Kirby's Rule of 20: the veterinary nurse's critical patient checklist part 4

2020 ◽  
Vol 11 (9) ◽  
pp. 416-421
Author(s):  
Courtney Waxman
Keyword(s):  
Wound Healing ◽  
Critical Care ◽  
Critically Ill ◽  
Nursing Care ◽  
Pain Control ◽  
Drug Dosage ◽  
Critical Care Medicine ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Loving Care

Kirby's Rule of 20 is a patient checklist including 20 parameters that should be checked daily in the critically ill patient. It reviews the established evidence-based information regarding patient checklist use in veterinary emergency and critical care medicine. The list of 20 will be discussed over a four-part series to give an appropriate level of information and attention to each patient parameter. Part 4 includes: wound healing, drug dosage and metabolism, pain control, nursing care, tender loving care.

Kirby's Rule of 20: the veterinary nurse's critical patient checklist part 1

2020 ◽  
Vol 11 (6) ◽  
pp. 270-275
Author(s):  
Courtney Waxman
Keyword(s):  
Heart Rate ◽  
Critical Care ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critical Care Medicine ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Acid Base

Kirby's Rule of 20 is a patient checklist including 20 parameters that should be checked daily in the critically ill patient. It reviews the established evidence-based information regarding patient checklist use in veterinary emergency and critical care medicine. The list of 20 will be discussed over a four-part series to give an appropriate level of information and attention to each patient parameter. Part 1 includes: fluid balance, albumin and oncotic pull, electrolytes and acid–base, mentation, and heart rate/rhythm/contractility.

Kirby's Rule of 20: the Veterinary Nurse's Critical Patient Checklist Part 3

2020 ◽  
Vol 11 (8) ◽  
pp. 364-369
Author(s):  
Courtney Waxman
Keyword(s):  
Renal Function ◽  
Critical Care ◽  
Critically Ill ◽  
Gastrointestinal Motility ◽  
Immune Status ◽  
Critical Care Medicine ◽  
Critically Ill Patient ◽  
Evidence Based

Kirby's Rule of 20 is a patient checklist including 20 parameters that should be checked daily in the critically ill patient. It reviews the established evidence-based information regarding patient checklist use in veterinary emergency and critical care medicine. The list of 20 will be discussed over a four-part series to give an appropriate level of information and attention to each patient parameter. Part 3 includes: renal function, gastrointestinal motility and integrity, nutrition, glucose and immune status.

Kirby's Rule of 20: the veterinary nurse's critical patient checklist part 2

2020 ◽  
Vol 11 (7) ◽  
pp. 296-301
Author(s):  
Courtney Waxman
Keyword(s):  
Blood Pressure ◽  
Critical Care ◽  
Body Temperature ◽  
Red Blood Cells ◽  
Critically Ill ◽  
Blood Cells ◽  
Critical Care Medicine ◽  
Coagulation Cascade ◽  
Critically Ill Patient ◽  
Evidence Based

Kirby's Rule of 20 is a patient checklist including 20 parameters that should be checked daily in the critically ill patient. It reviews the established evidence-based information regarding patient checklist use in veterinary emergency and critical care medicine. The list of 20 will be discussed over a four-part series to give an appropriate level of information and attention to each patient parameter. Part 2 includes: blood pressure, body temperature, oxygenation and ventilation, red blood cells and haemoglobin, and coagulation cascade.

scholarly journals Vancomycin Dosing Practices among Critical Care Pharmacists: A Survey of Society of Critical Care Medicine Pharmacists

2020 ◽  
Vol 13 ◽  
pp. 117863372095207
Author(s):  
Alexander H Flannery ◽  
Drayton A Hammond ◽  
Douglas R Oyler ◽  
Chenghui Li ◽  
Adrian Wong ◽  
...  
Keyword(s):  
Critical Care ◽  
Infectious Diseases ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Online Survey ◽  
Critical Care Medicine ◽  
Guideline Recommendation ◽  
Critically Ill Patient ◽  
Critically Ill Adults ◽  
Monitoring Protocols

Introduction: Critically ill patients and their pharmacokinetics present complexities often not considered by consensus guidelines from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Prior surveys have suggested discordance between certain guideline recommendations and reported infectious disease pharmacist practice. Vancomycin dosing practices, including institutional considerations, have not previously been well described in the critically ill patient population. Objectives: To evaluate critical care pharmacists’ self-reported vancomycin practices in comparison to the 2009 guideline recommendations and other best practices identified by the study investigators. Methods: An online survey developed by the Research and Scholarship Committee of the Clinical Pharmacy and Pharmacology (CPP) Section of the Society of Critical Care Medicine (SCCM) was sent to pharmacist members of the SCCM CPP Section practicing in adult intensive care units in the spring of 2017. This survey queried pharmacists’ self-reported practices regarding vancomycin dosing and monitoring in critically ill adults. Results: Three-hundred and sixty-four responses were received for an estimated response rate of 26%. Critical care pharmacists self-reported largely following the 2009 vancomycin dosing and monitoring guidelines. The largest deviations in guideline recommendation compliance involve consistent use of a loading dose, dosing weight in obese patients, and quality improvement efforts related to systematically monitoring vancomycin-associated nephrotoxicity. Variation exists regarding pharmacist protocols and other practices of vancomycin use in critically ill patients. Conclusion: Among critical care pharmacists, reported vancomycin practices are largely consistent with the 2009 guideline recommendations. Variations in vancomycin dosing and monitoring protocols are identified, and rationale for guideline non-adherence with loading doses elucidated.

