194 results match your criteria Dynamics [Journal]


Vasopressor stewardship: a case report and lesson shared.

Dynamics 2014 ;25(1):26-9

A case report, focused on vasopressor use and presented in this article, is likely to resonate with many critical care nurses. In this article the authors describe opportunities to enhance safety with vasopressor therapy. Specifically, the goal of improving communication among physicians, nurses, and pharmacists around desired endpoints for vasopressor therapy, triggers for reassessment of the therapeutic strategy and cause of the patient's shock was identified as an area for improvement. Read More

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May 2014
15 Reads

Subglottic secretion volume and viscosity: effect of systemic volume and oral hydration.

Dynamics 2014 ;25(1):19-25

Objectives: Removal of secretions from the subglottic space, which is the larynx cavity below the glottis that contains the vocal cords, reduces the risk for ventilator associated pneumonia. Relationships between factors associated with subglottic secretion volume and viscosity have not been investigated. Subglottic secretions may have a possible link with systemic volume status and oral cavity hydration. Read More

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May 2014
11 Reads

The relation of critical care nurses' information-seeking behaviour with perception of personal control, training, and non-routineness of the task.

Dynamics 2014 ;25(1):13-8

Aims: The purpose of the study was to examine the relationship between (1) critical care nurses' information-seeking behaviour and the non-routineness of tasks; and (2) the extent to which nurses' perception of their problem-solving abilities when completing patient care tasks, moderate the relationship between information-seeking behaviour and non-routineness of tasks.

Methods: A cross-sectional survey design was used. A random sample (n = 177) of critical care nurses working in hospital settings was selected from the College of Nurses of Ontario (CNO) database. Read More

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May 2014
7 Reads

Speak with conviction.

Authors:
Teddie Tanguay

Dynamics 2014 ;25(1):5-6

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May 2014
9 Reads

Consenting to pediatric critical care research: understanding the perspective of parents.

Dynamics 2013 ;24(3):18-24

Children's Hospital of Eastern Ontario, Ottawa, ON.

Unlabelled: Pediatric clinical research is dependent on obtaining consentfrom the parents or legal guardian of eligible patients. Little is known about parents' perspectives and the process by which they make the decision to enroll their child in a pediatric critical care trial.

Objective: To describe the experience of parents/legal guardians who consented or declined consent for their child to be enrolled in a pediatric critical care research study. Read More

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January 2014
14 Reads

The experience of critically ill children: A phenomenological study of discomfort and comfort.

Dynamics 2013 ;24(1):19-27

Department of Pediatrics, McGill University, Montreal, QC.

Background: Emerging evidence indicates that critically ill children are particularly at risk for incurring significant psychological harm. Little is known about these children's actual experiences.

Aim: The aim of the study was to examine children's experience of critical illness. Read More

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August 2013
13 Reads

An exploration of knowledge, attitudes and beliefs toward organ and tissue donation among the adult Haitian population living in the Greater Montreal area.

Dynamics 2013 ;24(1):12-8

McGill University Health Centre.

Background: The decision to donate organs and tissues has the potential to save and improve the quality of life of the transplant recipient. Previous studies suggest lack of information, fears, and prejudices have prevented some cultural minorities from participating in organ and tissue donation (OTD). There is scarce information about the views of those who might be approached for potential donation in the Haitian community. Read More

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August 2013
20 Reads

Critical thinking.

Authors:
Teddie Tanguay

Dynamics 2013 ;24(1)

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August 2013
11 Reads

The building bridges initiative: learning with, from and about to create an interprofessional end-of-life program.

Dynamics 2012 ;23(4):37-41

Medical Surgical Intensive Care Unit, Toronto General Hospital, University Halth Network, Toronto, ON.

