Barriers to the implementation of checklists in the ICU: a survey on the perceptions of 314 Brazilian critical care nurses and physicians

• Background Language barriers are significant impediments to providing quality healthcare, and increased stress levels among nurses and physicians are associated with these barriers. However, little evidence supports the usefulness of a translation tool specific to healthcare. • Objectives To evaluate the effectiveness of a novel English-Spanish translator designed specifically for nurses and physicians. The hypothesis was that the translator would be useful and that use of the translator would decrease stress levels among nurses and physicians caring for Spanish-speaking patients. • Methods Novel English-Spanish translators were developed entirely on the basis of input from critical care nurses and physicians. After 7 months of use, users completed surveys. Usefulness of the translator and stress levels among users were reported. • Results A total of 60% of nurses (n = 32) and 71% (n = 25) of physicians responded to the survey. A total of 96% of physicians and 97% of nurses considered the language barrier an impediment to delivering quality care. Nurses reported significantly more stress reduction than did physicians (P = .01). Most nurses and physicians had used the translator during the survey period. Overall, 91% of nurses and 72% of physicians found that the translator met their needs at the bedside some, most, or all of the time. All nurses thought that they most likely would use the translator in the future. • Conclusions The translator was useful for most critical care nurses and physicians surveyed. Healthcare providers, especially nurses, experienced decreased stress levels when they used the translator.

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Monitoring Delirium in the Intensive Care Unit Practices, perceptions and attitudes of critical care nurses and physicians. A French National Survey

Intensive and Critical Care Nursing ◽

10.1016/j.iccn.2021.103178 ◽

2021 ◽

pp. 103178

Author(s):

C. Alaterre ◽

C. Fazilleau ◽

J.M. Constantin ◽

A. James

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

National Survey ◽

Critical Care Nurses ◽

Perceptions And Attitudes ◽

Nurses And Physicians

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Readiness of critical care physicians and nurses to handle requests for organ donation

American Journal of Critical Care ◽

10.4037/ajcc1998.7.1.4 ◽

1998 ◽

Vol 7 (1) ◽

pp. 4-12 ◽

Cited By ~ 75

Author(s):

MJ Evanisko ◽

CL Beasley ◽

LE Brigham ◽

C Capossela ◽

GR Cosgrove ◽

...

Keyword(s):

Critical Care ◽

Brain Death ◽

Organ Donation ◽

The United States ◽

Critical Care Nurses ◽

Care Staff ◽

Factual Knowledge ◽

Donation Process ◽

Nurses And Physicians ◽

Effective Procedures

BACKGROUND: Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. OBJECTIVE: To assess the readiness of critical care staff to successfully handle requests for organ donation. METHODS: A total of 1061 critical care staff from 28 hospitals in four separate regions of the United States completed a questionnaire that assessed (1) factual knowledge about organ donation, (2) understanding of brain death, (3) previous training in procedures for requesting donations, and (4) comfort levels with the donation process. RESULTS: Staff training in effective procedures for requesting organ donations was significantly correlated with hospitals' donation rates. Less than a third of respondents, however, had received training in explaining brain death to and requesting organ donation from a grieving family. In hospitals with high rates of organ donation, 52.9% of staff had received training; in hospitals with low rates of organ donation, 23.5% of staff had received training. Levels of factual knowledge about organ donation and brain death were unexpectedly low but were not significantly related to hospitals' rates of organ donation. CONCLUSIONS: Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.

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Seeing the Patient and Family Through: Nurses and Physicians Experiences With Withdrawal of Life-Sustaining Therapy in the ICU

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118801011 ◽

2018 ◽

Vol 36 (1) ◽

pp. 13-23 ◽

Cited By ~ 7

Author(s):

Debra L. Wiegand ◽

Jooyoung Cheon ◽

Giora Netzer

Keyword(s):

