scholarly journals Towards definitions of critical illness and critical care using concept analysis

2022 ◽  
Author(s):  
Raphael K Kayambankadzanja ◽  
Carl Otto Schell ◽  
Martin Gerdin Warnberg ◽  
Thomas Tamras ◽  
Hedi Mollazadegan ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
High Risk ◽  
Organ Dysfunction ◽  
Concept Analysis ◽  
Practice Research ◽  
Organ Support ◽  
Vital Organ ◽  
Imminent Death ◽  
Definition Of

Objective As critical illness and critical care lack consensus definitions, this study aims to explore how the concepts are used, describe their defining attributes and propose potential definitions. Design We used the Walker and Avant stepwise approach to concept analysis. The uses and definitions of the concepts were identified through a scoping review of the literature and an online survey of 114 global clinical experts. Through content analysis of the data we extracted codes, categories and themes to determine the concepts defining attributes and we proposed potential definitions. To assist understanding, we present model, related and contrary cases concerning the concepts, we identified antecedents and consequences to the concepts, and defined empirical referents. Results The defining attributes of critical illness were a high risk of imminent death; vital organ dysfunction; requirement for care to avoid death; and potential reversibility. The defining attributes of critical care were the identification, monitoring and treatment of critical illness; vital organ support; initial and sustained care; any care of critical illness; and specialized human and physical resources. Our proposed definition of critical illness is, a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and the potential for reversibility. Our proposed definition of critical care is, the identification, monitoring and treatment of patients with critical illness through the initial and sustained support of vital organ functions. Conclusion The concepts critical illness and critical care lack consensus definitions and have varied uses. Through concept analysis of uses and definitions in the literature and among experts we have identified the defining attributes of the concepts and propose definitions that could aid clinical practice, research, and policy making.

Acute and Critical Care Echocardiography

2017 ◽  
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Organ Support ◽  
Critical Care Echocardiography ◽  
Frequent Use ◽  
Left And Right ◽  
Clinical Questions ◽  
Echocardiographic Images ◽  
And Function ◽  
Time Critical

This is a comprehensive practical guide to the practice of the new subspecialty of critical care echocardiography. The text covers all aspects of clinical practice and describes how to use transthoracic echocardiography to approach and manage common clinical questions. Specific emphasis is placed on the appropriate use of clinical echocardiographic data in the context of the patient’s critical illness; this is illustrated by the frequent use of case studies including both still and moving echocardiographic images. The text covers assessment of, and disorders affecting, the left and right heart, including shock and sepsis. It also looks at how to interpret diastolic information during critical illness and the effect of that illness on valve disease and function. The important subject of fluid responsiveness is explored in detail, as is the influence of organ support and illness on the diagnosis of cardiac tamponade. The information given in the text is summarized using algorithms in a field guide for the critical care echocardiographer, which also provides a rapid guide to assessing time-critical patient presentations.

scholarly journals Analysis of the NANDA-I taxonomy “maternal-fetal dyad” concept in high-risk pregnancy: integrative review

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Ryanne Carolynne Marques Gomes ◽  
Marcos Venícios de Oliveira Lopes ◽  
Jaqueline Galdino Albuquerque Perrelli ◽  
Cleide Maria Pontes ◽  
Francisca Márcia Pereira Linhares ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Literature Review ◽  
Conceptual Analysis ◽  
Concept Analysis ◽  
High Risk Pregnancy ◽  
Analysis Model ◽  
Pregnancy Risk ◽  
Risk Pregnancy ◽  
Definition Of

ABSTRACT Objective: to analyze the NANDA-I taxonomy “maternal-fetal dyad” concept in high-risk pregnancy. Method: an integrative literature review based on the Conceptual Analysis model proposed by Walker and Avant. It was conducted at PUBMED, CINAHL, SCOPUS, LILACS and SciELO, with the descriptors: Complications of pregnancy, Risk Factors, and Pregnancy, High-Risk (from 2008-2020). Result: the sample consisted of 44 articles, which identified two attributes and 21 antecedents of the concept. Conclusion: concept analysis allowed to identify the attributes and antecedents of the “maternal-fetal dyad” concept in high-risk pregnancy, in addition to raising and clarifying ideas. It was possible to identify 12 antecedents that are not included in NANDA-I as well as the need to review the definition of the diagnosis proposed by the taxonomy.

