This Is My Unit: Surgical ICU, BG Klinikum, Hamburg, Germany

2020 ◽  
Vol 14 (1) ◽  
pp. 29-34
Author(s):  
Sabrina Pelz

This article provides insight into a German intensive care unit in a surgery department. It describes the nursing care, nursing management monitoring and infection surveillance practices of the unit. We also describe the national educational pathway of a German nurse, which differs from those in other countries. The overview can help understand the context of German critical care nursing.

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Riitta-Liisa Lakanmaa ◽  
Tarja Suominen ◽  
Marita Ritmala-Castrén ◽  
Tero Vahlberg ◽  
Helena Leino-Kilpi

Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1–5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n=431). Intensive care unit nurses’ self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses’ basic competence was their experience of autonomy in nursing care (Fvalue 60.85,β0.11, SE 0.01, andP≤0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses’ experienced autonomy in nursing.


1991 ◽  
Vol 2 (1) ◽  
pp. 31-39
Author(s):  
Glenda A. Krum

A dilemma in critical care nursing practice is how to develop and implement a practical quality assurance program that incorporates high-quality standards of nursing care for critically ill patients and addresses those aspects of care considered important by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Standards for Nursing Care of the Critically Ill defines and describes structure and process standards and provides a comprehensive guide for the development of a program for the delivery of quality care to critically ill patients. The purpose of this chapter is to discuss practical application of the standards described by the American Association of Critical-Care Nurses (AACN) through the use of policies and procedures that support structure and process standards


1991 ◽  
Vol 11 (8) ◽  
pp. 12-12
Author(s):  
JG Alspach

The 1991 JCAHO nursing care standards represent a fundamental shift in the focus of the survey and accreditation processes from specifying the means to clarifying the ends of nursing services and from prescribing structures and processes to clarifying the intended outcomes of nursing care. As critical care nurses prepare to meet the compliance requirements of these new accreditation standards, it will be helpful to keep in mind that our services are nursing care, nursing management, and nursing education or research, but our purpose is quality nursing care.


2012 ◽  
Vol 32 (6) ◽  
pp. 62-69 ◽  
Author(s):  
Lisa-Mae Williams ◽  
Kenneth E. Hubbard ◽  
Olive Daye ◽  
Connie Barden

In tele–intensive care units, informatics, telecommunication technology, telenursing, and telemedicine are merged to provide expert, evidence-based, and cutting-edge services to critically ill patients. Telenursing is an emerging subspecialty in critical care that is neither well documented in the extant literature nor well understood within the profession. Documentation and quantification of telenursing interventions help to clarify the impact of the telenurse’s role on nursing practice, enhancement of patient care, patient safety, and outcomes. Tele–intensive care unit nursing will continue to transform how critical care nursing is practiced by enhancing/leveraging available resources through the use of technology.


2009 ◽  
Vol 18 (6) ◽  
pp. 592-588 ◽  
Author(s):  
Kathryn S. Jaramillo ◽  
Elizabeth Scruth ◽  
Eugene Cheng

After receiving mivacurium, a short-acting neuromuscular blocking agent used for intubation before surgery, a patient experienced prolonged paralysis and prolonged apnea that required ventilator support. Although this complication is rare, all critical care nurses should be aware of it so they can be competent in managing and providing holistic and comprehensive nursing care to the patient and the patient’s family. Although this complication has been documented in the anesthesia literature, it has received little mention in critical care nursing journals.


2018 ◽  
Vol 12 (6) ◽  
pp. 1727 ◽  
Author(s):  
Gislaine Rodrigues Nakasato ◽  
Juliana Lima Lopes ◽  
Camila Takao Lopes

