scholarly journals Operational Policies and Procedures for Critical Care Transport During a Respiratory Pandemic

Author(s):  
Michael A. Frakes ◽  
Todd Denison ◽  
David C. Leisten ◽  
Jennifer Wheeler ◽  
James Boomhower ◽  
...  
Author(s):  
Emily S. Patterson ◽  
Anne McIntire ◽  
Nicholas Beecroft ◽  
Mary Beth Happ ◽  
Susan D. Moffatt-Bruce

Translating validated handover protocols from physicians in non-critical care settings to nursing report in critical care is challenging. Our objectives are to identify information content in verbal reports, where information is documented, and the function of non-documented communication. This is a descriptive study of 20 reports describing 27 patients from two medical intensive care units. Analysis involved unique coding of phrases and emergent themes analysis. Information categories included: Identify patient (51.9%); Narrative history (96.3%); Unusual symptoms (88.9%); Response to care (37%); Status of tasks (100%); Expectations of patients and families (55.6%). Information is documented in progress notes, the medication administration record, nursing flowsheets, lab results, orders, and past medical history. Information not typically documented supports providing patient-centered care, sharing clinical judgments, coordinating work, and mentorship. These objectives may guide nursing administrators in tailoring policies and procedures for nursing report to the needs of registered nurses in a critical care setting.


1991 ◽  
Vol 2 (1) ◽  
pp. 31-39
Author(s):  
Glenda A. Krum

A dilemma in critical care nursing practice is how to develop and implement a practical quality assurance program that incorporates high-quality standards of nursing care for critically ill patients and addresses those aspects of care considered important by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Standards for Nursing Care of the Critically Ill defines and describes structure and process standards and provides a comprehensive guide for the development of a program for the delivery of quality care to critically ill patients. The purpose of this chapter is to discuss practical application of the standards described by the American Association of Critical-Care Nurses (AACN) through the use of policies and procedures that support structure and process standards


2003 ◽  
Vol 12 (4) ◽  
pp. 361-366 ◽  
Author(s):  
Margaret Hodge ◽  
Larry D. Kochie ◽  
Leslie Larsen ◽  
Maurine Santiago

The application of research findings to practice is critical for improving patients’ outcomes and for ensuring that nursing practice is both cost-efficient and effective. Unfortunately, research findings that clearly should be used are not always implemented, a fact termed the “research-practice gap.” In 2000, as a result of the interest of staff nurses in establishing evidence-based practice, nurses from 7 adult critical care units at the University of California Davis Health System, Sacramento, Calif, began discussions on how to implement such a practice. A critical care research utilization committee was formed with representation from each of the adult critical care units, the emergency department, and the postanesthesia care unit. This committee was responsible for reviewing and revising each critical care policy and procedure on the basis of the best available evidence. The impetus for this project was a concern that current policies and procedures were, in part, based on tradition rather than on science and did not always reflect rapid changes in critical care, including use of new equipment, new treatments, and new findings. This project produced a number of beneficial outcomes. Policies and procedures were revised on the basis of scientific evidence, new research questions were generated on the basis of gaps in the literature, and the number of clinical nurses involved in using research to improve practice increased.


1998 ◽  
Vol 18 (1) ◽  
pp. 83-87 ◽  
Author(s):  
SJ Fetzer

The laryngeal mask airway is the newest tool for airway management during the perianesthesia period. This device has joined other resuscitation equipment on emergency carts. Critical care nurses must be prepared to care for patients for whom laryngeal mask airways are indicated and used. A solid understanding of the purpose and placement of the laryngeal mask airway is necessary for safe removal of the device. Policies and procedures should be developed to define standards of care and responsibilities for care of patients with a laryngeal mask airway.