Endocrinology in the critically ill

2011 ◽  
pp. 1554-1563
Author(s):  
Hilke Vervenne ◽  
Greet Van den Berghe
Keyword(s):  
Critical Illness ◽  
High Risk ◽  
Critically Ill ◽  
Anterior Pituitary ◽  
Morbidity And Mortality ◽  
Vital Organ ◽  
Organ Systems

Critical illness is any condition requiring support of failing vital organ systems, without which survival would not be possible. It is characterized by striking alterations in the hypothalamic-anterior-pituitary axes that are known to contribute to the high risk of morbidity and mortality.

scholarly journals Effectiveness of Antimicrobial Filter Placement in ICU Taps to Prevent the Occurrence of HAIs by Pseudomonas aeruginosa (12-Months)

2020 ◽  
Vol 41 (S1) ◽  
pp. s206-s207
Author(s):  
Pablo Chico-Sánchez ◽  
Sandra Canovas-Javega ◽  
Natali J. Jimenez-Sepulveda ◽  
Edith Leutscher-Vasen ◽  
Cesar O. Villanueva-Ruiz ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Critical Care ◽  
Etiologic Agent ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Open Label ◽  
Filter Placement ◽  
Critical Care Units ◽  
Definition Of ◽  
Healthcare Associated

Background:Pseudomonas aeruginosa, is the third etiologic agent of healthcare associated infections, and the most frequent pathogen in ventilator-associated pneumonia (VAP). In critical care units is associated with high mortality, long hospital stay, and high healthcare-associated costs. We evaluated the effectiveness of filter placement in the water taps in critical care units to prevent the occurrence of healthcare-associated infections (HAIa) by Pseudomonas aeruginosa. Methods: This experimental study was both cross-over and open-label in nature. We included patients admitted for >24 hours in critical care units over 24 months. The study was divided into 4 periods of 6 months each. We divided the study into 2 groups: patients in units with filters and patients in units without filters. We compared the incidence density of P. aeruginosa HAIs (number of cases divided by the number of person days) according the ECDC definition of case criteria between the groups. The 2 test was used, and the magnitude of the association was calculated as a rate ratio with a 95% confidence interval, adjusted using a Poisson regression model. Results: Overall, 1,132 patients were included in the study: 595 in units with water tap filters and 537 in units without water tap filters. HAI incidence among patients in units with water tap filters was 5.3 per 1,000 person days stay; without water tap filters, HAI incidence was 4.7 per 1,000 person days stay (HR, 0.94; 95% CI, 0.47–1.90). Conclusions: The preliminary results of this study indicate a a lower incidence of P. aeruginosa HAIs in units with filters placed in water taps than in units without filters.Disclosures: NoneFunding: None

scholarly journals Impact of Critical Care Consultation Requests for Avoidable Central Venous Catheters on Medical-Surgical Units

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s258
Author(s):  
Madhuri Tirumandas ◽  
Theresa Madaline ◽  
Gregory David Weston ◽  
Ruchika Jain ◽  
Jamie Figueredo
Keyword(s):  
Critical Care ◽  
High Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Catheters ◽  
High Risk Population ◽  
Central Venous

