1,792 results match your criteria Dimensions of Critical Care Nursing - DCCN[Journal]


The Opioid Crisis: The Provider's Role.

Dimens Crit Care Nurs 2019 May/Jun;38(3):182

Editor - In Chief - DCCN Wolters Kluwer Health Duxbury, Massachusetts.

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http://dx.doi.org/10.1097/DCC.0000000000000358DOI Listing

A Quality Improvement Project to Increase Adherence to a Pain, Agitation, and Delirium Protocol in the Intensive Care Unit.

Dimens Crit Care Nurs 2019 May/Jun;38(3):174-181

Wendy Yan, DNP, CRNA, is a Nurse Anesthetist at Duke Regional Hospital. Brett T. Morgan, DNP, CRNA, is Director of the Nurse Anesthesia Program and an assistant professor at Duke University School of Nursing. Peter Berry, MSN, RN, CNL, CCRN, is nurse manager at the intensive care unit of Duke Raleigh Hospital. Mary K. Matthys, BSN, RN, CCRN, is clinical lead at the intensive care unit of Duke Raleigh Hospital. Julie A. Thompson, PhD, is a research associate and a statistical consultant at Duke University School of Nursing. Benjamin A. Smallheer, PhD, RN, ACNP-BC, FNP-BC, CCRN, CNE, is lead faculty of the Adult-Gerontology Acute Care Nurse Practitioner Program at Duke University School of Nursing. He actively practices within the Critical Care Setting at Duke Raleigh Hospital and has expertise in Pulmonary Critical Care. His current areas of research interest are the care of the aging critical care population, the implementation of innovative educational strategies to prepare Nurse Practitioner students for entry to practice, and gender-associated incivility experienced by male nursing students in the academic environment.

Background: In recent years, the incidence of delirium has grown to epidemic proportions in the intensive care setting with up to 80% of mechanically ventilated patients being affected. This can lead to adverse patient outcomes such as increased lengths of hospital stay, increased mortality rates, and increased long-term cognitive impairment.

Objectives: The objective of this project is to determine whether a quality improvement project can increase adherence to an existing pain, agitation, and delirium (PAD) protocol for enhanced patient outcomes. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000353DOI Listing
April 2019
2 Reads

Research Outcomes of Implementing CEASE: An Innovative, Nurse-Driven, Evidence-Based, Patient-Customized Monitoring Bundle to Decrease Alarm Fatigue in the Intensive Care Unit/Step-down Unit.

Dimens Crit Care Nurs 2019 May/Jun;38(3):160-173

Carmencita Lorenzo Lewis, BSN, RN, CCRN, is a staff nurse and charge nurse at the intensive care unit/step-down unit, Porter Adventist Hospital in Denver, Colorado. She is currently enrolled in the clinical nurse specialist master's degree program at the University of Colorado, College of Nursing, Aurora, Colorado. Cynthia A. Oster, PhD, RN, APRN, MBA, ACNS-BC, ANP, FAAN, is nurse scientist for patient safety, Emory Healthcare, and adjunct assistant professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. At the time this study was conducted, she was the nurse scientist and clinical nurse specialist for critical care and cardiovascular services at Porter Adventist Hospital, Denver, Colorado. In 2016, Dr Oster received a 2nd Place American Journal of Nursing Book Award in the Professional Issues Category for the textbook High Reliability Organizations: A Healthcare Handbook for Patient Safety & Quality.

Introduction: The research literature is replete with evidence that alarm fatigue is a real phenomenon in the clinical practice environment and can lead to desensitization of the need to respond among nursing staff. A few studies attest to the effectiveness of incorporating parts of the American Association of Critical-Care Nurses recommended nursing practices for alarm management. No studies could be found measuring the effectiveness of the American Association of Critical-Care Nurses recommendations in their entirety or the effectiveness of a nursing-driven, evidence-based, patient-customized monitoring bundle. Read More

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http://Insights.ovid.com/crossref?an=00003465-201905000-0000
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http://dx.doi.org/10.1097/DCC.0000000000000357DOI Listing
April 2019
5 Reads

Validation of the Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO II) Acuity Tool for Pediatric Critical Care Nursing.

Dimens Crit Care Nurs 2019 May/Jun;38(3):153-159

Jean A. Connor, PhD, RN, CPNP, FAAN, is director of Nursing Research, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Christine LaGrasta, DNP, RN, CPNP-PC/AC, is nurse practitioner II, Cardiac Acute Care Unit, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, Massachusetts. Kimberlee Gauvreau, ScD, is senior biostatistician, Department of Cardiology, Boston Children's Hospital, and associate professor, Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts. Courtney Porter, MPH, CPHQ, is program administrative manager II, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, Massachusetts. Patricia A. Hickey, PhD, MBA, RN, NEA-BC, FAAN, is vice president and associate chief nurse, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, and assistant professor of pediatrics, Harvard Medical School, Boston, Massachusetts.

Background: The Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO II) acuity tool was developed to quantify patient acuity in terms of nursing cognitive workload complexity in a large, freestanding children's hospital in the United States.

Objectives: To describe the acuity and complexity of pediatric critical care nursing at a large children's hospital and correlate the CAMEO II with pediatric physiologic measures.

Methods: Construct validation was conducted correlating the CAMEO II to a pediatric classification system and 2 physiologic acuity tools. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000355DOI Listing
April 2019
3 Reads

Scaling the Measurement of Pediatric Acuity Using the Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO II) Tool.

Dimens Crit Care Nurs 2019 May/Jun;38(3):146-152

Jean A. Connor, PhD, RN, CPNP, FAAN, is director of nursing research, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, and clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Christine LaGrasta, DNP, RN, CPNP-PC/AC, is nurse practitioner II, Cardiac Acute Care Unit, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, Massachusetts. Kimberlee Gauvreau, ScD, is senior biostatistician, Department of Cardiology, Boston Children's Hospital, and associate professor, Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts. Courtney Porter, MPH, CPHQ, is program administrative manager II, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, Massachusetts. Kendra O'Brien, BA, is nursing student, University of Massachusetts-Boston. Patricia A. Hickey, PhD, MBA, RN, NEA-BC, FAAN, is vice president and associate chief nurse, Cardiovascular and Critical Care Nursing Patient Services, Boston Children's Hospital, and associate professor of pediatrics, Harvard Medical School, Boston, Massachusetts.

