scholarly journals Nutrition in the intensive care unit

2015 ◽  
Vol 3 (10) ◽  
pp. 10 ◽  
Author(s):  
Chase C. Hansen ◽  
Sharmila Dissanaike
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Enteral Feeding ◽  
Surgical Patients ◽  
Evidence Based ◽  
Timing Of Initiation ◽  
Evidence Based Guidelines

Nutrition has evolved into an integral part of modern critical care for both medical and surgical patients. Multiple international societies now issue evidence-based guidelines to help clinician optimize their patients’ Nutrition. However, adherence to these guidelines throughout the country is poor, and education in nutrition is still lagging in medical school.  The authors also highlight four key areas where evidence-based recommendations exist – timing of initiation of enteral feeding, calculating and meeting total daily requirements, use of gastric residual volumes to guide delivery, and interuption of feeding for procedures – but are currently often not followed.  Reasons for this lack of adherence are explored, and potential solutions discussed.

Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

Reducing Foley Catheter Device Days in an Intensive Care Unit

2006 ◽  
Vol 17 (3) ◽  
pp. 272-283
Author(s):  
Laura Reilly ◽  
Patty Sullivan ◽  
Sharon Ninni ◽  
Denise Fochesto ◽  
Karen Williams ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Foley Catheter ◽  
Hospital Costs ◽  
Evidence Based ◽  
Tract Infections ◽  
Evidence Based Guidelines ◽  
Hospital Acquired

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

scholarly journals Physical Restraint in Adult Intensive Care Unit - Why and how are they used?

2016 ◽  
Vol 4 (2) ◽  
pp. 110-113
Author(s):  
Sushil Khanal ◽  
Subhash Prasad Acharya
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Patient Autonomy ◽  
Physical Restraint ◽  
Evidence Based ◽  
Adult Intensive Care Unit ◽  
Risk Of Injury ◽  
Ensure Patient Safety ◽  
Evidence Based Guidelines

Background: Physical restraint is preferred practice in adult critical care to reduce the risk of injury and ensure patient safety. However, data on the extent of restraint practice intensive care unit is unknown in our setting to develop evidence based guidelines to promote the scientific use of this modalityMethods: This observational study was conducted for determining the prevalence, motives and ongoing practices of physical restraint. Data were collected from direct observation of physically restrained patients, review of patients’ record and from the nursing staff.Results: The results revealed that physical restraint was commonly used to prevent device dislodgment and to ensure patient safety. The results illustrated a lack of documentation on initiation and monitoring of use physical restraint.Conclusion: For a better care of patients, it is very important to develop a restraint policy for rational use of physical restrain respecting the patient autonomy and freedom.Bangladesh Crit Care J September 2016; 4 (2): 110-113

Dexmedetomidine in Adult Patients in Cardiac Surgery Critical Care: An Evidence-Based Review

2019 ◽  
Vol 30 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Lyndsay Brock
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Drug Cost ◽  
Patient Population ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Advantages And Disadvantages ◽  
Adrenoceptor Agonist

Although several options are available for postoperative sedation in the intensive care unit, the selective α2-adrenoceptor agonist dexmedetomidine may offer advantages for patients after cardiac surgery. The author conducted a review of the literature on the use of dexmedetomidine in the cardiac surgery population to determine possible advantages and disadvantages in this patient population. Although the use of dexmedetomidine has not been conclusively shown to change overall morbidity and mortality and may be associated with higher drug cost, its other demonstrated effects offer advantages for postoperative cardiac surgery patients that other forms of sedation cannot match.

Development of Evidence-Based Guidelines and Critical Care Nurses ’ Knowledge of Enteral Feeding

2007 ◽  
Vol 27 (4) ◽  
pp. 17-29 ◽  
Author(s):  
Annette M. Bourgault ◽  
Laura Ipe ◽  
Joanne Weaver ◽  
Sally Swartz ◽  
Patrick J. O’Dea
Keyword(s):  
Critical Care ◽  
Enteral Feeding ◽  
Critical Care Nurses ◽  
Evidence Based ◽  
Evidence Based Guidelines ◽  
Nurses Knowledge