In this paper, the authors outline the rationale, planning, delivery, results, evaluation and knowledge transfer strategies employed in offering an eight-hour education day offered 12 times in 2010, to a total of 200 staff in three Toronto General Hospital (TGH) intensive care units (ICU) at the University Health Network (UHN). The integration of members from the point-of-care staff teams into the planning, development, presentation and attendance was a critical success factor for this initiative. Organizers and participants had the opportunity to build bridges with each other and across teams and programs by engaging in interprofessional learning, sharing narratives and consolidating increasing awareness of resources with facilitation from staff from nursing, medicine, palliative care, bioethics, social work, physiotherapy, respiratory therapy, wellness and spiritual care. Read More

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February 2013
16 Reads

Delirium in the intensive care unit: role of the critical care nurse in early detection and treatment.

Authors:
Terra Olson

Dynamics 2012 ;23(4):32-6

Grant MacEwan University, Edmonton, AB.

Critically ill patients are at increased risk of developing delirium, which has been considered one of the most common complications of intensive care unit (ICU) hospitalization. Despite the high occurrence of delirium in the ICU, researchers have shown it is consistently overlooked and often undiagnosed. An understanding of delirium and the three clinical subtypes of hyperactive, hypoactive and mixed-type delirium that exist are key to early detection and treatment. Read More

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http://www.ajan.com.au/Vol33/Issue1/6Bulic.pdf
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February 2013
18 Reads

Burnout in critical care nurses: a literature review.

Authors:
Kirstin Epp

Dynamics 2012 ;23(4):25-31

Grey Nuns Community Hopsital, Edmonton, AB.

Burnout and its development in critical care nurses is a concept that has received extensive study, yet remains a problem in Canada and around the world. Critical care nurses are particularly vulnerable to developing burnout due to the chronic occupational stressors they are exposed to, including high patient acuity, high levels of responsibility, working with advanced technology, caring for families in crisis, and involved in morally distressing situations, particularly prolonging life unnecessarily. The purpose of this article is to explore how the chronic stressors that critical care nurses are exposed to contribute to the development of burnout, and strategies for burnout prevention. Read More

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February 2013
55 Reads

A survey of nurses' perceptions of the intensive care delirium screening checklist.

Dynamics 2012 ;23(4):18-24

Department of Anesthesia, University of Toronto, Toronto, Canada.

Objectives: Delirium in critically ill patients is common and is associated with increased morbidity and mortality. Routine delirium screening is recommended by the Society of Critical Care Medicine. The Intensive Care Delirium Screening Checklist (ICDSC) is one validated and commonly-used tool, but little is known about nurses'perceptions of using the ICDSC, and of barriers to delirium assessment and treatment. Read More

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February 2013
22 Reads

Monitor alarm fatigue.

Authors:
Judy Rashotte

Dynamics 2013 ;24(4):42-3

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April 2014
28 Reads

Reflective debriefing to promote novice nurses' clinical judgment after high-fidelity clinical simulation: a pilot test.

Dynamics 2013 ;24(4):36-41

Background: Novice nurses are increasingly beginning their career paths in critical care areas, where they are expected to care for patients whose lives are potentially threatened. They are unable to benefit from years of experience to facilitate their clinical decisions. Reflection after simulation could possibly improve nurses' clinical judgment in complex situations. Read More

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April 2014
9 Reads

Napping during breaks on night shift: critical care nurse managers' perceptions.

Dynamics 2013 ;24(4):30-5

Background: Fatigue associated with shiftwork can threaten the safety and health of nurses and the patients in their care. Napping during night shift breaks has been shown to be an effective strategy to decrease fatigue and enhance performance in a variety of work environments, but appears to have mixed support within health care.

Purpose: The purpose of this study was to explore critical care unit managers'perceptions of and experiences with their nursing staff's napping practices on night shift, including their perceptions of the benefits and barriers to napping/not napping in terms of patient safety and nurses'personal health and safety. Read More

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April 2014
121 Reads

Supreme Court ruling.

Authors:
Marie Edwards

Dynamics 2013 ;24(4):14-5

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April 2014
6 Reads

BiVADs: a bridge to the future for patients and their families: the art and science of nursing combined in the face of technology.

Dynamics 2012 ;23(3):20-3

School of Nursing, McGill University, Montreal, QC.

