nurses' Empowerment Program on Ability in Visual Differential Diagnosis of Pressure Ulcer Classification.

Crit Care Nurs Q 2019 Jan/Mar;42(1):89-95

School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran (Ms Okhovati and Dr Shariat); and School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran (Dr Esmaeili).

Nurses play a vital role in preventing and detecting pressure ulcers within an intensive care unit. This study was conducted to investigate the effect of an empowerment program on nurses' ability to visually determine the stage of a pressure ulcer. This study was a nonrandomized clinical trial involving an intervention group and a control group. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000242DOI Listing
March 2019
5 Reads

Symptom Management and Hospital Readmission in Heart Failure Patients: A Qualitative Study From Portugal.

Crit Care Nurs Q 2019 Jan/Mar;42(1):81-88

Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal and Cardiology Unit/Heart Failure Intensive Care Unit, Centro Hospitalar e Universitário de Coimbra, Portugal (Ms Sousa); and Centro de Investigação Interdisciplinar em Saúde - Instituto Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal (Dr Santos).

This article reports a study aimed at identifying the factors that result in hospital readmissions for patients with heart failure. The high rates of readmission are often due to a lack of knowledge about symptoms and signs of disease progression, and these Portuguese nurses believed that readmissions could be decreased through disease management programs in which patients assumed a more active role in self-care. A study was designed to identify broad categories of problems that lead Portuguese patients with heart failure to be readmitted to hospital. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000241DOI Listing
March 2019
1 Read

Measurement and Nonpharmacologic Management of Sleep Disturbance in the Intensive Care Units: A Literature Review.

Crit Care Nurs Q 2019 Jan/Mar;42(1):75-80

Princess Aisha Bint Al-Hussein College of Nursing & Health Sciences, Al-Hussein Bin Talal University, Maan, Jordan (Dr Bani Younis); Faculty of Nursing, University of Jordan, Amman, Jordan (Dr Hayajneh); and Philadelphia University, Amman, Jordan (Dr Batiha).

The general goal of this review is to summarize, clarify, and evaluate what is known about patients' sleep in the intensive care units (ICUs) in terms of sleep measurement and management. In addition, this review focuses on the gap in knowledge in this field. A review of online databases for relevant articles in the period between 2000 and 2017 was conducted. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000240DOI Listing
March 2019
6 Reads

Lifestyle Modifications in Adults and Older Adults With Chronic Gastroesophageal Reflux Disease (GERD).

Crit Care Nurs Q 2019 Jan/Mar;42(1):64-74

NYU Langone Health, Tisch Hospital, New York (Mr Commisso) and NYU Rory Meyers College of Nursing, New York (Mr Lim).

Gastroesophageal reflux disease (GERD) is a chronic disorder that causes the unwanted backflow of gastric contents into the esophagus, throat, and mouth. Gastroesophageal reflux disease affects roughly 20% of the US population. It is estimated that older adults experience GERD symptoms more commonly and with greater severity because of age-related physiologic changes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000239DOI Listing
March 2019
25 Reads

Teaching Critical Care Nursing Online for RNs.

Crit Care Nurs Q 2019 Jan/Mar;42(1):53-63

Departments of Nursing (Dr Warren) and Educational Studies (Dr Spiegel), University of Tennessee at Martin.

Registered nurses are choosing to further their educational careers by seeking a bachelor's of science degree online (RN-to-BSN). The impetus for choosing the online delivery method is related to the ability to sign into a Learning Management System during times that are advantageous to their hospital work schedules, family, and daily living activities. The RN-to-BSN online option degree requires a Critical Care/Advanced Health Care Course as part of their curriculum plan; therefore, the article presents an overall view of the critical care course, the theoretical underpinnings for progression to the online delivery method, and examples of a module required by the critical care course. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000238DOI Listing
March 2019
3 Reads

Horseshoe, Cockpit, and Dragonfly: Nurse Movement in Headwall Patient Rooms.

Authors:
D Kirk Hamilton

Crit Care Nurs Q 2019 Jan/Mar;42(1):47-52

College of Architecture, Texas A&M University, College Station.

An exploratory, qualitative study conducted on 6 units in 4 hospitals featured field observations of 20 experienced nurses during complete 12-hour day and night shifts, followed by semistructured participant interviews. All patient rooms featured conventional headwall-type life support systems in which the head of the bed is against the wall where multiple electrical, gas, and communication utilities are located. Critical care nurses displayed repetitive movement patterns around the patient and the bed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000237DOI Listing
March 2019
3 Reads

Spurious Laboratory Values in Patients With Leukocytosis.

