The Use of an Electronic Augmentative Communication Device to Assess the Needs of Mechanically Ventilated Patients in Critical Care

2018 ◽  
Vol 5 (4) ◽  
pp. 27-32
Author(s):  
Salem , Aziza M. ◽  
Mohamed , Nagwa M. A.
Keyword(s):  
Critical Care ◽  
Augmentative Communication ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Communication Device ◽  
Ventilated Patients

Critical Care Nurses’ Knowledge of Sedation and Its Management in Mechanically Ventilated Patients at a Tertiary Care Hospital in Pakistan

2020 ◽  
Vol 14 (1) ◽  
pp. 7-18
Author(s):  
Samuel Masih ◽  
Khairunnisa Aziz Dhamani ◽  
Sadia Farhan Khan
Keyword(s):  
Critical Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Critical Care Nurses ◽  
Good Knowledge ◽  
Care Hospital ◽  
Poor Knowledge ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

BackgroundSedation assessment and management is an essential part of critical care nursing. The patients are at significant risks of undersedation and oversedation. Critical care nurses must possess sufficient knowledge about sedation assessment and its management.AimThis study aimed to determine critical care nurses’ knowledge of sedation and its management in mechanically ventilated patients in Pakistan.MethodologyA cross-sectional descriptive study was conducted. The participants were recruited from three critical care units of a tertiary care hospital using a consecutive sampling technique. Data were collected using a self-administered questionnaire.FindingsIn total, 91 critical care nurses participated in this study. Most of them had less than 2 years of experience as registered nurses and as intensive care unit nurses. The majority of them had insufficient knowledge (poor knowledge 18.7% and fair knowledge 63.7%), whereas only 17.6% had good knowledge of sedation and its management. The average correct response rate for general knowledge of sedation management practices was 71.3%. Almost half of the participants (51.6%) had poor knowledge of assessing undersedation and oversedation. Overall, 67% of nurses had good knowledge of managing sedative drugs.ConclusionThe majority of critical nurses lacked sufficient knowledge related to sedation and its management in mechanically ventilated patients. This poses risks to patients’ safety and quality of care.

scholarly journals Early Critical Care Transthoracic Echocardiography Improves the Mortality of Patients Undergoing Mechanical Ventilation: Observational Data From Two Large Databases.

2020 ◽  
Author(s):  
Xueshu Yu ◽  
Hao Jiang ◽  
Wenjing Chen ◽  
Lingling Pan ◽  
Zhendong Fang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Transthoracic Echocardiography ◽  
Favourable Effect ◽  
Research Database ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Abstract Background: Critical care transthoracic echocardiography (TTE) can quickly and accurately assess haemodynamic changes in ICU patients. However, it is not clear whether transthoracic echocardiography improves the prognosis of mechanically ventilated patients. In this study, we hypothesized that early critical care transthoracic echocardiography independently contributes to improvements in mortality in mechanically ventilated patients in the ICU.Methods: This was a retrospective study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU-CRD). Patients undergoing mechanical ventilation for more than 48 hours were selected. The exposure of interest was early TTE. The primary outcome was in-hospital mortality. We used propensity score matching to analyse the association between early TTE and in-hospital mortality and sensitivity analysis, including the inverse probability weighting model and covariate balancing propensity score model, to ensure the robustness of our findings.Results: A total of 8862 patients undergoing mechanical ventilation were enrolled. The adjusted OR showed a favourable effect between the early TTE group and in-hospital mortality [MIMIC: OR 0.77, 95% CI (0.63–0.94), (P=0.01); eICU-CRD: OR 0.78, 95% CI (0.68–0.89), (P<0.01) ]. Furthermore, TTE was also associated with 30-day mortality in the MIMIC database [OR 0.74, 95% CI (0.6-0.92), P=0.01].Conclusions: Early application of critical care transthoracic echocardiography during mechanical ventilation is beneficial for improving in-hospital mortality. Further investigation with prospectively collected data is required to validate this relationship.

Critical care nurses' perception of care coordination competency for management of mechanically ventilated patients

2020 ◽  
Vol 29 (7-8) ◽  
pp. 1341-1351
Author(s):  
Abdalkarem F. Alsharari ◽  
Ammar M. Aroury ◽  
Mohammad H. Dhiabat ◽  
Jazi S. Alotaibi ◽  
Farhan F. Alshammari ◽  
...  
Keyword(s):  
Critical Care ◽  
Care Coordination ◽  
Critical Care Nurses ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Perception Of Care ◽  
Ventilated Patients

Pain assessment using a Polish version of the Behavioral Pain Assessment Scale in sedated and mechanically ventilated patients

Ból ◽  
2016 ◽  
Vol 17 (3) ◽  
pp. 27-35
Author(s):  
Aleksandra Gutysz-Wojnicka ◽  
Dorota Ozga ◽  
Ewa Mayzner-Zawadzka
Keyword(s):  
Critical Care ◽  
Clinical Practice ◽  
Pain Assessment ◽  
Pain Scale ◽  
Adult Patients ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Polish Version ◽  
Behavioral Pain Scale ◽  
Ventilated Patients

“Gold standard” in the assessment of pain is patient’s subjective assessment by means of standardized numerical, analog-visual or verbal scales. Unconscious, sedated, mechanically ventilated patients are able to subjectively assess pain in this way. Clinical practice guidelines for the management of pain, agitation and delirium in adult patients in the intensive care unit developed by a working group of the American College of Critical Care Medicine (ACCCM) state that adult patients treated in the ICU routinely experience pain at rest and during routine care. The guidelines recommend routine monitoring of pain in all adult patients in the ICU using the Behavioral Pain Scale (BPS) or Critical-Care Pain Observation Tool (CPOT). Cultural adaptation was conducted in Poland, psychometric properties of Polish version of Behavioral Pain Scale (BPS) were evaluated. Internal consistency determined by Cronbach’s alpha amounted to 0.6883. The correlation coefficients between items of the scale and the sum score in the pain phase were in the range 0.27-0.28. The analysis of principal components confirmed that all the components of the scale respectively, the face, the upper limbs, synchronization with the respirator are one factor and explain 63.9% of the rating variation, while discriminatory accuracy of the scale was unconfirmed. The value of pain assessment using the Polish version of BPS increased significantly, also in the case of routine painless procedures, most likely due to other factors. That prevented the unambiguous interpretation of the results of the pain assessment and enforced additional data from other sources in the assessment of pain. The reason for the lack of discriminant accuracy can be vague operationalization of the scale indicators especially in the category: Face and Synchronization with the ventilator and the lack of adequate training for personnel in scale application. The aim of the study was to prepare the Polish version of Behavioral Pain Scale (BPS) with more favorable psychometric properties. Based on the analysis of the literature individual scale indicators included in the categories of Face and Synchronization with the ventilator and the scheme of their scoring were re-defined. The result of the study is modified Polish version of BPS. Conclusions: The validation process of the research tool is not a one-time process. The implementation of the scale into clinical practice is required as well as further monitoring of its reliability and validity indicators. It is necessary to implement the system of personnel training in BPS application

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