Approximately 500,000 Canadians live with heart failure (Ross et al., 2006). These numbers continue to rise due to advancing technology and successes in treating cardiac conditions and potentially fatal events such as myocardial infarctions. Read More

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November 2012
11 Reads

Survey of Canadian critical care nurses' experiences of conflict in intensive care units.

Dynamics 2012 ;23(3):15-9

Faculty of Nursing, University of Manitoba, Winnipeg, MB.

The purpose of this study was to enhance our understanding of Canadian critical care nurses' experiences of and responses to situations of conflict in the ICU. Through a 35-item web-based survey, members of the Canadian Association of Critical Care Nurses were asked questions regarding the types, causes and frequency of conflict experienced, the nursing interventions found most helpful in situations of conflict, and the resources found most helpful in responding to situations of conflict. A total of 241 nurses responded to the survey. Read More

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November 2012
6 Reads

It is not what you leave behind ... it is what you take with you that counts!

Authors:
Teddie Tanguay

Dynamics 2012 ;23(2)

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August 2012
6 Reads

Charting a new course in knowledge: creating life-long critical care thinkers.

Dynamics 2012 ;23(1):24-8

Registered Nurses Professional Development Centre, Halifax, NS.

The Registered Nurses Professional Development Centre's Critical Care Nursing Program situated in Halifax, Nova Scotia, aspires to provide evidence-based critical care nursing education. Using a didactic traditional lecture-based teaching method, the faculty noted that some learners were not prepared for class, preferred memorization of content and were not engaged in their learning. In 2008, faculty acknowledged the need to change their principal teaching method in the full-time program to a method that would foster student engagement and active learning while inspiring registered nurses to become life-long critical thinkers. Read More

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June 2012
8 Reads

Journal club in a critical care unit: an innovative design triggering learning through reading and dialogue.

Dynamics 2012 ;23(1):18-23

Jewish General Hospital, Intensive Care Unit, Montreal, QC.

Journal club has been used for decades to incorporate reading clinical and research articles into professional practice of numerous health care providers to disseminate knowledge and to bridge the gap between research and clinical practice. In this article, the authors describe how such activity was implemented by and for the nursing team of an intensive care unit. This journal club was designed to trigger dialogue among the nurses related to cardiac surgery topics, while providing an organizational support for them aimed to facilitate the incorporation of reading in their professional habits. Read More

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June 2012
5 Reads

Critical care nurses' information-seeking behaviour during an unfamiliar patient care task.

Dynamics 2012 ;23(1):12-7

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, ON.

Critical care nurses complete tasks during patient care to promote the recovery or maintain the health of their patients. These tasks can be routine or non-routine to the nurse. Non-routine tasks are characterized by unfamiliarity, requiring nurses to seek additional information from a variety of sources to effectively complete the tasks. Read More

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June 2012
10 Reads

It is not what you leave behind...it is what you take with you that counts!

Authors:
Kate Mahon

Dynamics 2012 ;23(1):5-6

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June 2012
5 Reads

Caring for patients and families at end of life: the experiences of nurses during withdrawal of life-sustaining treatment.

Dynamics 2011 ;22(4):31-5

University of Ottawa, School of Nursing.

Background: Withdrawal of life-sustaining treatment is a process in which active treatment and the accompanying technology are removed, ending in the death of the patient.

Purpose: To understand the lived experience of critical care nurses who care for patients during the process of withdrawal of life-sustaining treatment.

Methods: A phenomenological study was undertaken and interviews were conducted with six critical care nurses. Read More

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February 2012
14 Reads

Practical steps for discontinuation of life-sustaining treatment.

Authors:
Lara Parker

Dynamics 2011 ;22(4):38-40

British Columbia Institute of Technology, Vancouver General Hospital, Vancouver, B.C..

Discontinuing life-sustaining interventions requires an artful skill perhaps even more challenging than providing life-sustaining treatments. Critical care nurses require advanced skills to provide comfort care and, ultimately, a "good death" that encompasses the family and patient. Educational focus has been placed on maintaining the living, but with increasing palliation in critical care, education must include comfort care. Read More

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February 2012
4 Reads

Last rights: guidelines for religious accommodation at end of life.