Health Care ◽

Critical Care ◽

Data Analysis ◽

Health Care Providers ◽

Quality Care ◽

Phenomenological Approach ◽

Critical Care Nurses ◽

Care Providers ◽

Therapy Decision ◽

Nurses And Physicians

Withdrawal of life-sustaining therapy at the end of life is a complex phenomenon. Intensive care nurses and physicians are faced with caring for patients and supporting families, as these difficult decisions are made. The purpose of this study was to explore and describe the experience of critical care nurses and physicians participating in the process of withdrawal of life-sustaining therapy. A hermeneutic phenomenological approach was used to guide this qualitative investigation. Interviews were conducted with critical care nurses and physicians from 2 medical centers. An inductive approach to data analysis was used to understand similarities between the nurses and the physicians’ experiences. Methodological rigor was established, and data saturation was achieved. The main categories that were inductively derived from the data analysis included from novice to expert, ensuring ethical care, uncertainty to certainty, facilitating the process, and preparing and supporting families. The categories aided in understanding the experiences of nurses and physicians, as they worked individually and together to see patients and families through the entire illness experience, withdrawal of life-sustaining therapy decision-making process and dying process. Understanding the perspectives of health-care providers involved in the withdrawal of life-sustaining therapy process will help other health-care providers who are striving to provide quality care to the dying and to their families.

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Survey among critical care nurses and physicians about delirium management

Nursing in Critical Care ◽

10.1111/nicc.12299 ◽

2017 ◽

Vol 23 (1) ◽

pp. 23-29 ◽

Cited By ~ 8

Author(s):

Peter Nydahl ◽

Michael Dewes ◽

Rolf Dubb ◽

Carsten Hermes ◽

Arnold Kaltwasser ◽

...

Keyword(s):

Critical Care ◽

Critical Care Nurses ◽

Delirium Management ◽

Nurses And Physicians

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Developing a deep learning system to drive the work of the critical care outreach team

10.1101/2020.07.07.20148064 ◽

2020 ◽

Author(s):

Georgina Kennedy ◽

John Rihari-Thomas ◽

Mark Dras ◽

Blanca Gallego

Keyword(s):

Critical Care ◽

Deep Learning ◽

Critical Care Nurses ◽

Learning System ◽

Patient Death ◽

Outreach Team ◽

Patients At Risk ◽

Nurses And Physicians ◽

Watch List ◽

Critical Care Outreach

Care of patients at risk of deterioration on acute medical and surgical wards requires timely identification, increased monitoring and robust escalation procedures. The critical care outreach role brings specialist-trained critical care nurses and physicians into acute wards to facilitate these processes. Performing this role is challenging, as the breadth of information synthesis required is both high and rapidly updating. We propose a novel automated `watch-list' to identify patients at high risk of deterioration, to help prioritise the work of the outreach team. This system takes data from the electronic medical record in real-time and creates a discrete tokenized trajectory, which is fed into a recurrent neural network model. These models achieve an AUROC of 0.928 for in-patient death and 0.778 for unplanned ICU admission (within 24 hours), which compares favourably with existing early warning scores and is comparable with proof of concept deep learning systems requiring significantly more input data.

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The effect of scenario based teaching for critical care nurses and physicians on their knowledge of fluid creep

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n4p86 ◽

2018 ◽

Vol 9 (4) ◽

pp. 86

Author(s):

Ghada Shalaby Khalaf Mahran ◽

Asmaa Ali Mahgoub ◽

Mostafa Samy Abass

Keyword(s):

Critical Care ◽

Intensive Care ◽

Critically Ill ◽

Fluid Resuscitation ◽

Fluid Balance ◽

Critically Ill Patients ◽

Critical Care Nurses ◽

University Hospital ◽

P Value ◽

Nurses And Physicians

Introduction: Fluid resuscitation is a major component of the acute management of critically ill patients. The phenomenon of providing excessive fluid resuscitation volumes has been termed “fluid creep”. Today, the science of nursing becomes more complex. Accurate fluid balance assessment and recording is important component of nursing care that assures patient’s safety especially in critically ill patients. The aim of the work is to examine the effect of scenario based teaching for critical care nurses and physicians on their knowledge of fluid balance & fluid creep.Methods: The study design: pre & posttest research design. Setting: This study was implemented in general, trauma, obstetric and burn intensive care units (ICUs) at Assiut university Hospital-Assiut-Egypt. Subjects: 35 critical care nurses and 29 intensive care physicians were drawn from the previously mentioned ICUs. Methodology: A pre & posttest questionnaire of nurses’ and physicians’ knowledge, perception and satisfaction regarding fluid creep and fluid balance was adapted from the articles and was used in data collection before and after the application of scenario based teaching. This questionnaire was implemented on two phases (pre and after the teaching program). The data was collected from January 2018 to July 2018.Results: There is a considerable improvement in participants’ knowledge and perception concerning fluid balance and fluid creep after applying the scenario based teaching (p value < .001).Conclusions: Nowadays, nurses and physicians need advanced level of knowledge to be able to deal with the physiological changes that occur in critically ill.

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