Background: Although central-line–associated bloodstream infections (CLABSI) in US hospitals have improved in the last decade, ~30,100 CLABSIs occur annually.1,2 Central venous catheters (CVC) carry a high risk of infections and should be limited to appropriate clinical indications.6,7 Montefiore Medical Center, a large, urban, academic medical center in the Bronx, serves a high-risk population with multiple comobidities.8–11 Despite this, the critical care medicine (CCM) team is often consulted to place a CVC when a peripheral intravenous line (PIV) cannot be obtained by nurses or primary providers. We evaluated the volume of CCM consultation requests for avoidable CVCs and related CLABSIs. Methods: Retrospective chart review was performed for patients with CCM consultation requests for CVC placement between July and October 2019. The indication for CVC, type of catheter inserted or recommended, and NHSN data were used to identify CLABSIs. CVCs were considered avoidable if a PIV was used for the stated indication and duration of therapy, with no anatomical contraindications to PIV in nonemergencies, according to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC).6Results: Of 229 total CCM consults, 4 (18%) requests were for CVC placement; 21 consultations (9%) were requested for avoidable CVCs. Of 40 CVC requests, 18 (45%) resulted in CVC placement by the CCM team, 4 (10%) were deferred for nonurgent PICC by interventional radiology, and 18 (45%) were deferred in favor of PIV or no IV. Indications for CVC insertion included emergent chemotherapy (n = 8, 44%) and dialysis (n = 3, 16%), vasopressors (n = 3, 16%), antibiotics (n = 2, 11%) and blood transfusion (n = 2, 11%). Of 18 CVCs, 9 (50%) were potentially avoidable: 2 short-term antibiotics and rest for nonemergent indications; 2 blood transfusions, 1 dialysis, 2 chemotherapy and 2 vasopressors. Between July and October 2019, 6 CLABSIs occurred in CVCs placed by the CCM team; in 3 of 6 CLABSI events (50%), the CVC was avoidable. Conclusions: More than half of consultation requests to the CCM team for CVCs are avoidable, and they disproportionately contribute to CLABSI events. Alternatives for intravenous access could potentially avoid 9% of CCM consultations and 50% of CLABSIs in CCM-inserted CVCs on medical-surgical wards.Funding: NoneDisclosures: None

Institutional betrayal in nursing: A concept analysis

2021 ◽  
pp. 096973302199244
Author(s):  
Katherine C Brewer
Keyword(s):  
Organizational Behavior ◽  
Moral Distress ◽  
Well Being ◽  
Concept Analysis ◽  
Ethical Culture ◽  
Negative Events ◽  
Moral Standards ◽  
Conceptual Clarity ◽  
Definition Of ◽  
Conceptual Relationships

Background: Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal. Research aim: The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal. Design: This analysis uses the method developed by Walker and Avant. Research context: Studies were reviewed using health literature databases with no date restrictions. Ethical considerations: Analysis was conducted using established guidelines for ethical research. Findings: Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic. Discussion: A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept. Conclusion: In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.

scholarly journals Spiritual nursing care: A concept analysis

Curationis ◽  
2012 ◽  
Vol 35 (1) ◽  
Author(s):  
Lydia V. Monareng
Keyword(s):  
Nursing Care ◽  
Concept Analysis ◽  
Operational Definition ◽  
The Body ◽  
Empirical Literature ◽  
Spiritual Needs ◽  
Optimal Care ◽  
Health Crisis ◽  
Group Interviews ◽  
Definition Of

Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

scholarly journals What is professionalism in occupational therapy? A concept analysis

2021 ◽  
pp. 000841742199437
Author(s):  
Alexandra Lecours ◽  
Nancy Baril ◽  
Marie-Josée Drolet
Keyword(s):  
Occupational Therapy ◽  
Professional Identity ◽  
Cultural Influences ◽  
Occupational Therapists ◽  
Concept Analysis ◽  
Operational Definition ◽  
Analysis Design ◽  
Definition Of ◽  
Over Time ◽  
Extract Information

Background. Professionalism has been given different definitions over time. These are, commonly theoretical and difficult to operationalize. Purpose. This study aimed to provide an operational definition of the concept of professionalism in occupational therapy. Method. Based on a concept analysis design, a meta-narrative review was conducted to extract information from 30 occupational therapy manuscripts. Findings. Professionalism is a complex competence defined by the manifestation of distinct attitudes and behaviours that support excellence in the occupational therapy practice. In addition, professionalism is forged and evolves according to personal and environmental characteristics. The manifestation of professionalism can lead to positive consequences for occupational therapists, clients, and the discipline, notably contributing to a positive and strong professional identity. Moreover, professionalism is also subject to cultural influences, which leads to variations in its development, manifestations, and consequences. Implications. This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance.

Concept Analysis of Family + Health = A New Definition of Family Health

1994 ◽  
Vol 19 (4) ◽  
pp. 207-210 ◽  
Author(s):  
Sandra Kenney Weeks ◽  
Priscilla C. O'Connor
Keyword(s):  
Family Health ◽  
Concept Analysis ◽  
Definition Of
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