scholarly journals Deep Impact of Ultrasound in the Intensive Care Unit

2012 ◽  
Vol 117 (4) ◽  
pp. 801-809 ◽  
Author(s):  
Emilpaolo Manno ◽  
Mauro Navarra ◽  
Luciana Faccio ◽  
Mohsen Motevallian ◽  
Luca Bertolaccini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Ultrasound Examination ◽  
Treatment Plan ◽  
Invasive Procedures ◽  
Deep Impact ◽  
High Prevalence ◽  
Critical Patients ◽  
Critical Care Ultrasonography

Background Ultrasound can influence the diagnosis and impact the treatment plan in critical patients. The aim of this study was to determine whether, without encountering major environment- or patient-related limitations, ultrasound examination under a critical care ultrasonography protocol can be performed to detect occult anomalies, to prompt urgent changes in therapy or induce further testing or interventions, and to confirm or modify diagnosis. Methods One hundred and twenty-five consecutive patients admitted to a general intensive care unit were assessed under a critical care ultrasonography protocol, and the data were analyzed prospectively. Systematic ultrasound examination of the optic nerve, thorax, heart, abdomen, and venous system was performed at the bedside. Results Environmental conditions hampered the examination slightly in 101/125 patients (80.8%), moderately in 20/125 patients (16%), and strongly in 4/125 patients (3.2%). Ultrasonographic findings modified the admitting diagnosis in 32/125 patients (25.6%), confirmed it in 73/125 patients (58.4%), were not effective in confirming or modifying it in 17/125 patients (13.6%), and missed it in 3/125 patients (2.4%). Ultrasonographic findings prompted further testing in 23/125 patients (18.4%), led to changes in medical therapy in 22/125 patients (17.6%), and to invasive procedures in 27/125 patients (21.6%). Conclusions In this series of patients consecutively admitted to an intensive care unit, ultrasound examination revealed a high prevalence of unsuspected clinical abnormalities, with the highest number of new ultrasound abnormalities detected in patients with septic shock. As part of rapid global assessment of the patient on admission, our ultrasound protocol holds potential for improving healthcare quality.

scholarly journals PENGALAMAN PERAWAT TENTANG CARING BERBASIS TEKNOLOGI PADA PASIEN KRITIS DI INTENSIVE CARE UNIT

2018 ◽  
Vol 2 (2) ◽  
pp. 70
Author(s):  
Lina Anggraeni ◽  
Suhartini Ismail
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Sampling Technique ◽  
Phenomenological Approach ◽  
Caring Behaviors ◽  
Central Java ◽  
Technological Competence ◽  
Critical Patients ◽  
High Competence

AbstrakICU merupakan suatu unit dengan pasien yang menerima perawatan intensif dan monitoring yang ketat. Untuk itu, diperlukan perawat yang terlatih secara khusus dengan menggunakan teknik yang canggih dan dapat memenuhi kebutuhan dasar dari pasien. Dengan membangun keseimbangan antara aspek perawatan pasien dan teknologi, perawat akan dapat memberikan perawatan yang lebih efisien dengan kualitas yang lebih tinggi. Penelitian ini bertujuan untuk mendeskripsikan pengalaman perawat tentang caring berbasis teknologi pada pasien kritis di intensive care unit. Penelitian ini merupakan penelitian kualitatif dengan pendekatan deskriptif fenomenologi. Penelitian dilakukan di Himpunan Perawat Critical Care Jawa Tengah. Partisipan penelitian sebanyak 10 perawat yang ditentukan dengan metode purpose sampling. Pengumpulan data dilakukan melalui wawancara mendalam kepada partisipan selama 40-60 menit sesuai dengan pedoman wawancara yang telah disusun sebelum penelitian. Data yang terkumpul dianalisa menggunakan metode Colaizzi. Hasil penelitian menghasilkan tiga tema yaitu kompetensi penggunaan teknologi menjadi bagian dari caring yang harus dimiliki perawat, keseimbangan perilaku caring dan kompetensi teknologi perawat di ruang pelayanan kritis, serta maleficient dan beneficient. Perawat ICU harus berperilaku caring yang ditunjukkan dengan memiliki kompetensi yang tinggi pada penggunaan teknologi agar terciptanya perawatan yang lebih baik untuk pasien kritis. Kata kunci: Caring berbasis teknologi, perawat ICU, pasien kritis, intensive care unit AbstractThe nurses’ experiences of technology-based caring in critical patients in the intensive care unit. Intensive Care Unit (ICU) is a unit in which patients receive intensive care and strict monitoring. For this reason, nurses who are specifically trained to use sophisticated techniques and able to meet the basic needs of patients are needed. By developing a balance between the aspects of patient care and technology, nurses will be able to provide more efficient care with higher quality. This study aimed to describe the nurses’ experiences of technology-based caring in critical patients in the intensive care unit. This study was qualitative research with a descriptive phenomenological approach conducted at the Critical Care Nurse Association of Central Java. The participants were ten nurses selected by using purposive sampling technique. The data were collected through in-depth interviews with the participants for 40-60 minutes based on the prepared interview guidelines. The collected data were analyzed using the Colaizzi method.  The results showed three themes that technological competence to be part of the caring that nurses must have, the balance between nurses’ caring behaviors and technological competence in the critical area, then, maleficient and beneficient. Nurses should behave caring which is shown by having high competence using of technology to provide better care for critical patients. Keywords: Caring based on technology, critical nurse, critical patient, intensive care unit