Authors:
Klara Siber

Dynamics 2011 ;22(4):36-7

Sunnybrook Health Science Centre, Toronto, Ontario.

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February 2012
6 Reads

Conversations about challenging end-of-life cases: ethics debriefing in the medical surgical intensive care unit.

Dynamics 2011 ;22(4):26-30

Critical Care Department, St. Michael's Hospital, Toronto, Ontario.

Clinicians frequently encounter and grapple with complex ethical issues and perplexing moral dilemmas in critical care settings. Intensive care unit (ICU) clinicians often experience moral distress in situations in which the ethically right course of action is intuitively known, but cannot be acted on. Most challenging cases pertain to end-of-life issues. Read More

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February 2012
165 Reads

Learning end-of-life care in ICU: strategies for nurses new to ICU.

Dynamics 2011 ;22(4):22-5

University of Ottawa, School of Nursing.

The experience of critical care nurses caring for patients and families during the withdrawal of life support has recently been explored (Vanderspank-Wright, Fothergill Bourbonnais, Brajtman, & Gagnon, 2011). In that study, the nurses were able to find, using their developing knowledge and experience, their own way, over time, through the process of withdrawing life support. Challenges in caring for patients and families were described by the participants in themes such as "the runaway train of technology," which explored nurses' experience of caring in a technologically complex environment. Read More

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February 2012
20 Reads

Critical care nursing: our kaleidoscope.

Authors:
Pamela Cybulski

Dynamics 2011 ;22(4):14-5

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February 2012
7 Reads

A critical care nurse's role in the provision of end-of-life care.

Authors:
Pamela Cybulski

Dynamics 2011 ;22(4):7-8

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February 2012
5 Reads

In praise of servant leadership--horizontal service to others.

Authors:
Kate Mahon

Dynamics 2011 ;22(4):5-6

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February 2012
5 Reads

Drug name alert: potential for confusion between pradax and plavix.

Dynamics 2011 ;22(3):25-6

Institute for Safe Medication Practices Canada.

In this article, the authors highlight an incident that involved a mix-up between the oral anticoagulant medication Pradax (dabigatran etexilate) and the antiplatelet medication Plavix (clopidogrel). Because critical care nurses may admit or care for patients who are receiving (or have received) one of these medications, it is important that they be aware of the potential for confusion between these two drug names throughout the medication-use process. Read More

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November 2011
5 Reads

Cerebrospinal fluid collection: a comparison of different collection sites on the external ventricular drain.

Authors:
Frankie W H Wong

Dynamics 2011 ;22(3):19-24

Clinical Neurosciences Department, Calgary Zone Alberta Health Services, Calgary, AB.

Background: Intracranial pressure monitoring using an external ventricular drainage (EVD) system is the most commonly used technology to monitor intracranial pressure or drain cerebrospinal fluid (CSF) in neurological and neurosurgical patients. CSF samples are collected routinely from the EVD system for laboratory tests. No study has been conducted to identify where the most appropriate site for CSF collection is in order to reduce the disruption of the closed EVD system and reduce the risk of infection. Read More

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November 2011
7 Reads

Increased mortality among the critically ill patients admitted on weekends: a global trend.

Dynamics 2011 ;22(3):14-8

Grant MacEwan University, Edmonton, AB.

Critical illness and injury have no concept of time and do not always occur within regular business hours or at times conducive to optimal hospital function. In fact, it is a global trend that critically ill patients admitted to hospitals on weekends suffer higher mortality rates than those admitted during the week. Using a Canadian nursing lens, it is clear that there are some obvious differences in hospital function on weekends that include decreased hospital staffing, access to diagnostic services, intensivist coverage and the reluctance of patients to seek care on weekends. Read More

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November 2011
4 Reads

The impressions we leave...

Authors:
Kate Mahon

Dynamics 2011 ;22(3):5-6

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November 2011
6 Reads

Dynamics of Critical Care 2010, Edmonton, Alberta, September 19-21, 2010. Abstracts.

Authors:

Dynamics 2010 ;21(2):13-42

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September 2011
4 Reads

Position statement: structure of critical care units.