Crit Care Nurs Q 2019 Jan/Mar;42(1):44-46

Emergency Department, Bellevue Hospital Center, NYU School of Medicine, New York (Mr Malek); and Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, and NYU Rory Meyers College of Nursing, New York (Dr Chen).

Physiological derangements such as hypoxemia and hyperkalemia are medical emergencies that warrant prompt interventions to prevent further patient clinical deterioration. However, in patients with myeloproliferative diseases or malignancies that result in extreme leukocytosis, hypoxemia and hyperkalemia demonstrated in laboratory results could be deceiving due to in vitro reactions and may not reflect actual patient condition. Clinicians have to be familiar with these phenomena so as to not cause harm by treating these spurious laboratory values. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000236DOI Listing
March 2019
14 Reads

Clinical Education to Decrease Perceived Barriers to Delirium Screening in Adult Intensive Care Units.

Crit Care Nurs Q 2019 Jan/Mar;42(1):41-43

Medical University of South Carolina, Charleston.

Despite current advances in critical care medicine, delirium remains a frequent complication of an intensive care unit stay. The consequences can be severe and far reaching, including an increase in mortality, length of stay, and long-term cognitive sequelae. Frequently, delirium can be missed by clinicians who fail to complete a standardized delirium screening tool and, therefore, many cases go unrecognized and untreated. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000235DOI Listing
March 2019
17 Reads

Nursing Considerations When Using Neuromuscular Blocking Agents to Assist With Intubation: A Review of Literature.

Crit Care Nurs Q 2019 Jan/Mar;42(1):30-40

Department of Baccalaureate Nursing, Indiana State University, Monroeville (Mr Blauvelt); and School of Nursing, Indiana State University, Terre Haute (Drs Burdick and Cannon).

The use of neuromuscular blocking agents (NMBAs) in acute care settings during intubation is vitally important. The NMBAs increase first pass success rates significantly while protecting patients from gastric aspiration, tracheal injury, and death. During emergent intubations, succinylcholine and rocuronium are commonly used, but each comes with specific risks and individualized interventions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000234DOI Listing
March 2019
3 Reads

Recognition, Assessment, and Pharmacotherapeutic Treatment of Alcohol Withdrawal Syndrome in the Intensive Care Unit.

Crit Care Nurs Q 2019 Jan/Mar;42(1):12-29

Department of Pharmacy Services, UC Health-University of Cincinnati Medical Center, Ohio (Drs Foertsch, Winter, Droege, and Ernst); University of Cincinnati James L. Winkle College of Pharmacy, Ohio (Drs Foertsch, Winter, Rhoades, Martin, Droege, and Ernst); Department of Pharmacy Services, The Christ Hospital Health Network, Cincinnati, Ohio (Dr Rhoades); and Department of Pharmacy Services, St Elizabeth Healthcare, Edgewood, Kentucky (Dr Martin).

Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000233DOI Listing
March 2019
5 Reads

Pharmacologic Approach to Management of Clostridium difficile Infection.

Crit Care Nurs Q 2019 Jan/Mar;42(1):2-11

Department of Pharmacy, St Elizabeth Healthcare, Edgewood, Kentucky (Drs Martin, Vincent, Gillian, Moore, and Ratermann); Department of Pharmacy Services, University of Cincinnati Medical Center, and Division of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, Cincinnati, Ohio (Dr Droege).

Clostridium difficile is a gram-positive, anaerobic, spore-forming bacterium that is the leading cause of nosocomial infections in hospitals in the United States. Critically ill patients are at high risk for C. difficile infection (CDI) and face potentially detrimental effects, including prolonged hospitalization, risk of recurrent disease, complicated surgery, and death. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000232DOI Listing
March 2019
4 Reads

Foreword.

Authors:
Carmen Warner

Crit Care Nurs Q 2019 Jan/Mar;42(1)

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000231DOI Listing
December 2018
1 Read

Emergency Airway Response Team (EART) Documentation: Criteria, Feasibility, and Usability.

