scholarly journals Rethinking ‘essential’ and ‘nonessential’: the developmental paediatrician’s COVID-19 response

2020 ◽  
Vol 25 (5) ◽  
pp. 265-267 ◽  
Author(s):  
Alastair Fung ◽  
M Florencia Ricci
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Developmental Disabilities ◽  
Child Development ◽  
Intensive Care Units ◽  
Practical Purpose ◽  
Quality Care ◽  
Emergency Rooms ◽  
Phone Calls ◽  
Provide Quality Care

Abstract While terms such as ‘essential’ and ‘nonessential’ used amidst the COVID-19 pandemic may serve a practical purpose, they also pose a risk of obstructing our view of the harmful indirect health consequences of this crisis. SARS-CoV-2 cases and deaths in children are minimal compared to adults, but the pandemic impacts other ‘essential’ aspects of children’s health including child development and the associated areas of paediatric behaviour, mental health, and maltreatment. Alongside the management of severe SARS-CoV-2 cases in emergency rooms and intensive care units, continuing to care for children with developmental disabilities must also be concurrently championed as ‘essential’ during this crisis. The potentially devastating lifelong effects of the pandemic and isolation on an already vulnerable population demand that action be taken now. Video conferences and phone calls are ‘essential’ instruments we can use to continue to provide quality care for our patients.

An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Coordinated Care ◽  
Community Based ◽  
Provide Quality Care

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

scholarly journals Nursing care time and quality indicators for adult intensive care: correlation analysis

2012 ◽  
Vol 20 (4) ◽  
pp. 651-658 ◽  
Author(s):  
Paulo Carlos Garcia ◽  
Fernanda Maria Togeiro Fugulin
Keyword(s):  
Intensive Care ◽  
Correlation Analysis ◽  
Intensive Care Units ◽  
Quality Indicators ◽  
Nursing Care ◽  
Nursing Staff ◽  
Care Delivery ◽  
Average Length ◽  
Quality Care ◽  
Descriptive Study

The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.

scholarly journals Inter-professional collaboration in an Intensive Care Unit: Challenges and opportunities

Rev Rene ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 10
Author(s):  
Eveline Rodrigues da Silva Barros ◽  
Ana Ecilda Lima Ellery
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Workers ◽  
Quality Care ◽  
Team Leadership ◽  
Professional Collaboration ◽  
Organizational Boundaries ◽  
Challenges And Opportunities ◽  
Provide Quality Care ◽  
The Times

To understand the relationship between health professionals in an intensive care unit, to explore the inter-professional collaboration. Methods: it is a qualitative study, inspired by the Hermeneutics Phenomenology of Paul Ricoeur, for the production of knowledge. Interviews were conducted with 36 intensive care professionals of a tertiary public hospital. Results: the professionals are satisfied with the work, and there is a commitment to provide quality care despite organizational boundaries such as precarious employment relationships and turnover of professionals. The inter-professional collaboration is an indispensable factor for assistance, but in practice is not effective most of the times by the absence of provisions for the integration of the team, leadership presence, as well as the overcrowding of services that overwhelm health workers. Conclusion: while recognizing the need for inter-professional collaboration, professionals do their work even in a very individualized way, with no strategies to boost this cooperation.

scholarly journals Psychiatric intensive care and low secure units: where are we now?

2008 ◽  
Vol 32 (12) ◽  
pp. 441-443 ◽  
Author(s):  
M. Dominic Beer
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Health Services ◽  
Intensive Care Units ◽  
Short Term ◽  
Term Care ◽  
Policy Makers ◽  
General Mental Health ◽  
Department Of Health ◽  
Patient Groups

SummaryThe last decade has seen clinicians and policy makers develop psychiatric intensive care units and low secure units from the so-called ‘special care wards’ of the 1980s and 1990s. Psychiatric intensive care units are for short-term care, while low secure units are for care for up to about 2 years. Department of Health standards have been set for these units. A national survey has shown that there are two main patient groups in the low secure units: patients on forensic sections coming down from medium secure units and those on civil sections who are transferred from general psychiatric facilities. Recent clinical opinion has emphasised the important role both psychiatric intensive care units and low secure units play in providing a bridge between forensic and general mental health services.

scholarly journals Historical Perspectives: Unsilencing Suffering: Promoting Maternal Mental Health in Neonatal Intensive Care Units

NeoReviews ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. e708-e715
Author(s):  
Jessica X. Ouyang ◽  
Jessica L.W. Mayer ◽  
Cynthia L. Battle ◽  
Joanna E. Chambers ◽  
Zeynep N. Inanc Salih
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Maternal Mental Health ◽  
Neonatal Intensive Care Units ◽  
Historical Perspectives

scholarly journals Critical incidents connected to nurses’ leadership in Intensive Care Units

2017 ◽  
Vol 70 (5) ◽  
pp. 1018-1025 ◽  
Author(s):  
Elaine Cantarella Lima ◽  
Andrea Bernardes ◽  
Priscila Lapaz Baldo ◽  
Vanessa Gomes Maziero ◽  
Silvia Helena Henriques Camelo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critical Incident ◽  
Critical Incidents ◽  
Quality Care ◽  
Communication Process ◽  
Leadership Theories ◽  
Leadership Model ◽  
Daily Exercise ◽  
The Face

ABSTRACT Objective: The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Method: Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results: Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets. Final considerations: Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.

Current Practices for Withdrawal of Life Support in Intensive Care Units

2010 ◽  
Vol 19 (6) ◽  
pp. 532-541 ◽  
Author(s):  
Karin T. Kirchhoff ◽  
Jennifer A. Kowalkowski
Keyword(s):  
Intensive Care ◽  
Nursing Education ◽  
Intensive Care Units ◽  
Life Support ◽  
Quality Care ◽  
The United States ◽  
Health Care Team ◽  
Intensive Care Nurses ◽  
Care Plans

BackgroundNurses are present at the bedside of patients undergoing withdrawal of life support more often than any other member of the health care team, yet most publications on this topic are directed at physicians.ObjectivesTo describe the training, guidance, and support related to withdrawal of life support received by nurses in intensive care units in the United States, how the nurses participated, and how the withdrawal of life support occurred.MethodsA questionnaire about withdrawal of life support was sent to 1000 randomly selected members of the American Association of Critical-Care Nurses, with 2 follow-up mailings.ResultsResponses were received from 48.4% of the nurses surveyed. Content on withdrawal of life support was required in only 15.5% of respondents’ basic nursing education and was absent from work site orientations for 63.1% of respondents. Nurses’ actions during withdrawal were most often guided by individual physician’s orders (63.8%), followed by standardized care plans (20%) and standing orders (11.8%). Nurses rated the importance of emotional support during and after the withdrawal of life support very highly, but they did not believe they were receiving that level of support. Most respondents (87.5%) participated in family conferences where withdrawal of life support was discussed. After physicians, nurses were most influential concerning administration of palliative medications. Patients’ families were present during withdrawal procedures between 32.3% and 58.4% of the time.ConclusionsTo improve their practice, intensive care nurses should receive formal training on withdrawal of life support, and institutions should develop best practices that support nurses in providing the highest quality care for patients undergoing this procedure.

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