Background: The Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) acuity tool was developed to quantify patient acuity in terms of nursing cognitive workload complexity. An expert panel including representatives from 4 intensive care units (ICUs) convened to scale and implement the CAMEO II across the ICUs in a large, freestanding children's hospital in the United States.

Objectives: The aims of this study were to scale and implement a standardized acuity measure of pediatric critical care nursing. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000356DOI Listing
April 2019
5 Reads

The Effect of Infection Control Course on Nursing Students' Knowledge of and Compliance With Universal Precautions: A Quasi-experimental Study.

Dimens Crit Care Nurs 2019 May/Jun;38(3):137-145

Loai Issa Tawalbeh, PhD, RN, is an associate professor in the Faculty of Nursing at Al-AlBayt University, Al-Mafraq, Jordan. Omar M. AL-Rawajfah, PhD, RN, is an associate professor of Acute Care Nursing, College of Nursing-Sultan Qaboos University, Muscat, Oman. Laila Habiballah, PhD, RN, is an assistant professor in the Faculty of Nursing at Irbid National University, Jordan.

Background: Knowledge of and compliance with universal isolation precautions are important issues and were found to be low in many previous studies. However, there were no Jordanian studies that have examined the effect of an infection control teaching course on nursing students' knowledge of and compliance with universal precautions.

Purpose: This study aimed to assess knowledge and compliance levels, assess the relationships between knowledge and compliance, and examine the effect of infection control teaching courses on knowledge of and compliance with universal precautions among university nursing students. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000352DOI Listing
April 2019
6 Reads

Nurse Preceptor Role in New Graduate Nurses' Transition to Practice.

Dimens Crit Care Nurs 2019 May/Jun;38(3):131-136

Kelly Powers, PhD, RN, CNE, is an assistant professor at the School of Nursing of The University of North Carolina at Charlotte, Charlotte, North Carolina. Elizabeth K. Herron, PhD, RN, CNE, CHSE, is an assistant professor at the School of Nursing of James Madison University, Harrisonburg, Virginia. Julie Pagel, MSN, RN, CCRN, SCRN, CNE-cl, is a service line educator at Carolinas HealthCare System/Atrium Health, Carolinas Medical Center, Charlotte, North Carolina.

The transition to practice period is a challenging and demanding time for new graduate nurses. Leaving the structured environment of nursing school and entering professional practice can cause reality and transition shock for the new nurse resulting in unsafe patient care, as well as intention to leave their position or the profession. Successful transition to practice depends on the new nurse building confidence and gaining essential clinical reasoning abilities while orienting to their role. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000354DOI Listing
April 2019
15 Reads

Extracorporeal Life Support in Adult Patients: A Global Perspective of the Last Decade.

Dimens Crit Care Nurs 2019 May/Jun;38(3):123-130

Eva R. Kurniawati, MSc, is a PhD student in the Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. Patrick W. Weerwind, PhD, is head of the Department of Extracorporeal Circulation, Maastricht University Medical Center, Maastricht, the Netherlands.

Extracorporeal life support (ECLS) is an external medical device to treat critically ill patients with cardiovascular and respiratory failure. In a nutshell, ECLS is only a "bridging" mechanism that provides life support while the heart and/or the lungs is recovering either by therapeutic medical interventions, transplantation, or spontaneously. Extracorporeal life support has been developed since 1950s, and many studies were conducted to improve ECLS techniques, but unfortunately, the survival rate was not improved. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000351DOI Listing
April 2019
2 Reads

The Gift of Time.

Dimens Crit Care Nurs 2019 May/Jun;38(3):121-122

Editor-in-Chief, Dimensions of Critical Care Nursing.

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http://dx.doi.org/10.1097/DCC.0000000000000359DOI Listing
April 2019
2 Reads

Reply to Letter to Editor.

Authors:
Kelly A Powers

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):114

University of North Carolina at Charlotte, North Carolina.

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http://dx.doi.org/10.1097/DCC.0000000000000344DOI Listing
February 2019
12 Reads

Attitudes of Intensive Care Unit Nurses to Family Involvement and Their Presence During Cardiopulmonary Resuscitation: What Should Be Done to Make Family Presence During Cardiopulmonary Resuscitation a Common Practice in Hospitals?

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):113-114

Department of Emergency Medicine, Faculty of Medicine, University of Rzeszów, Poland. Department of Emergency Medicine, Faculty of Medicine, University of Rzeszów, Poland.

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http://dx.doi.org/10.1097/DCC.0000000000000345DOI Listing
February 2019
2 Reads

Certified and Advanced Degree Critical Care Nurses Improve Patient Outcomes.

Authors:
Patricia Conley

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):108-112

Patricia Conley, PhD, RN, PCCN, is a progressive care: unit charge nurse at the Research Medical Center at Kansas City, Missouri.

The need for highly skilled and knowledgeable critical care nurses continues to evolve today and will in the future. Demands in critical care medicine for nurses with advanced degrees (master's in nursing: clinical nurse specialist; or doctorate in nursing: doctorate of philosophy in nursing or doctor of nursing practice) working in intensive care units or progressive care units can help meet these challenges. Nurses with certification and advanced degrees in nursing can be employed to work in 1 or combined roles such as nurse leaders and nurse researcher or intermittently fulfill roles as bedside nurses. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000342DOI Listing
February 2019
1 Read

Increasing Light Exposure for the Prevention of Delirium: A Systematic Review.

Authors:
Rachel L Groves

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):96-107

Rachel L. Groves, MSN, RN, AGACNP-BC, is a recent graduate of the University of Pennsylvania with a master's degree in adult-gerontology acute care nurse practitioner. She currently works as a cardiac nurse practitioner and is a member of Sigma Theta Tau International Honor Society of Nursing.

Background: Delirium is a neurological disorder with correlations to increased hospital length of stays and higher morbidity and mortality rates, particularly in the growing elderly population, making prevention strategies key in improving patient outcomes and health care systems.

Objectives: Does increased exposure to light, by artificial or natural means, decrease the incidence of delirium?

Methods: A systematic review was conducted of 4 revered databases, CINAHL, PubMed, PsycINFO, and Scopus, for articles related to key words "delirium" and "lighting" or "daylight" or "natural light" or "bright light" or "sunlight." Results were narrowed to adult inpatients, defined as age older than 18 years. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000343DOI Listing
February 2019
13 Reads

Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study.

