scholarly journals Words Faithful to the Phenomenon

2018 ◽  
Vol 17 (1) ◽  
pp. 160940691879779
Author(s):  
Luigina Mortari ◽  
Roberta Silva
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Critical Care ◽  
Intensive Care ◽  
Phenomenological Approach ◽  
Discursive Practice ◽  
Team Members ◽  
The Creation ◽  
Do So

The article presents the developing of a tool aimed to analyze the decision-making (DM) processes in critical care contexts. It was developed in a study conducted through a phenomenological approach. By analyzing the discursive practice through which physicians in an intensive care unit (ICU) arrive at decisions, we construct a discursive profile of each ICU involved, to improve the ICU team members’ knowledge of the complexity of their DM processes. To do so, we develop a system of analysis capable of capturing discursive actions faithfully. Our method facilitates a system of analysis that highlights the role of the various discursive acts in conversational flow, starting from the needs in an ICU setting, which are spontaneously recognized from the data, to the almost simultaneous processes of description and understanding. This has led to the creation of a tool follows the phenomenological-grounded route.

Organization and Structure of the Cardiothoracic Intensive Care Unit

2015 ◽  
pp. 86-104
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

Oncology ◽  
2017 ◽  
pp. 709-727
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

scholarly journals The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention

2016 ◽  
Vol 3 (4) ◽  
pp. 108-118 ◽  
Author(s):  
Kelly N Michelson ◽  
Joel Frader ◽  
Lauren Sorce ◽  
Marla L Clayman ◽  
Stephen D Persell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Stakeholder Engagement ◽  
Pediatric Intensive Care ◽  
Healthcare Team ◽  
Team Members ◽  
Core Elements ◽  
Stakeholder Input

Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

scholarly journals The role of speech and language therapists in the intensive care unit

2019 ◽  
Vol 21 (4) ◽  
pp. 344-348 ◽  
Author(s):  
Jackie McRae ◽  
Elizabeth Montgomery ◽  
Zoë Garstang ◽  
Eibhlin Cleary
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Multidisciplinary Team ◽  
Skills Development ◽  
Technological Innovations ◽  
Speech And Language ◽  
National Guidance

National guidance recommends the involvement of speech and language therapists in intensive care particularly for those requiring tracheostomy and ventilation. However, the role of speech and language therapists is poorly understood especially in the context of critical care. This article aims to increase awareness of the background training and skills development of speech and language therapists working in this context to demonstrate their range of specialist abilities. Speech and language therapists support and enhance the process of laryngeal weaning alongside the rehabilitation of speech and swallowing as part of the multidisciplinary team. Examples are provided of the types of interventions that are used and technological innovations that may enhance rehabilitation of oropharyngeal impairments.

scholarly journals The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e55964 ◽  
Author(s):  
Zainna C. Meyer ◽  
Jennifer M. J. Schreinemakers ◽  
Paul G. H. Mulder ◽  
Ruud A. L. de Waal ◽  
Antonius A. M. Ermens ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Sofa Score ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Surgical Patients ◽  
C Reactive Protein ◽  
Reactive Protein

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

INFORMED CONSENT

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 556-556
Author(s):  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Informed Consent ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Newborn Baby ◽  
Maximum Extent ◽  
The Family ◽  
Do So

Let us address ourselves to the problem of informed consent. I believe, as a physician who has had prior contact with the family, that I can persuade 99% of parents to my way of thinking if I really work at it, even if I am 100% wrong. If I tell them in such a way that I appear concerned and that I am knowledgeable and that I have their interests at heart and the interest of their foetus or their newborn baby, there is no question they will be totally agreeable to my suggestion. I think informed consent is an absolute farce, legalistically, morally and ethically. The information is what I want it to be. Certainly, the physician must try to involve the parents in decision making. He should do so to the maximum extent feasible, but we are fooling ourselves if we believe that the parent or the physician can make all the decisions.—Director of a Neonatal Intensive Care Unit.

The tracheostomy clinical nurse specialist: an essential member of the multidisciplinary team

2014 ◽  
Vol 128 (2) ◽  
pp. 171-173 ◽  
Author(s):  
R Crosbie ◽  
J Cairney ◽  
N Calder
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidisciplinary Team ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Intensive Care Unit Treatment ◽  
Common Procedure ◽  
Clinical Nurse ◽  
The Creation

AbstractBackground:Tracheostomies are a common procedure within the specialties of otolaryngology and intensive care. The ENT department at Monklands Hospital has developed the position of tracheostomy clinical nurse specialist to improve the management of tracheostomy patients. There is evidence to support the development of a multidisciplinary team for the management of tracheostomy patients following intensive care unit treatment; however, the creation of a specific tracheostomy clinical nurse specialist position has not been widely endorsed in the literature.Objective:This paper describes the role of the tracheostomy clinical nurse specialist, advocating this position within the multidisciplinary team.

Sign in / Sign up

Export Citation Format

Share Document