Crit Care Nurs Q 2018 Oct/Dec;41(4):426-438

Departments of Nursing (Dr Crimlisk) and Otolaryngology (Mr Krisciunas), Boston University Medical Center, Boston, Massachusetts; MGH Institute of Health Professions, Boston, Massachusetts (Dr Sipe); Boston University School of Public Health, Boston, Massachusetts (Mr Winter); and Departments of Anesthesiology (Dr Gonzalez) and Otolaryngology-Head and Neck Surgery (Dr Grillone), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.

Patients in an acute care hospital who experience a difficult airway event outside the operating room need a specialized emergency airway response team (EART) immediately. This designated team manages catastrophic airway events using advanced airway techniques as well as surgical intervention. Nurses respond as part of this team. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201810000-0001
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000230DOI Listing
November 2018
8 Reads

Transport of Critically Ill Cardiovascular Patients.

Crit Care Nurs Q 2018 Oct/Dec;41(4):413-425

Sulpizio Cardiovascular Intensive Care Unit, University of California San Diego Medical Center (Ms Ignatyeva); and Department of Anesthesiology UC San Diego Medical Center (Drs Nguyen and Barak), Peri-Operative Medicine and Anesthesiology UCSD Medical Center (Dr Schmidt), UCSD-School, volunteer CVC/ICU (Mr Agarwal), and University of California San Diego Health (Dr Davidson), San Diego, California.

Intra-hospital transport (IHT) of intensive care unit (ICU) patients is associated with a 30% to 60% incidence of adverse events (AEs). This prospective observational study collected data from 200 patient transports from a 24-bed cardiovascular intensive care unit (ICU) between July 2017 and December 2017. Phase 1 of the study focused on identifying and correcting deficiencies in nurses' knowledge regarding IHT. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000229DOI Listing
November 2018
26 Reads

Operational Excellence in the CTSICU.

Authors:
Kim Bartolowits

Crit Care Nurs Q 2018 Oct/Dec;41(4):407-412

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Operational Excellence is about allowing the system to put the correct processes in place to empower all staff members to make change. These processes will evolve into continuous quality improvement, allowing the best outcomes to be achieved. At Allegheny Health Network, Pittsburgh, the right structures are in place to incorporate continuous process improvement by using an Operational Excellence board. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000228DOI Listing
November 2018
1 Read

Blood Glucose Management for Reducing Cardiac Surgery Infections.

Authors:
Susan Leininger

Crit Care Nurs Q 2018 Oct/Dec;41(4):399-406

Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania.

Stress-induced hyperglycemia can occur after cardiac surgery unless the patient is carefully managed. Postoperative hyperglycemia is typically associated with surgical site infections and mediastinitis, resulting in a longer length of stay and escalated costs for the hospitalization. The American Association of Clinical Endocrinologists recommend keeping the intraoperative and postoperative blood glucose levels below 180 mg/dL to avoid postoperative infections. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000227DOI Listing
November 2018
1 Read

ECMO: Nursing Care of Adult Patients on ECMO.

Authors:
Alex Calhoun

Crit Care Nurs Q 2018 Oct/Dec;41(4):394-398

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Extracorporeal membrane oxygenation (ECMO) is used for both cardiac and pulmonary failure when conventional measures are no longer substantial in supporting life. ECMO is not a permanent device. It is used as a temporary measure to allow the lungs and heart, as well as other organs to recover. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000226DOI Listing
November 2018
4 Reads

Learning to Live Again: The Role of Education in Heart Transplant Recipients.

Authors:
Kari Mohney

Crit Care Nurs Q 2018 Oct/Dec;41(4):389-393

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

The heart transplant nurse coordinator plays a key role in educating and supporting the postoperative heart transplant patient to achieve the best outcomes for a long and healthy life. The time leading up to transplantation, wait-list candidates will hear vital information regarding life after they have received their life-sustaining heart transplant. Unfortunately, at times, the information is minimally retained. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000225DOI Listing
November 2018
1 Read

Common Postoperative Heart Transplant Complications.

Crit Care Nurs Q 2018 Oct/Dec;41(4):383-388

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Heart failure or congestive heart failure remains a major public health concern on the global scale. End-stage heart failure is a severe disease where the heart is unable to pump enough oxygen and nutrients to other tissues and organs of the body. When the lines of treatment of heart failure such as lifestyle adjustments, medical management, and device therapy fail, a patient may be deemed a candidate for heart transplantation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000224DOI Listing
November 2018
30 Reads

The Use of Left Ventricular Assist Devices in End-Stage Heart Failure.