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):90-95

Akram M. Rasheed, MSN, RN, is part of the Nursing Education & Development Committee at the Critical Care Department in King Saud Medical City, Riyadh, Saudi Arabia. Mohammad F. Amirah, MSN, RN, is part of the Nursing Education & Development Committee at the Critical Care Department in King Saud Medical City, Riyadh, Saudi Arabia. Mohammad Abdallah, PharmD, is currently employed at the Pharmaceutical Care Services in King Saud Medical City, Riyadh, Saudi Arabia. Parameaswari P.J., PhD, is a biostatistician at the research center in King Saud Medical City, Riyadh, Saudi Arabia. Marwan Issa, MSN, RN, is part of the Nursing Education & Development Committee at the Critical Care Department in King Saud Medical City, Riyadh, Saudi Arabia. Abdulrhman Alharthy, MD, PhD, is an intensives MD consultant at the Critical Care Department in King Saud Medical City, Riyadh, Saudi Arabia.

Background: Many sedation scales and tools have been developed and compared for validity in critically ill patients. However, selection and use of sedation scales vary among intensive care units.

Objective: The aim of this study is to compare the reliability of 2 sedation scales-Ramsay Sedation Scale and Richmond Agitation-Sedation Scale (RASS)-in the adult intensive care unit. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000346DOI Listing
February 2019

Gap Analysis to Identify Clinical Education Needs of Aeromedical Evacuation Clinicians.

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):83-89

Marla J. De Jong, PhD, RN, CCNS, Colonel (Ret), FAAN, is Chair of the Division of Acute and Chronic Care and a professor at the University of Utah, Salt Lake City, UT. Susan F. Dukes, PhD, RN, CCNS, Colonel, is commandant/assistant dean for student affairs at the Uniformed Services University, Bethesda, MD. Tiffany Losekamp, MSN, RN, CNE, CHSE, is assistant professor of Practice and coordinator of the Simulation Learning Center at Wittenberg University in Springfield, OH.

Background: The Air Force has unique challenges in ensuring clinical proficiency for en route care clinicians. These challenges pertain to existing care environments, training opportunities, and the spectrum of training needed to care for patients with polytrauma and complicated medical conditions while being transported between medical treatment facilities.

Objective: The purpose of this study was to identify the clinical education needs of students entering the United States Air Force School of Aerospace Medicine Flight Nurse (FN) or Aeromedical Evacuation Technician (AET) course and Air Force FNs and AETs assigned to active duty aeromedical evacuation units. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000349DOI Listing
February 2019
10 Reads

Nurse Influence in Meeting Compliance With the Centers for Medicare and Medicaid Services Quality Measure: Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1).

Authors:
Ann L Jorgensen

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):70-82

Ann L. Jorgensen, MS, APN, PCCN, CVN, CPHQ, is a quality improvement coordinator at Advocate Aurora South Suburban Hospital, Hazel Crest Illinois. Her knowledge of sepsis includes medical record abstraction and experience as a Clinical Nurse Specialist in progressive care.

Increased mortality has been identified as the sepsis cascade progresses from sepsis to severe sepsis to septic shock. Estimates reflect sepsis death rates ranging from 10% to 20%, severe sepsis death rates of 20% to 50%, and septic shock fatality rates of 40% to 80%. The high rates of morbidity, mortality, and Medicare costs prompted the Centers for Medicare and Medicaid Services to implement bundled care and public reporting of the Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1) quality measure in 2015. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000340DOI Listing
February 2019
3 Reads

Management of Intracranial Pressure Part II: Nonpharmacologic Interventions.

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):61-69

Tara L. Sacco, MS, RN, CCRN-K, AGCNS-BC, ACCNS-AG, is a visiting assistant professor at Wegmans School of Nursing, St John Fisher College, Rochester, New York; and clinical nurse specialist at Adult Critical Care Nursing, University of Rochester Medical Center, Rochester, New York; and PhD student in the M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania; Jonas Scholar Cohort 2016-2018. Her research interests include quality improvement, critical care nursing, and nursing workforce support, specifically regarding compassion satisfaction and compassion fatigue. She is a member of the American Association of Critical-Care Nurses, Sigma Theta Tau International, National, the National Association of Clinical Nurse Specialists, and the Society of Trauma Nurses. Jenna Gonillo Davis, MS, ACNPC-AG, CCRN, is critical care nurse practitioner in the Neuromedicine Intensive Care Unit, University of Rochester Medical Center, New York. Her research interests include nursing education, critical care nursing, and nursing workforce support, specifically regarding moral distress. She is a member of the American Association of Critical-Care Nurses, Sigma Theta Tau International, and the Neurocritical Care Society.

Pharmacologic and nonpharmacologic interventions are available to treat patients who experience serious elevations in intracranial pressure (ICP). In some cases, patients may experience ICP that is refractory to treatment. Significant negative effects on cerebral blood flow, tissue oxygenation, and cerebral metabolism occur as a result of intracranial hypertension, leading to secondary brain injury. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000341DOI Listing
February 2019

DCCN Appoints Stefano Bambi, RN, CCRN, MSN, PhD, to the Editorial Board.

Dimens Crit Care Nurs 2019 Mar/Apr;38(2):59-60

Kathleen Ahern Gould, RN, MSN, PhD Editor-in-Chief, Dimensions of Critical Care Nursing.

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http://dx.doi.org/10.1097/DCC.0000000000000348DOI Listing
February 2019

Wolters Kluwer Author Services and Educational Resources.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):54

Kathleen Ahern Gould, PhD, MSN, RN, Editor - In Chief - DCCN Duxbury, Massachusetts.

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http://dx.doi.org/10.1097/DCC.0000000000000338DOI Listing
December 2018
1 Read

Creating a Culture of Promoting From Within.

Authors:
Brian W Jones

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):50-53

Brian W. Jones, DHSc, is president/CEO of SHARE Foundation, El Dorado, Arizona.