Intensive Care Nurses’ Views and Practices for Eye Care: An International Comparison

2016 ◽  
Vol 26 (4) ◽  
pp. 504-524 ◽  
Author(s):  
Elem Kocaçal Güler ◽  
İsmet Eşer ◽  
Imad Hussein Deeb Fashafsheh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Normal Saline ◽  
Descriptive Study ◽  
Sterile Water ◽  
Eye Care ◽  
Icu Patients ◽  
Intensive Care Nurses ◽  
Critical Patients

Eye care is an important area of critical care. However, lack of eye care studies is a common issue across the globe. The aim of this study is to determine the views and practices of intensive care unit (ICU) nurses on eye care in Turkey and Palestine. This descriptive study was conducted using a self-administrated questionnaire. The data were collected from 111 nurses in nine kinds of ICUs in two education hospital. Normal saline (75.9%) was the most commonly reported solution for eye hygiene among the Palestinian nurses, and gauze soaked in normal saline or sterile water (64.3%) were the most frequently used supplies by the Turkish nurses. Although both Palestinian and Turkish ICU nurses took some precautions to prevent eye complications in critical patients, there were some gaps and insufficiencies in the eye care of ICU patients. There is a need for continuing training in this area.

scholarly journals A Timely Call to Arms: COVID-19, the Circadian Clock, and Critical Care

2021 ◽  
Vol 36 (1) ◽  
pp. 55-70
Author(s):  
Jeffrey Haspel ◽  
Minjee Kim ◽  
Phyllis Zee ◽  
Tanja Schwarzmeier ◽  
Sara Montagnese ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Human Physiology ◽  
Critical Care ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Circadian Clock ◽  
Clinical Course ◽  
Disease Expression ◽  
Severe Manifestation ◽  
Novel Coronavirus

We currently find ourselves in the midst of a global coronavirus disease 2019 (COVID-19) pandemic, caused by the highly infectious novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we discuss aspects of SARS-CoV-2 biology and pathology and how these might interact with the circadian clock of the host. We further focus on the severe manifestation of the illness, leading to hospitalization in an intensive care unit. The most common severe complications of COVID-19 relate to clock-regulated human physiology. We speculate on how the pandemic might be used to gain insights on the circadian clock but, more importantly, on how knowledge of the circadian clock might be used to mitigate the disease expression and the clinical course of COVID-19.

scholarly journals Quality improvement of delirium status communication and documentation for intensive care unit patients during daily multidisciplinary rounds

2018 ◽  
Vol 7 (2) ◽  
pp. e000239 ◽  
Author(s):  
Krishna Aparanji ◽  
Shreedhar Kulkarni ◽  
Megan Metzke ◽  
Yvonne Schmudde ◽  
Peter White ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Tertiary Care ◽  
Care Hospital ◽  
Icu Patients ◽  
Quality Metric ◽  
Risk Of Mortality ◽  
Simulation Based ◽  
Multidisciplinary Rounds

Delirium is a key quality metric identified by The Society of Critical Care Medicine for intensive care unit (ICU) patients. If not recognised early, delirium can lead to increased length of stay, hospital and societal costs, ventilator days and risk of mortality. Clinical practice guidelines recommend ICU patients be assessed for delirium at least once per shift. An initial audit at our urban tertiary care hospital in Illinois, USA determined that delirium assessments were only being performed 31% of the time. Nurses completed simulation based education and were trained using delirium screening videos. After the educational sessions, delirium documentation increased from 40% (12/30) to 69% (41/59) (two-proportion test, p<0.01) for dayshift nurses and from 27% (8/30) to 61% (36/59) (two-proportion test, p<0.01) during the nightshift. To further increase the frequency of delirium assessments, the delirium screening tool was standardised and a critical care progress note was implemented that included a section on delirium status, management strategy and discussion on rounds. After the documentation changes were implemented, delirium screening during dayshift increased to 93% (75/81) (two-proportion test, p<0.01). Prior to this project, physicians were not required to document delirium screening. After the standardised critical care note was implemented, documentation by physicians was 95% (106/111). Standardising delirium documentation, communication of delirium status on rounds, in addition to education, improved delirium screening compliance for ICU patients.

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