Authors:

Dynamics 2011 ;22(2):13-4

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July 2011
54 Reads

Our voice... it is in our stories...

Authors:
Kate Mahon

Dynamics 2011 ;22(2):5-6

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July 2011
5 Reads

ALERT: mix-ups between conventional and lipid formulations of amphotericin B can be extremely dangerous.

Dynamics 2011 ;22(1):24-6

Institute for Safe Medication Practices Canada.

In this column, the authors review Amphotericin B incidents reported Although amphotericin B may be less commonly used today because to ISMP Canada. In particular, we focus on incidents reported to have of alternative antifungal agents available, incident reports suggest resulted in patient harm due to mix-ups between the conventional there continues to be a need to alert practitioners to the different (non-lipid)formulation and lipid formulations of amphotericin B. formulations, and to implement system safety strategies. Read More

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June 2011
13 Reads

The intensive care unit as an untapped learning resource: a student perspective.

Dynamics 2011 ;22(1):19-23

McGill University, Montreal, QC.

The nursing student's clinical experience serves to form a bridge between the theoretical knowledge of the classroom and its application to patient care. The intensive care unit (ICU) has not traditionally been considered an ideal placement for undergraduate nursing students (Ballard & Trowbridge, 2004). However, in the fall of 2008, with a rise in enrolment, the school was faced with finding more clinical sites to accommodate our placement needs. Read More

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June 2011
10 Reads

Position statement: clinical nurse specialist in critical care.

Authors:

Dynamics 2011 ;22(1):14-5

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June 2011
5 Reads

Position statement: nurse practitioner in critical care.

Authors:

Dynamics 2011 ;22(1):12-3

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June 2011
5 Reads

Position statement: advanced nursing practice in critical care.

Authors:

Dynamics 2011 ;22(1):11

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June 2011
5 Reads

Position statement: providing end-of-life care in the intensive care unit.

Authors:

Dynamics 2011 ;22(1):9-10

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June 2011
5 Reads

It is all about perspective.

Authors:
Kate Mahon

Dynamics 2011 ;22(1):5-6

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June 2011
5 Reads

Novice nurses' first death in critical care.

Dynamics 2010 ;21(4):26-36

Misericordia Hospital-Covenant Health, Edmonton, AB.

Background: The curative focus of critical care and the advanced technology may overshadow the fact that critically ill patients die. Research investigating critical care nurses involvement with death has predominately focused on experienced nurses, but these findings may not be applicable to novice nurses. Increasingly, novice nurses are beginning their careers in critical care and there is minimal research describing their experiences with death. Read More

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February 2011
6 Reads

Development, dissemination and implementation of a sedation and analgesic guideline in a pediatric intensive care unit...it takes creativity and collaboration.

Dynamics 2010 ;21(4):16-25

Pediatric Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa.

Sedation and analgesia are administered to critically ill children to provide comfort and pain relief, decrease anxiety and to promote patient safety in relation to life-saving treatments. A comprehensive practice guideline focused on ways to implement evidence-based sedation and analgesia practices was developed, disseminated and implemented by an interprofessional team in the pediatric intensive care unit (PICU) at the Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada. The goals of this quality of care initiative were to (1) reduce inconsistent practices, (2) improve patient outcomes related to comfort, and (3) enhance collaboration among health care team members caring for critically ill children. Read More

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February 2011
11 Reads

Find your voice!

Authors:
Kate Mahon

Dynamics 2010 ;21(4):5-6

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February 2011
5 Reads

Hospitals report on medication safety in Canada.

Dynamics 2010 ;21(3):28-30

Institute for Safety Medication Practices Canada.

Measurement of safety can be difficult. Given that incident reporting systems rely primarily on voluntary reporting and some types of medication incidents may occur rarely, lack of reports about a particular type of incident cannot be interpreted as evidence that the underlying causes are resolved. Proxy measurements, such as the level of implementation of evidence-based practices known to reduce the risk of a particular incident, may provide an indication of progress toward safer systems. Read More

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November 2010
9 Reads