Although it is common to promote direct care nurses to management positions in nursing, it is important to have a well-defined process. Excelling in clinical skills at the bedside does not always translate into management and leadership abilities. Having a way to internally identify and develop frontline leaders for future management positions is important in succession planning, creating organizational culture, decreasing costs, and increasing employee engagement. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000330DOI Listing
December 2018
6 Reads

Nurses' Competence Caring for Hospitalized Patients With Ventricular Assist Devices.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):38-49

Jesus M. Casida, PhD, RN, APN-C, is a faculty associate at Johns Hopkins University, Baltimore, Maryland. His program of research focuses on the self-management of patients with VADs. Martha Abshire, PhD, RN, is an assistant professor at the Johns Hopkins School of Nursing, Baltimore, Maryland. Her research focuses on improving psychosocial outcomes for patients and caregivers managing advanced heart failure. Brian Widmar, PhD, RN, ACNP-BC, is assistant professor and director of the Adult-Gerontology Acute Care Nurse Practitioner program at Vanderbilt University School of Nursing, Nashville, Tennessee. He is also an acute care nurse practitioner in the Heart Transplant Program at Vanderbilt University Medical Center. Pamela Combs, PhD, RN, is internationally known for her leadership and expertise in the management of patients with VADs. Currently, she is clinical research nurse at the University of Chicago's Department of Cardiac Surgery, Illinois. Regi Freeman, MSN, RN, ACNS-BC, is a board-certified adult health clinical nurse specialist in the cardiovascular intensive care unit (CVICU) at Michigan Medicine, Ann Arbor. The CVICU is a 32-bed high-acuity intensive care unit caring for complex surgical procedures, mechanical circulatory support, and extracorporeal membrane oxygenation. Ms Freeman has published multiple articles and also presented nationally. Linda Baas, PhD, RN, is professor emeritus at the University of Cincinnati College of Nursing, Ohio. She served as president of the American Association of Heart Failure Nurses in 2012-2013.

Background: Nursing care is an essential component of the delivery of high-quality patient care for advanced heart failure patients with ventricular assist devices (VADs). However, there is little information about how VAD patient care competence is formed, and there are no empirical data regarding the bed nurses' competence.

Objectives: The aim of this study was to explain how nurses perceived their competence related to VAD technology and how they utilized resources to equip themselves for the management of patients with implantable VADs. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000332DOI Listing
December 2018
18 Reads

An Educational and Skill-Building Intervention to Improve Symptom Recognition and Interpretation in Women With Acute Coronary Syndrome: A Pilot Study.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):29-37

Leslie L. Davis, PhD, RN, ANP-BC, FAANP, FAHA, is an associate professor of nursing at the School of Nursing, University of North Carolina, Greensboro. Dr Davis is a board certified adult nurse practitioner and has clinical expertise in hypertension, heart failure, and coronary artery disease. Her program of research focuses on self-care related to symptom monitoring and symptom management of cardiovascular conditions. Thomas P. McCoy, PhD, PStat, is a statistician and clinical associate professor at the School of Nursing, University of North Carolina, Greensboro. Dr McCoy has a PhD in Educational Research, Measurement, and Evaluation. He is also an Accredited Professional Statistician by the American Statistical Association. His research interests are biostatistics and psychometrics.

Background: The type of symptoms that a woman experiences during an acute coronary syndrome (ACS) event influences symptom recognition and interpretation. Women who experience intense, abrupt symptoms are more likely to correctly attribute symptoms to a cardiac etiology and seek care faster than women with less intense, intermittent symptoms.

Objective: A single-group pretest-posttest design was used to evaluate the feasibility and acceptability of a nurse-delivered education and skill-building intervention designed to improve symptom recognition and interpretation in women with recurrent ACS symptoms. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278947PMC
January 2020
11 Reads

Sleep and Intensive Care Unit-Acquired Weakness in Critically Ill Older Adults.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):20-28

Maya N. Elías, PhD, MA, RN, is a postdoctoral research fellow at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Cindy L. Munro, PhD, ANP-BC, FAAAS, is dean and professor at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Zhan Liang, PhD, RN, is an assistant professor at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Karel Calero, MD, is an assistant professor at the College of Medicine, Department of Pulmonary, Critical Care, & Sleep Medicine at the University of South Florida, Tampa. Ming Ji, PhD, is a professor at the College of Nursing at the University of South Florida, Tampa.

Background: Older adults in the intensive care unit (ICU) often experience sleep disturbances, which may stem from life-threatening illness, the ICU environment, medications/sedation, or psychological stress. Two complementary endocrinological responses occur as a result of compromised sleep and consequently could exacerbate ICU-acquired weakness: a decrease in anabolic hormones leading to decreased protein synthesis and an increase in catabolic hormones leading to increased protein degradation. Age-associated decreases in anabolic hormones, such as insulin-like growth factor 1, testosterone, and growth hormone, may inhibit protein synthesis. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000335DOI Listing
December 2018
13 Reads

Impact of Nursing Education on Phlebotomy Blood Loss and Hospital-Acquired Anemia: A Quality Improvement Project.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):13-19

Stacy Jones, DNP, RN, AGACNP-BC, recently completed her doctor of nursing practice degree at the University of Michigan-Flint School of Nursing. Paris Spangler, DNP, RN, AGACNP-BC, recently completed her doctor of nursing practice degree at the University of Michigan-Flint School of Nursing. Megan Keiser, DNP, RN, CNRN, SCRN, ACNS-BC, NP-C, is the director of Undergraduate Nursing Affairs and is an assistant professor at the University of Michigan-Flint School of Nursing. Carman Turkelson, DNP, MSN, RN, CCRN, CHSE, is the associate director of the Simulation Center and is an assistant professor at the University of Michigan-Flint School of Nursing.

Background: Phlebotomy blood loss resulting in hospital-acquired anemia remains a significant problem in the critically ill population. A quality improvement project focused on decreasing phlebotomy blood loss and increasing nursing knowledge regarding blood conservation strategies was undertaken in the intensive care unit of a community hospital.

Methods: The project followed a quasi-experimental design. Read More

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http://dx.doi.org/10.1097/DCC.0000000000000333DOI Listing
December 2018
17 Reads

The Effects of Oral Care Protocol on the Incidence of Ventilation-Associated Pneumonia in Selected Intensive Care Units in Jordan.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):5-12

Mahmoud Ali Alja'afreh, RN, PhD, is an assistant professor, vice dean, and head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Mutah, Karak, Jordan. His research interest is focused on four major areas: (1) studying of patient and family satisfaction in acute and critical care settings; (2) use of local resources to develop student center knowledge about disaster education; (3) development of patient safety guidelines for pressure ulcers patients, mechanically ventilated patients, and critical care practices issues; and (4) reshaping and enforcement of structures, processes, and outcomes of risk assessment, and management of pressure ulcers patients and critical care/cancer patients. Sultan Mosleh, RN, PhD, is an associate professor and a former head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Jordan. His research interest is focused on four major areas: (1) critical care environment issues for patients and staff; (2) palliative care and end-of-life care of cancer patients; (3) clinical cardiac patients' rehabilitation; and (4) patient and nursing education. Sakhaa S. Habashneh, RN, MsN, is a lecturer at the Department of Adult Health Nursing, Faculty of Nursing, University of Mutah, Mutah, Karak, Jordan. Her research interest is focused on four major areas: (1) clinical critical nursing issues; (2) knowledge and compliances of critical care units' staff; and (3) patient and nursing education.