Authors:
Ashley Blair

Crit Care Nurs Q 2018 Oct/Dec;41(4):376-382

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Heart failure is one of the most common diagnoses in patients requiring multiple hospitalizations. The use of mechanical circulatory support (both temporary and durable), especially left ventricular assist devices (LVADs), in this patient population has evolved over the last decade. There are thousands of durable LVADs implanted in the United States annually as bridge to transplantation, destination therapy, or bridge to recovery. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201810000-0000
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000223DOI Listing
November 2018
27 Reads

Managing Patients With Heart Failure All the Way to a Heart Transplant.

Authors:
Rebecca Pirozzi

Crit Care Nurs Q 2018 Oct/Dec;41(4):369-375

Allegheny General Hospital, Pittsburgh, Pennsylvania.

Heart transplantation is a viable option for many patients with end-stage heart failure. An extensive evaluation by specialists and in-depth testing are done to determine the risks of advanced therapies including the left ventricular assist device, since most patients need one to safely make it to transplant. A multidisciplinary approach is the most effective approach to successfully progressing a patient to transplant safely and helping him or her prosper after transplant. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000222DOI Listing
November 2018
2 Reads

Evolution of a TAVR Program.

Authors:
Diane Berger

Crit Care Nurs Q 2018 Oct/Dec;41(4):360-368

Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Transcatheter aortic valve replacement (TAVR) is quickly becoming the new standard of care for high- and intermediate-risk patients requiring aortic valve replacement. From May 2012 through April 2018, 1850 patients were evaluated for severe aortic valve stenosis, and over 900 TAVR procedures were performed at the author's institution, Allegheny General Hospital, Pittsburgh. Efficient screening processes, comprehensive review of data, and the less invasive delivery of care have made the TAVR program a viable and sustainable treatment option for patients with severe symptomatic aortic valve stenosis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000221DOI Listing
November 2018
13 Reads

Coronary Artery Bypass Grafting: A Clinical Overview.

Authors:
Laurie Weatherby

Crit Care Nurs Q 2018 Oct/Dec;41(4):356-359

Allegheny Health System, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Coronary artery bypass grafting remains a viable and successful option for treating high-grade coronary artery stenosis. The postoperative recovery is individual for each patient, but when following long-standing guidelines and physician orders, outcomes are generally positive. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000220DOI Listing
November 2018
2 Reads

When Transfusion Is Not an Option-the Challenges and Rewards.

Crit Care Nurs Q 2018 Oct/Dec;41(4):347-355

Patient Blood Management, Allegheny Health Network, Pittsburgh, Pennsylvania (Ms Schwab); and Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania (Mss Kosoglow and Philp and Dr Suydam).

The decision to develop a formal Bloodless Medicine Program to attract and effectively care for patients who decline blood transfusion was made in 1998 by clinical and administrative leaders at our flagship hospital, Allegheny General Hospital, part of the Allegheny Health Network. The Bloodless Medicine Program has more than 20 years of experience in caring for this sometimes challenging patient population and with this experience has provided extensive insight into best practices related to effective, safe, patient blood management. Patient blood management is a patient-centered, evidence-based approach to transfusion that seeks to provide the right care, in the right setting, in the right way, every time. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000219DOI Listing
November 2018
17 Reads

Foreword.

Crit Care Nurs Q 2018 Oct/Dec;41(4):345-346

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000218DOI Listing
August 2018
1 Read

Multifactorial Strategies for Sustaining Safe Patient Handling and Mobility.

Crit Care Nurs Q 2018 Jul/Sep;41(3):340-344

Michigan Medicine, Ann Arbor.

Reduction in nursing staff injuries has occurred with the use of an evidence-based approach to safe patient handling and mobility. Parts of the evidence-based practice initiative include having the appropriate equipment, such as mechanical patient-lifting devices, a no-lift policy, and the use of peer coaches. The combination of the implementation of a culture of safety can sustain evidence-based, safe patient-handling practices that reduce patient-handling injuries. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201807000-0001
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000213DOI Listing
July 2018
21 Reads

A Multidisciplinary Approach to Equipment Use in Pediatric Patient Mobilization.

Crit Care Nurs Q 2018 Jul/Sep;41(3):330-339

Department of Physical Medicine and Rehabilitation, C.S. Mott Children's and Von Voigtlander Women's Hospital, Michigan Medicine, Ann Arbor.