Fever Management in Patients With Brain Injury

2012 ◽  
Vol 23 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Laura Mcilvoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elevated Temperature ◽  
Brain Injury ◽  
Acute Brain Injury ◽  
Evidence Based ◽  
Medical Opinion ◽  
Lengths Of Stay ◽  
Evidence Based Guidelines ◽  
Fever Management

Elevated temperature in patients with brain injury has been linked to increased hospital and intensive care unit lengths of stay, increased morbidity, greater disability, and higher mortality. The prevailing medical opinion is that maintaining normothermia in patients with acute brain injury is beneficial. However, little evidence exists to support this recommendation. Nurses are responsible for diagnosing and treating fever, but evidence-based guidelines that would govern fever management for these patients do not exist. This article discusses what evidence is available to support the management of fever in patients with brain injury and in what areas evidence is lacking.

scholarly journals Nursing Surge Capacity Strategies for Management of Critically Ill Adults with COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 23-32
Author(s):  
Abbas Al Mutair ◽  
Anas Amr ◽  
Zainab Ambani ◽  
Khulud Al Salman ◽  
Deborah Schwebius
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Nursing Staff ◽  
Best Practice ◽  
Expert Panel ◽  
Evidence Based ◽  
Surge Capacity ◽  
Starting Point

Background: There is a vital need to develop strategies to improve nursing surge capacity for caring of patients with coronavirus (COVID-19) in critical care settings. COVID-19 has spread rapidly, affecting thousands of patients and hundreds of territories. Hospitals, through anticipation and planning, can serve patients and staff by developing strategies to cope with the complications that a surge of COVID-19 places on the provision of adequate intensive care unit (ICU) nursing staff—both in numbers and in training. Aims: The aim is to provide an evidence-based starting point from which to build expanding staffing models dealing with these additional demands. Design/Method: In order to address and develop nursing surge capacity strategies, a five-member expert panel was formed. Multiple questions directed towards nursing surge capacity strategies were posed by the assembled expert panel. Literature review was conducted through accessing various databases including MEDLINE, CINAHL, Cochrane Central, and EMBASE. All studies were appraised by at least two reviewers independently using the Joanna Briggs Institute JBI Critical Appraisal Tools. Results: The expert panel has issued strategies and recommendation statements. These proposals, supported by evidence-based resources in regard to nursing staff augmentation strategies, have had prior success when implemented during the COVID-19 pandemic. Conclusion: The proposed guidelines are intended to provide a basis for the provision of best practice nursing care during times of diminished intensive care unit (ICU) nursing staff capacity and resources due to a surge in critically ill patients. The recommendations and strategies issued are intended to specifically support critical care nurses incorporating COVID-19 patients. As new knowledge evidence becomes available, updates can be issued and strategies, guidelines and/or policies revised. Relevance to Clinical Practice: Through discussion and condensing research, healthcare professionals can create a starting point from which to synergistically develop strategies to combat crises that a pandemic like COVID-19 produces.

scholarly journals Top 10 publications of Intensive Care Medicine journal 2020

2020 ◽  
Vol 5 (4) ◽  
pp. 89-96
Author(s):  
Е. V. Grigoriev ◽  
O. N. Ivanova ◽  
V. V. Krasnov ◽  
V. V. Zhdanov
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Evidence Based ◽  
Medicine Journal ◽  
Number Of Patients ◽  
Evidence Based Guidelines ◽  
Critical Care Patients

COVID-19 pandemic provoked an increasing interest in recent advances in diagnosis and treatment of critical care patients. Among the main problems are the lack of evidence-based guidelines and a growing number of patients with multiple organ dysfunction syndrome. Therefore, indications for the use of previously uncommon intensive care approaches are expanding. These reasons, along with a large pool of non-systematic literature, dictate the need in the narrative review of top 10 recent publications which provide a snapshot of the most relevant research in critical care. These papers overview evidence-based information on the control of acute kidney injury, ventilator-associated pneumonia and sepsis in critically ill patients including those with COVID-19, principles of proper haemodynamic and ventilatory support, timely cessation of antimicrobial therapy, efficient prevention of gastrointestinal bleeding, and the use of the prone position in patients with acute respiratory distress syndrome.

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