Purpose: This study aims to evaluate the effects of oral care protocol on the incidence of ventilator-associated pneumonia (VAP) at selected intensive care units (ICUs) in Jordan using clinical pulmonary infection score.

Methods: A quasi-experimental design was used, and 1 large teaching hospital from the Jordanian capital, along with 2 hospitals from the southern region, was selected. A total of 218 patients participated, among which VAP risk in 2 independent groups was evaluated through the Clinical Pulmonary Infection Score sheet. Read More

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http://Insights.ovid.com/crossref?an=00003465-201901000-0000
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http://dx.doi.org/10.1097/DCC.0000000000000334DOI Listing
December 2018
6 Reads

Got Narcan?

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):1-4

Kathleen Ahern Gould, RN, MSN, PhD Editor-in-Chief, Dimensions of Critical Care Nursing.

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http://dx.doi.org/10.1097/DCC.0000000000000337DOI Listing
December 2018
1 Read

Celebrating "What Matters" for the Holidays.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):326

Kathleen Ahern Gould, RN, MSN, PhD, Editor - In Chief - DCCN, Wolters Kluwer Health, Duxbury, Massachusetts.

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http://dx.doi.org/10.1097/DCC.0000000000000327DOI Listing
October 2018
1 Read

Nurse-Initiated Mobilization Practices in 2 Community Intensive Care Units: A Pilot Study.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):318-323

Deonni Stolldorf, PhD, RN, is an assistant professor and research faculty member at Vanderbilt University School of Nursing, Nashville, Tennessee, with a clinical background and specialized training in critical care. Dr Stolldorf's research focus is on the implementation and sustainability of healthcare interventions. She is currently funded by the Agency for Healthcare Research and Quality (K01 HS25486-01) to investigate the implementation and sustainment of medication reconciliation interventions. Mary S. Dietrich, PhD, MS, is a professor of statistics and measurement at Vanderbilt University School of Nursing, Nashville, Tennessee, with more than 30 years of experience collaborating with researchers in all areas of study. Dr Dietrich's own interests revolve around the use and development of statistical methods that bridge the psychological, sociological, and biological sciences, in particular systems-level and longitudinal methods. Tiffani Chidume, MSN, RN, CCRN, has 17 years of nursing experience. She is certified as a critical care nurse and has more than 11 years of intensive care unit experience. She has transitioned her clinical expertise to academia, where she is a nursing instructor and the simulation laboratory coordinator. She is currently a doctoral nursing student at the University of Alabama in Huntsville. Marie McIntosh, MSN, FNP-C, is an experienced critical care nurse. She is currently a nurse practitioner in Columbus, Georgia, with more than 5 years of experience. She is affiliated with SFH Electrophysiologist Group in Columbus, as well as St Francis Hospital in Columbus. Cathy Maxwell, PhD, RN, is an assistant professor and research faculty member at Vanderbilt University School of Nursing, Nashville, Tennessee, with a clinical background in critical care and trauma. Dr Maxwell's research is directed at understanding outcomes trajectories of older adults after physical injury.

Background: Critical-care nurses play a vital role in promoting safe early mobilization in intensive care unit (ICU) settings to reduce the risks associated with immobility in ICUs, including the risk of delirium, ICU-acquired weakness, and functional decline.

Objective: The purposes of this study were to describe nurse-led mobilization practices in 2 community hospital ICUs and to report differences and similarities between the 2 settings.

Methods: This was a cross-sectional exploratory study of 18 nurses (ICU A: n = 12, ICU B: n = 6) and 124 patients (ICU A: n = 50, ICU B: n = 74). Read More

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February 2019
3 Reads

Impact of a Nurse Intervention to Improve Sleep Quality in Intensive Care Units: Results From a Randomized Controlled Trial.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):310-317

Julián Díaz-Alonso, RN, is a registered nurse specialized in critical care and with extensive formation in emergencies at the Intensive Care Unit, Asturias Central University Hospital, Oviedo, Spain. He is currently a PhD candidate at the University of Oviedo. Andrea M. Smith-Plaza, RN, is a registered nurse specialized in family and community health at the Preventive Medicine and Public Health Department, School of Medicine and Health Sciences, Oviedo, Spain. She is also junior researcher in the Department of Medicine at the University of Oviedo. Belén Suárez-Mier, RN, is a senior clinical researcher and a preventive medicine nurse at the Preventive Medicine Unit, Asturias Central University Hospital, Oviedo, Spain. Furthermore, she is a nursing assistant professor at the University of Oviedo. Alberto Lana, PhD, is senior researcher at the University of Oviedo. He has extensively published on several health related topics, including nursing practice.

Background: Patients of adult intensive care units (ICUs) often suffer from a lack of sleep. Reducing anxiety by promoting adaptation to the ICU prior to admission may be an appropriate way to increase sleep quality.

Objective: The aim of this study was to evaluate the impact on sleep quality of a brief nurse intervention. Read More

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February 2019
13 Reads

Qualitative Research Methods: A Phenomenological Focus.

Authors:
Brigitte Cypress

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):302-309

Brigitte S. Cypress, EdD, RN, CCRN, is an associate professor at East Stroudsburg University of Pennsylvania.

Data collection and management are often neglected subjects of qualitative research. Qualitative data collection, management, and analysis are complex and challenging for researchers especially for early career and doctoral students. These processes involve anticipating for ethical issues and developing means and methods for collecting, recording, and storing data securely. Read More

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February 2019
1 Read

2018 Guide to Nursing Certification Boards.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):294-301

Lisa Morris Bonsall, MSN, RN, CRNP, is the senior clinical editor for Lippincott NursingCenter.com. Myrna Buiser Schnur, MSN, RN, is a clinical editor for Lippincott NursingCenter.com. Kim Fryling-Resare, BA, is the managing editor for Lippincott NursingCenter.com. Lindsey Lynch, BA, is the digital editor for Lippincott NursingCenter.com.