RESUMOObjetivo: identificar na literatura as complicações associadas à oxigenação por membrana extracorpórea (ECMO) em adultos. Método: estudo bibliográfico, tipo revisão integrativa de artigos publicados de 2011 a 2016 em português, inglês ou espanhol, nas bases de dados Medline e CINAHL utilizando-se termos padronizados (MeSH e títulos CINAHL). Os títulos, resumos e textos na íntegra dos artigos encontrados foram lidos para aplicação dos critérios de elegibilidade e classificação do nível de evidência. As complicações da ECMO foram agrupadas em hemorrágicas, infecciosas, renais, vasculares, mecânicas, neurológicas e outras. Resultados: foram encontrados 666 estudos, dos quais 45 foram incluídos. As principais complicações identificadas foram: as hemorrágicas, encontradas em 747 indivíduos (21,23%), seguidas das infecciosas (10,85%), renais (9,18%), vasculares (5,99%), mecânicas (4,15%) e neurológicas (3,8%) Conclusão: identificaram-se as principais complicações da ECMO em pacientes adultos. Conhecê-las subsidia o planejamento do cuidado prestado, podendo evitá-las ou diagnosticá-las precocemente, diminuindo assim, a morbimortalidade, custos e tempo de internação. Descritores: Adulto; Cardiologia; Cuidados Críticos; Cuidados de Enfermagem; Oxigenação por Membrana Extracorpórea; Pneumologia.ABSTRACTObjective: to identify the complications associated with extracorporeal membrane oxygenation (ECMO) in adults, as described in the literature. Methods: An integrative review including articles published from 2011 to 2016, in Portuguese, English or Spanish, using standardized terms (MeSH and CINAHL titles) in the Medline and CINAHL databases. The complete titles, abstracts and texts of the articles meeting eligibility criteria were read and classified, based on the level of evidence. The complications of ECMO were grouped into: hemorrhagic, infectious, renal, vascular, mechanical, neurological, and other. Results: Six hundred sixty-six studies were found, of which 45 were included. The main complications identified were: hemorrhagic, in 747 individuals (21.23%), followed by infectious (10.85%), renal (9.18%), vascular (5.99%), mechanical (15%), and neurological (3.8%). Conclusion: The main complications of ECMO in adult patients were identified. The knowledge about them supports planning of care, avoiding complications and, thus, reducing morbidity and mortality, costs, and length of hospitalization. Descriptors: Adult; Cardiology; Critical Care; Nursing care; Extracorporeal membrane oxygenation; Pneumology.RESUMENObjetivo: identificar en la literatura las complicaciones de la oxigenación de membrana extracorpórea (ECMO) en adultos. Método: estudio bibliográfico de revisión integradora con artículos publicados desde 2011 hasta 2016 en portugués, inglés o español, en MEDLINE y CINAHL utilizando términos estandarizados (MeSH y CINAHL). Se leyeron Los títulos, resúmenes y textos en su totalidad de los artículos encontrados para aplicación de los criterios de elegibilidad y clasificación del nivel de evidencia. Se agruparon las complicaciones de la ECMO en hemorrágicas, infecciosas, renales, vasculares, mecánicas, neurológicas y otras. Resultados: se encontraron 666 estudios, de los cuales se incluyeron 45. Las principales complicaciones identificadas fueron: las hemorrágicas, encontradas en 747 individuos (21,23%), seguidas de las infecciosas (10,85%), renales (9,18%), vasculares (5,99%), mecánicas (4, 15%) y neurológicas (3,8%). Conclusión: se identificaron las principales complicaciones de la ECMO en pacientes adultos. Conocerlas subsidia la planificación del cuidado prestado, pudiendo evitarlas o diagnosticarlas precozmente, disminuyendo así, la morbimortalidad, costos y tiempo de internación. Descriptores: Adulto; Cardiología; Cuidados Críticos; Atención de Enfermería; Oxigenación por Membrana Extracorpórea; Neumología.


2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Sarinti Sarinti ◽  
Reni Sulung Utami ◽  
Awal Prasetyo

Latar belakang : Pasien di ICU ( Intensive Care Unit ) yang membutuhkan bantuan ventilasi mekanik hampir mencapai 30% dari total pasien. Ventilasi mekanik yang digunakan dalam jangka panjang dapat meningkatkan resiko terjadinya mortalitas, dan ventilator associated pneumonia sehingga diperlukan perencanaan penyapihan yang tepat.  Tujuan : Studi literatur ini bertujuan untuk mengidentifikasi metode penyapihan pasien dari ventilasi mekanik di ICU. Metode : Penelusuran literatur dilakukan melalui database Google scholar dan Google search dengan menggunakan kata kunci weaning mechanical ventilation, weaning protocol, critical care nursing. Literatur yang digunakan dari tahun 1997-2015 dalam bentuk full text. Literatur yang sesuai kriteria inklusi dan eksklusi dianalisis secara narasi. Hasil: Penelusuran mendapatkan 7 artikel penelitian yang menunjukkan metode penyapihan pasien dari ventilasi mekanik. Metode penyapihan dari ke 7 artikel tersebut adalah metode protokol dan non protokol. Metode non protokol misalnya physician direct weaning ( PDW ) dan collaboration weaning plan ( CWP ). Metode penyapihan dengan protokol antara lain : nurse` protokol directed weaning ( NPDW ) dan protokol base weaning ( PBW ). Kesimpulan : Metode penyapihan protokol menunjukkan hasil lebih efektif dibandingkan metode non protokol. Kata Kunci: Penyapihan Ventilasi Mekanik, Protokol Penyapihan, Keperawatan Kritis Methode of Weaning from Mechanical Ventilation in Intensive Care Unit : Study Literature ABSTRACT Back ground : patients in the ICU who require mechanical ventilation assistance almost 30% of the total patients. Mechanical ventilation is used in the long term can increase the risk of mortality and ventilator associated pneumonia so that proper planning is necessary weaning. Objectives : the literature study aims to identify methods of weaning patients from mechanical ventilation in the ICU. Methods : the literature study search pass through by Google scholar and Google search using keywords weaning mechanical ventilation, weaning protocol, critical care nursing. Literature is used from the year 1997-2015 in the form of full text. Appropriate literature inclusion and exclusion criteria were analyzed narrative. Results : search get 7 articles studies showing methods of weaning patients from mechanical ventilation. Method of weaning to the article 7 is the method protocol and non-protocol. Methods of non protocols eg physician-direct weaning ( PDW ) and collaboration weaning plan ( CWP ). Methods of weaning protocols include: nurse` protocol directed weaning (NPDW) and protocols base weaning ( PBW ). Conclusion : the method of weaning protocol shows the results more effective than non - protocol methods Key word : weaning mechanical ventilation; weaning protocol; critical care nursing


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