Author(s):  
Maria Verzbolovskis ◽  
Jorge Ballesio

Change is inevitable in any type of business. Successful organizations are dynamic and are constantly undergoing change, striving for innovative and cost-effective solutions to achieve sustainability in a robust and competitive business environment. Modifications may be required to equipment, operational policies, and organizational structure or personnel. History has illustrated the potential negative consequences associated with changes that are not managed appropriately. Common problems with respect to the implementation of a change include: • changes that are not technically sound, • lack of careful consideration of the ramifications, • poor execution, and • failure to effectively communicate change information to key personnel. A Management of Change (MoC) system is a combination of policies and procedures used to evaluate the potential impacts of a proposed change so that it does not result in unacceptable risks. A thorough MoC system manages both temporary and permanent modifications in a ship or offshore unit including equipment, materials, operating procedures and conditions, and personnel. An effective MoC system will not only minimize significant impacts on safety and the environment, but will incorporate strategies in managing the associated business risks on quality, continued commerce and security. A system requiring MoC for every modification is likely to become onerous and unproductive. This paper provides guidance for selection of the activities and systems to be subject to management of change, the life-cycle applicability, types of changes to be evaluated, and boundaries and overlaps with other administrative programs or elements. It describes key functions and interrelationships for personnel at various levels of a representative organization. In summary, this paper describes the core principles to be considered when developing and implementing an MoC program that will optimize existing safety and risk management efforts.


Author(s):  
David C. Leisten ◽  
Jennifer Wheeler ◽  
James Boomhower ◽  
Michael A. Frakes ◽  
Todd Denison ◽  
...  

Abstract The severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2) pandemic of 2020-2021 created unprecedented challenges for clinicians in critical care transport (CCT). These CCT services had to rapidly adjust their clinical approaches to evolving patient demographics, a preponderance of respiratory failure, and transport utilization stratagem. Organizations had to develop and implement new protocols and guidelines in rapid succession, often without the education and training that would have been involved pre-coronavirus disease 2019 (COVID-19). These changes were complicated by the need to protect crew members as well as to optimize patient care. Clinical initiatives included developing an awake proning transport protocol and a protocol to transport intubated proned patients. One service developed a protocol for helmet ventilation to minimize aerosolization risks for patients on noninvasive positive pressure ventilation (NIPPV). While these clinical protocols were developed specifically for COVID-19, the growth in practice will enhance the care of patients with other causes of respiratory failure. Additionally, these processes will apply to future respiratory epidemics and pandemics.


2020 ◽  
Vol 49 (1) ◽  
pp. 42-42
Author(s):  
Jennifer Wang ◽  
Jaime Hyman ◽  
Sanam Ahmed ◽  
Joshua Hamburger ◽  
Jean Hsieh ◽  
...  

1994 ◽  
Vol 3 (6) ◽  
pp. 409-415 ◽  
Author(s):  
J Kaye ◽  
CG Donald ◽  
S Merker

BACKGROUND. Sexual harassment in the workplace is a prevalent form of impermissible sex discrimination in employment. The high profile of this issue in the media, together with laws prohibiting sexual harassment, have not prevented this problem for working nurses. OBJECTIVES. To describe and determine the extent of sexual harassment incidents experienced by nurses working in critical care areas, and to determine attitudes about, and presence of policies regarding, sexual harassment in hospitals. METHODS. For this descriptive study the federal government's definition of sexual harassment and a list of sexually harassing behaviors was mailed with a survey to 188 critical care nurses. RESULTS. Findings indicated that 46% of the respondents had been harassed. Offensive sexual remarks (56%), unwanted physical contact (53%), unwanted nonverbal attention (27%), requests for dates (16%), and sexual propositions (9%) were types of sexual harassment experienced. Sexual assault was experienced by one woman. Harassers were physicians (82%), coworkers (20%), or immediate supervisors (7%). A majority of the incidents (69%) were not reported. Most nurses (80%) had not received training, nor were there policies and procedures to follow in most cases for reporting harassment. CONCLUSIONS. These results suggest that many critical care nurses are harassed and that relatively few hospitals have sexual harassment policies known to employees. They also indicate that sexual harassment training, policies, and procedures are needed to provide a safe, healthy work environment for critical care nurses.


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