Nursing specialty certification is a way to demonstrate clinical and professional growth. Use this resource to learn about available certifications and contact the certifying body that meets your needs. Read More

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February 2019
2 Reads

Oral Care Protocols With Specialty Training Lead to Safe Oral Care Practices and Reduce Iatrogenic Bleeding in Extracorporeal Membrane Oxygenation Patients.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):285-293

Alberto Lucchini, RN, is head nurse at the General Intensive Care Unit, ASST Monza, San Gerardo Hospital, Italy. He is the coordinator of the master's degree program in intensive and critical care nursing at Milano-Bicocca University, Italy. His main publications concern the nursing workload in intensive care, nursing care of ECMO patients, invasive and non-invasive mechanical ventilation, endotracheal suctioning. Stefano Bambi, PhD, MSN, RN, CCN, is staff nurse at the Emergency & Trauma Intensive Care Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Christian de Felippis, RN, is staff nurse at the Adult Intensive Care Unit, Glenfield Hospital, University Hospital of Leicester-NHS Trust, Leicester, United Kingdom. Alessandro Galazzi, MSN, RN, CCN, is staff nurse at General Intensive Care Unit, Department of Anesthesia and Intensive Care Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. Grazia Addis, RN, CCN, is staff nurse at Hematology Department, Niguarda Ca' Granda Hospital, Milan, Italy. Roberto Rona, MD, is head at General Intensive Care Unit, ASST Monza, San Gerardo Hospital, Italy. Giacomo Grasselli, MD, is associate professor at General Intensive Care Unit, Department of Anesthesia and Intensive Care Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. Antonio Pesenti, MD, is full professor at General Intensive Care Unit, Department of Anesthesia and Intensive Care Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. Roberto Fumagalli, MD, is director and full professor at the Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda Hospital University of Milan-Bicocca, Milan, Italy. Giuseppe Foti, MD, is director and associate professor, Emergency Department, ASST Monza, San Gerardo Hospital, Italy.

Introduction: Oral care, using either a mouth rinse, gel, toothbrush, or combination of them, together with aspiration of secretions, may reduce the risk of ventilator-acquired pneumonia in intubated patents. Oral care procedure in patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) may cause bleeding due to the systemic anticoagulation required.

Purpose: The aim of this study was to investigate the rate of bleeding episodes during oral care in patients supported by VV-ECMO. Read More

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February 2019
18 Reads

DCCN Appoints Dr Brigitte Cypress to the Editorial Board.

Dimens Crit Care Nurs 2018 Nov/Dec;37(6):283-284

Kathleen Ahern Gould, RN, MSN, PhD, Editor-in-Chief, Dimensions of Critical Care Nursing.

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October 2018
1 Read

A Message to New Authors.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):279

Kathleen Ahern Gould, PhD, RN, is editor-in-chief, Dimensions of Critical Care Nursing, Duxbury, Massachusetts.

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August 2018
2 Reads

The Effects of Bed Bathing on Vital Signs and Oxygen Saturation in Children Who Are Connected to Mechanical Ventilation.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):272-278

Hamiyet Kizil, MSc, RN, is teaching assistant at the Nursing Department, Beykent University School of Health Sciences, Beykent University Beylikdüzü Campus, Büyükcekmece, Istanbul, Turkey. Dr Kizil obtained her bachelor's degree in nursing in 2009 and master's degree in fundamental of nursing in 2015 from Istanbul University Florence Nightingale Nursing Faculty and doctor of philosophy degree in fundamental of nursing in 2017 from the University of Health Sciences Nursing Faculty. Research topics that are of interest to her are fundamental of nursing, intensive care nursing, evidence-based nursing, and health information systems. Merdiye endir, PhD, MSc, RN, is Nursing Faculty at Sağlik Bilimleri University, Istanbul, Turkey. Dr Şendir obtained her bachelor's degree in nursing in 1989 and master's degree in management of nursing in 1994 from Istanbul University Florence Nightingale Nursing Faculty and doctor of philosophy degree in fundamental of nursing in 2000 from the University of Health Sciences Nursing Faculty. She was associate professor in nursing in 2010 and professor in 2015 at Istanbul University Florence Nightingale Nursing Faculty. Research topics that are of interest to her are fundamental of nursing, evidence-based nursing, and health information systems.

Aim: This study is a quasi-experimental research that was conducted to evaluate the effects of bathing on vital signs and oxygen saturation in intubated children who are connected to mechanical ventilation.

Methods: The study sample consisted of children who are treated in the pediatric intensive care unit, University of Istanbul Cerrahpasa Faculty of Medicine Hospital. A total of 60 children who met the criteria of the sample group were included in the study. Read More

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January 2019
9 Reads

Nurses' Perceptions of Barriers to Rapid Response System Activation: A Systematic Review.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):259-271

Ricardo M. Padilla, PhD(c), MSN, RN, CCRN, is an assistant clinical professor and PhD student at the University of San Diego, Hahn School of Nursing and Health Science, California. Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN, is a professor at the University of San Diego, Hahn School of Nursing and Health Science, California. Kathleen M. Stacy, PhD, RN, APRN-CNS, CCNS, is a clinical associate professor at the University of San Diego, Hahn School of Nursing and Health Science, California.

Background: The rapid response system (RRS) was designed to identify and intervene on patients exhibiting clinical deterioration in the non-critical-care setting but is not always effectively activated by nurses, leading to adverse patient outcomes.

Objectives: The objective of this systematic review was to explore nurses' perceived barriers to RRS activation in the acute adult inpatient setting.

Method: A systematic review was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist. Read More

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January 2019
3 Reads

Critical Care Nurses' Qualitative Reports of Experiences With Family Behaviors as Obstacles in End-of-Life Care.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):251-258

Renea L. Beckstrand, PhD, RN, CCRN, CNE, is professor, Brigham Young University College of Nursing, Provo, UT. Caitlin Mallory, BS, RN, is graduate student, NSTICU, Utah Valley Hospital, Provo. Janelle L. B. Macintosh, PhD, RN, is associate professor, Brigham Young University College of Nursing, Provo, Utah. Karlen E. Luthy, DNP, FNP-c, FAAN, is associate professor, Brigham Young University College of Nursing, Provo, Utah.