Evidence-based practice: fever-related interventions

1999 ◽  
Vol 8 (1) ◽  
pp. 481-487 ◽  
Author(s):  
R Henker
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
American Association ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Common Phenomenon ◽  
Research Questions ◽  
Research Studies

Fever is a common phenomenon in critically ill patients. Ideally, all decisions about treatment of fever would be based on results of well-developed research studies. Instead, some research questions related to treatment of fever have been studied more extensively than others. This article is an evaluation of the usefulness of the research studies related to treatment of fever in the critically ill. Two questions are addressed: when is treatment of fever most beneficial to a critically ill patient, and how is fever most effectively treated in the critically ill? Evidence related to the treatment of fever is evaluated by using the recommendation levels of the research-based practice protocols of the American Association of Critical-Care Nurses.

Guidelines for the transfer of critically ill patients. Guidelines Committee, American College of Critical Care Medicine, Society of Critical Care Medicine and the Transfer Guidelines Task Force

1993 ◽  
Vol 2 (3) ◽  
pp. 189-195 ◽  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Policy Development ◽  
Personal Experience ◽  
Task Force ◽  
Data Extraction ◽  
Critical Care Medicine ◽  
Critically Ill Patient ◽  
Quality Improvement Process ◽  
Interhospital Transport

OBJECTIVE: The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. DATA SOURCES: A task force of experts in the field of patient transport drawn from the membership of the Society of Critical Care Medicine and the American Association of Critical-Care Nurses provided the personal experience and published literature from which these guidelines were developed. STUDY SELECTION: Study design was not a factor in selecting the literature to validate the experts' personal experience. The lack of well-designed clinical outcome studies was an important factor in determining the method of practice policy development utilized. DATA EXTRACTION: The expert task force met and developed a draft of these guidelines based on their experiences and the available literature. This draft document was then reviewed by an additional group of experts whose input was used by the task force to develop this final consensus report. RESULTS OF DATA SYNTHESIS: Each hospital should have a formalized plan for intra- and interhospital transport that addresses the following elements: pretransport coordination and communication, transport equipment, accompanying personnel, monitoring during the transport and documentation. The transport plan should be developed by a multidisciplinary team and should be evaluated and refined by the continuous quality improvement process. CONCLUSION: The available data has allowed the authors to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.

Efficacy of Epidural Analgesia for Pain Management of Critically Ill Patients and the Implications for Nursing Care

1991 ◽  
Vol 2 (4) ◽  
pp. 729-740 ◽  
Author(s):  
Jeanne F. Slack ◽  
Margaret Faut-Callahan
Keyword(s):  
Critical Care ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Critically Ill ◽  
Nursing Care ◽  
Critically Ill Patients ◽  
Continuous Epidural Analgesia ◽  
Analgesic Agents ◽  
Care Problems ◽  
Critical Care Patients

Management of pain for critically ill patients has been shown to be inadequately controlled and can have serious deleterious effects on a patient’s recovery. Continuous epidural analgesia can be used to control pain in critical care patients. This mode of analgesia administration provides pain relief without the delays inherent in the as-needed administration of analgesics. Fifteen critical care unit patients were part of a multidisciplinary, prospective, randomized, double-blind study of various epidural analgesic agents in 43 thoracic and 66 abdominal surgery patients. The purpose of the study was to identify the benefits and problems associated with continuous epidural analgesia administration and the implications for the nursing care of critically ill patients. Evaluation of the effectiveness of the analgesia was based on the following measures: 1) pain measured at regular intervals in the 72-hour period with a visual analog; 2) pain as measured after 72 hours with the word descriptor section of the McGill pain questionnaire; 3) amount of supplemental systemic narcotic analgesic needed; 4) recovery of ambulatory and respiratory function, including ability to perform coughing and deep-breathing exercises; 5) occurrence of adverse effects, and 6) the type and distribution of nursing care problems associated with continuous epidural infusions. The results of this study showed that the level of pain relief and recovery of postoperative function was superior to that provided by the more widely used as-needed systemic administration of narcotics. Although some nursing care problems were identified, continuous epidural analgesia can be used for pain relief in critical care patients, if the analgesia is administered by accurate reliable infusion systems and carefully monitored by nursing staff who are knowledgeable about the pharmacologic considerations of epidural analgesic agents and the management of patient care

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