Research has shown that patients who are mechanically ventilated or immobile for greater than 7 days are at increased risk for deconditioning and muscle atrophy. Immobility impacts length of stay as well as patients' ability to return to their prior level of function. As part of the safe patient-handling initiative created at Michigan Medicine, a special team of nurses and therapists was assembled to adapt an adult mobility framework for the pediatric population. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000211DOI Listing
July 2018
4 Reads

Development of Medical Criteria for Mobilizing a Pediatric Patient in the PICU.

Crit Care Nurs Q 2018 Jul/Sep;41(3):323-329

Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases (Ms Van Damme and Dr Flori), and Pediatric Intensive Care Unit, Department of Nursing (Mss Van Damme and Owens), Michigan Medicine, Ann Arbor.

Physical activity in acute and critical care has been recognized as a successful method of improving patient outcomes. Challenges lie, however, in mobilizing pediatric critically ill patients and establishing consensus among health care providers about the safety and feasibility. The challenge of mobilizing pediatric patients is balancing developmental level, functional ability, and level of acuity; therefore, a mobility guideline was developed for use in the pediatric intensive care unit (PICU). Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201807000-0001
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000212DOI Listing
July 2018
18 Reads

Pediatric Mobility: The Development of Standard Assessments and Interventions for Pediatric Patients for Safe Patient Handling and Mobility.

Crit Care Nurs Q 2018 Jul/Sep;41(3):314-322

Pediatric Intensive Care Unit, Michigan Medicine, Ann Arbor (Ms Owens); and Department of Physical Medicine and Rehabilitation, C. S. Mott Children's and Von Voigtlander Women's Hospitals, Michigan Medicine, Ann Arbor (Mr Tapley).

Due to improvements in biomedical sciences and clinical expertise, childhood mortality has decreased. Pediatric patients experience similar complications from inactivity as adults, such as hospital-acquired conditions and delirium. Interdisciplinary collaboration is imperative to improve functional and developmental outcomes of children who suffers from either a chronic illnesses or an acute illness that results in a prolonged hospitalization. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000210DOI Listing
July 2018
5 Reads

"Add It to the Parking Lot": Safe Patient Handling and Mobility in the Emergency Department.

Crit Care Nurs Q 2018 Jul/Sep;41(3):302-311

Adult Emergency Services, Michigan Medicine, Ann Arbor.

Nelson and Baptiste noted that a standard approach to safe patient handling and mobility (SPHM) cannot be generalized to all patient care areas because the unique, high-risk tasks of each area require specific intervention. Matching the SPHM program to the setting, tasks, and roles is important in developing a program that will prevent harm. However, there is little evidence related to the use of SPHM programs in nontraditional care environments, such as emergency departments (EDs). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000216DOI Listing
July 2018
2 Reads

Moving the Bariatric Patient.

Crit Care Nurs Q 2018 Jul/Sep;41(3):297-301

University of Michigan Health System, Ann Arbor.

The health care team must be able to mobilize bariatric patients efficiently and safely. It is challenging to find the proper equipment of sufficient variety to meet the need. Patients can feel self-conscious when staff are struggling to provide care, and staff can be injured when trying to mobilize patients without the proper equipment. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00002727-201807000-0000
Publisher Site
http://dx.doi.org/10.1097/CNQ.0000000000000209DOI Listing
July 2018
12 Reads

Instituting a Standardized Mobility Aid in the Cardiovascular Intensive Care Unit.

Crit Care Nurs Q 2018 Jul/Sep;41(3):289-296

Cardiovascular Intensive Care Unit, Samuel and Jean Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor.

The complexity of ambulation increases when patients are challenged with acute illness in the cardiovascular intensive care unit (CVICU). The difficulties in this setting entailed limited ancillary assistance, proper equipment, and complex medical devices. It was imperative that mobility was made a priority in the CVICU despite multiple barriers. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000208DOI Listing
July 2018
28 Reads

A Nurse-Led Mobility Program on an Acute Rehabilitation Unit.

Crit Care Nurs Q 2018 Jul/Sep;41(3):282-288

University of Michigan Hospital and Health Systems, Ann Arbor.

Rehabilitation assists patients with return to baseline activities of daily living after catastrophic events or long hospitalizations. In an effort to increase mobility episodes in the rehabilitation patient, a nurse-led mobility program was suggested. This allows the rehabilitation nurse to participate in the improvement of mobility for rehabilitation patients by mobilizing the patients safely during hours in which physical therapy is not available. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CNQ.0000000000000207DOI Listing
July 2018
2 Reads