Background: Critical care nurses (CCNs) frequently provide end-of-life (EOL) care for critically ill patients. Critical care nurses may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Read More

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January 2019
5 Reads

Creative Teaching Methods for Educators: A Compendium of Critical-Care Concepts.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):245-250

Michael D. Aldridge, PhD, RN, CNE, is an assistant professor of nursing at the University of Northern Colorado, Greeley. His research interests include innovative teaching methods, effective methods for teaching psychomotor skills, and giving families the option to be present during resuscitations and invasive procedures.

In order to gain expertise, intensive care unit nurses must have a good understanding of the pathophysiology and complicated disease processes seen in their units. Nurse educators and critical-care preceptors must be able to explain these complex concepts to a wide variety of audiences including nursing students, graduate nurses, and experienced critical-care nurses. Many times, demonstrations, analogies, visual aids, games, and creative teaching methods can help communicate these complicated ideas. Read More

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January 2019
4 Reads

From Death to Health in 30 Days: A Hemochromatosis Case Report.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):239-244

Susan E. Becker, DNP, RN, CNS, CCRN, CCNS, is an assistant professor in the Marymount University Malek School of Health Professions with her bachelor of science in nursing degree and master of science in nursing degree (critical-care clinical nurse specialist) from George Mason University, and doctor of nursing practice degree from Duke University. She has worked the majority of her 35 years as a registered nurse in the intensive care unit. Diane Nickloy, BSN, RN, is a registered nurse unit coordinator in the intensive care unit at Sentara Northern Virginia Medical Center in Woodbridge. She received her bachelor of science in nursing degree from Old Dominion University, Norfolk, Virginia. She has more than 38 years of critical-care experience. She chairs the Washington Regional Transplant Community committee at her facility.

Background: Heredity hemochromatosis (HH) is an underdiagnosed genetic disease that can lead to life-threatening multisystem organ failure. Identifying and treating HH early can prevent the progression of the disease.

Case Presentation: For a 60-year-old white patient without obvious symptoms, it was a revelation to discover that he had HH. Read More

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January 2019
6 Reads

Considering the "Informed" in Informed Consent.

Dimens Crit Care Nurs 2018 Sep/Oct;37(5):237-238

Suzanne Hall, RN, MN, CNSDCCN Editor Emerita Lakewood, Colorado.

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August 2018
3 Reads

Adoption of an Electronic Template to Promote Evidence-Based Practice for Policies, Procedures, Guidelines, and Directives Documents.

Dimens Crit Care Nurs 2018 Jul/Aug;37(4):225-234

Juliann Corey, MSN, RN, is clinical nurse IV at Beth Israel Deaconess Medical Center, Boston, and an associate professor at Massachusetts Bay Community College, Wellesley, Massachusetts. Sharon C. O'Donoghue, DNP, RN, is a nurse specialist in Critical Care at Beth Israel Deaconess Medical Center, and an affiliate professor at Northeastern University, Boston, Massachusetts. Veronica Kelly, BSN, RN, is clinical nurse IV at Beth Israel Deaconess Medical Center, Boston, Massachusetts. Lynn Mackinson, MS, RN, ACNS-BC, CCRN-K, is a nurse specialist at Cardiology Beth Israel Deaconess Medical Center, Boston, Massachusetts. Donna Williams, MS, RN, CCRN, is a nurse specialist in cardiology at Beth Israel Deaconess Medical Center, Boston, Massachusetts. Kristin O'Reilly, BSN, MPH, RN, is director of project management and process improvement at the Office of Improvement and Innovation, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Susan DeSanto-Madeya, PhD, RN, is a nurse scientist at Beth Israel Deaconess Medical Center, Boston, and clinical associate professor at Boston College, Chestnut Hill, Massachusetts.

Background: Policies, procedures, and guidelines standardize care, meet regulatory requirements, and can promote safety in clinical practice. The existing protocols, policies, guidelines, and directives (PPGDs) at a level 1 trauma academic medical center were underused by the intensive care unit clinicians and did not always clearly represent the supporting evidence.

Aims: The goals of this project were to update the Critical Care Practice Manual (CCPM) and to ensure that clinical practice was aligned with best evidence. Read More

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December 2018
3 Reads

Nurse Satisfaction With Medical Emergency Team Nurses: A 3-Year Study.

Dimens Crit Care Nurs 2018 Jul/Aug;37(4):217-224

Colleen M. Halupa, EdD, MS MLS, MLT(ASCP), is the dean of online education at East Texas Baptist University in Marshall Texas. Dr Halupa has an EdD in Curriculum and Instruction/Education Leadership and Management, an MS in Health Administration, a BS in Healthcare Management, and an AS in Medical Laboratory Science. She has taught in the health sciences and education fields and has chaired more than 80 doctoral dissertations. She publishes and presents both nationally and internationally. Michael S. Halupa, BSN, CCRN, TCRN, is a graduate of Creighton University in Omaha, Nebraska, and has been a nurse for more than 25 years. He spent all of his career in critical care, primarily as an intensive care nurse, as well as 3 years as a transplant intensive care nurse. He is certified as a CCRN through the American Association of Critical Care Nurses and as a trauma certified RN (TCRN) through the Board of Certification for Emergency Nursing. He has served as a medical emergency team nurse for the last 2 years. Marty S. Warren, PhD, received her PhD in Statistics from Baylor University. She was a professor of mathematics at East Texas Baptist University (ETBU) in Marshall, Texas, for more than 25 years. She now serves as the dean of academic services and institutional research at ETBU where she oversees regional accreditation compliance and institutional effectiveness.

Background: This 3-year study measured the satisfaction of staff nurses with medical emergency team (MET) nurse services at a 573-bed hospital in the south from 2015 through 2017. Nurse satisfaction is a key management issue. Barriers to effective MET use can negatively impact patient outcomes, staffing, and nurse turnover. Read More

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December 2018
6 Reads

Family Presence During Resuscitation: The Education Needs of Critical Care Nurses.

Authors:
Kelly A Powers

Dimens Crit Care Nurs 2018 Jul/Aug;37(4):210-216

Kelly A. Powers, PhD, RN, CNE, is an assistant professor at the School of Nursing, The University of North Carolina at Charlotte, Charlotte, North Carolina.

Background: Education on family presence during resuscitation (FPDR) has been shown to improve critical care nurses' support for FPDR; however, there have been limited studies in this area. Exploring nurses' perceived needs related to FPDR education is important to design educational interventions to promote FPDR in practice.

Objectives: The aim of this study was to explore the FPDR education needs of critical care nurses to provide recommendations for future educational interventions. Read More

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December 2018
6 Reads

Integrating a Mobility Champion in the Intensive Care Unit.

Dimens Crit Care Nurs 2018 Jul/Aug;37(4):201-209

Rose Bruce, MSN, RN, ACNS-BC, CCRN, PCCN, is a critical care clinical nurse specialist at Legacy Health Systems. Cheryl Forry, MSN, RN, is a nurse manager at ICU/IMCU, Legacy Salmon Creek Medical Center.

In recent years, early progressive mobilization programs have become mainstays in intensive care units (ICUs). Significant evidence exists that early mobility programs decrease length of stay, reduce time on the ventilator, and decrease the development of delirium in ICU patients. Yet, current literature still describes many barriers to performing early mobility, such as the time required, staffing pressures, and increased workload. Read More

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December 2018
7 Reads

Parkland Students Provide a Model for Personal and Public Narratives to Say #NeverAgain.

Authors:

Dimens Crit Care Nurs 2018 Jul/Aug;37(4):199-200

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December 2018
5 Reads

Innovation in Clinical Practice: A Preliminary Study on Delirium Assessment in Intensive Care Unit Using an Application for Smartphone.

Dimens Crit Care Nurs 2018 May/Jun;37(3):194-195

Gian Domenico Giusti, MSN, RN Perugia University Hospital, Perugia, Italy Marco Proietti Righi, RN Porta Sole Private Hospital, Perugia, Italy Stefano Bambi, PhD, RN, MSN, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.

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November 2018
16 Reads

Increasing Access to Palliative Care Services in the Intensive Care Unit.

Dimens Crit Care Nurs 2018 May/Jun;37(3):180-192

Caitlin Marie McCarroll, DNP, APRN, FNP-BC, obtained her BSN from the University of South Carolina, Columbia, and her DNP from the Medical University of South Carolina, Charleston. She is a member of Sigma Theta Tau International Honor Society of Nursing and the American Association of Nurse Practitioners. She also serves as a board member for Capitol Nurse Practitioner Group in Columbia, South Carolina. She is currently employed as a nurse practitioner providing both inpatient and outpatient palliative care.

Background: The Institute of Medicine's report, Dying in America, highlights the critical need for the widespread implementation of palliative care to improve end-of-life care. Approximately 20% of all deaths in America occur during or shortly after an intensive care unit (ICU) admission; therefore, it is important for critical care units to have systems in place to facilitate patient access to palliative care services.

Objectives: The aim of this quality improvement (QI) project was to develop and implement a palliative care screening tool using evidence-based triggers to help increase the proportion of palliative care consultations in the ICU setting. Read More

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November 2018
5 Reads

Family Presence During Resuscitation: Physicians' Perceptions of Risk, Benefit, and Self-Confidence.

Dimens Crit Care Nurs 2018 May/Jun;37(3):167-179

Renee Samples Twibell, PhD, RN, CNE, is an associate professor at Ball State University School of Nursing, and nurse researcher at Indiana University Health Ball Memorial Hospital, Muncie, IN. Debra Siela, PhD, RN, CCNS, ACNS-BC, CCRN-K, CNE, RRT, is an associate professor and critical care clinical nurse specialist at Ball State University School of Nursing, Muncie, IN. Alexis Neal, MA, RN, is a cardiovascular service line leader at Indiana University Health Ball Memorial Hospital, Muncie, IN. Cheryl Riwitis, MSN, RN, FNP-BC, CEN, CFRN, TCRN, EMT-B, is a critical care transport nurse, family nurse practitioner, and nurse educator at Indiana University Health Lifeline, Indianapolis, IN. Heather Beane, MS, RN, is an instructor at Ball State University School of Nursing, and clinical nurse at the Cardiac Intensive Care Unit, Indiana University Health Ball Memorial Hospital, Muncie, IN.

Background: Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Read More

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November 2018
8 Reads

Informing Leadership Models: Nursing and Organizational Characteristics of Neonatal Intensive Care Units in Freestanding Children's Hospitals.

Dimens Crit Care Nurs 2018 May/Jun;37(3):156-166

Cheryl A. Toole, MS, RN, CCRN, NEA-BC, is director of nursing patient services, Neonatal Intensive Care Unit, Cardiovascular and Critical Care Nursing and Patient Services, Boston Children's Hospital, Massachusetts. Michele DeGrazia, PhD, RN, NNP-BC, FAAN, is director of nursing research, Neonatal Intensive Care Unit, Cardiovascular and Critical Care Nursing and Patient Services, Boston Children's Hospital; and assistant professor, Pediatrics Harvard Medical School, Boston, Massachusetts. Jean Anne Connor, PhD, RN, CPNP, FAAN, is director of nursing research, Cardiovascular and Critical Care Nursing and clinical instructor, Pediatrics Patient Services, Boston Children's Hospital, Massachusetts. Kimberlee Gauvreau, ScD, is senior biostatistician, Department of Cardiology, Boston Children's Hospital; and Harvard Medical School, Boston, Massachusetts. Hillary Bishop Kuzdeba, MPH, is program coordinator, Cardiovascular and Critical Care Nursing and Patient Services, Boston Children's Hospital, Massachusetts. Patricia A. Hickey, PhD, MBA, RN, NEA-BC, FAAN, is vice president and associate chief nursing officer, Cardiovascular and Critical Care Nursing and Patient Services, Boston Children's Hospital; and assistant professor, Pediatrics Harvard Medical School, Boston, Massachusetts.

Background: Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes.

Objectives: Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States.

Methods: Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Read More

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November 2018
17 Reads

Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting.

Dimens Crit Care Nurs 2018 May/Jun;37(3):144-155

Katie L. George, DNP, RN, AG-ACNP-BC, CCRN, is an acute care nurse practitioner with the Emergency General Surgery Service at the University of Virginia Health System, Charlottesville, VA. She is also current President of the Monticello Chapter of American Association of Critical Care Nurses (AACN). Her interests include nursing education, critical care, and improving outcomes in surgical patients. Beth Quatrara, DNP, RN, CMSRN, ACNS-BC, is an assistant professor of nursing at the Unversity of Virginia (UVA) School of Nursing, Charlottesville, Virginia. She is also clinical co-director for the UVA Center for Academic Strategic Partnerships for Interprofessional Research and Education (ASPIRE).

Background: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Read More

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November 2018
41 Reads