scholarly journals Ethical Issues Recognized by Critical Care Nurses in the Intensive Care Units of a Tertiary Hospital during Two Separate Periods

2015 ◽  
Vol 30 (4) ◽  
pp. 495 ◽  
Author(s):  
Dong Won Park ◽  
Jae Young Moon ◽  
Eun Yong Ku ◽  
Sun Jong Kim ◽  
Young-Mo Koo ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Ethical Issues ◽  
Tertiary Hospital ◽  
Critical Care Nurses

scholarly journals The challenges of using physical restraint in intensive care units in Iran: A qualitative study

2020 ◽  
pp. 175114371989278
Author(s):  
Zahra Salehi ◽  
Soodabeh Joolaee ◽  
Fatemeh Hajibabaee ◽  
Tahereh Najafi Ghezeljeh
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Structured Interviews ◽  
Standard Equipment ◽  
Restraint Use ◽  
Ensure Patient Safety

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

Critical care nurses provide their perspectives of patients' symptoms in intensive care units

Heart & Lung ◽  
2008 ◽  
Vol 37 (6) ◽  
pp. 466-475 ◽  
Author(s):  
Kathleen A. Puntillo ◽  
Deborah Smith ◽  
Shoshana Arai ◽  
Nancy Stotts
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Critical Care Nurses

scholarly journals Professional Stress and Health among Critical Care Nurses in Serbia

2012 ◽  
Vol 63 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Dragana Milutinović ◽  
Boris Golubović ◽  
Nina Brkić ◽  
Bela Prokeš
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Somatic Symptoms ◽  
Critical Care Nurses ◽  
Working Environment ◽  
Stress Factors ◽  
Sample Population ◽  
Professional Stress ◽  
Stress And Health

Professional Stress and Health among Critical Care Nurses in SerbiaThe aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a cross-sectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.

Knowledge and Nursing Practice of Critical Care Nurses Caring for Patients with Delirium in Intensive Care Units in Jordan

2010 ◽  
Vol 41 (12) ◽  
pp. 571-576 ◽  
Author(s):  
Ayman M. Hamdan-Mansour ◽  
Ne’ameh Abbas Farhan ◽  
Elham Hani Othman ◽  
Mohammed Ibrahim Yacoub
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Practice ◽  
Critical Care Nurses

scholarly journals Evaluation of prevention of ventilator-associated infections in four Australian intensive care units

2020 ◽  
Vol 21 (4) ◽  
pp. 147-154
Author(s):  
Natasha Ciampoli ◽  
Stephane Bouchoucha ◽  
Judy Currey ◽  
Ana Hutchinson
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Care Delivery ◽  
Critical Care Nurses ◽  
Respiratory Care ◽  
Chart Audit ◽  
Endotracheal Suctioning ◽  
Standard Precautions ◽  
Mouth Care

Background: Effective approaches to practice improvement require development of tailored interventions in collaboration with knowledge users. Objectives: To explore critical care nurses’ knowledge and adherence to best practice guidelines for management of patients with an artificial airway to minimise development of ventilator-associated pneumonia. Methods: A cross-sectional study was undertaken across four intensive care units that involved three phases: (1) survey of critical care nurses regarding their current practice; (2) observation of respiratory care delivery; and (3) chart audit. Key care processes evaluated were: (1) technique and adherence to standard precautions when performing endotracheal suction, cuff pressure checks and extubation; and (2) frequency of endotracheal suctioning and mouth care. Results: Observational and chart audit data on the provision and documentation of respiratory care were collected for 36 nurse/patient dyads. Forty-six nurses were surveyed and the majority responded that endotracheal suctioning and mouth care should be performed ‘as required’ or every 2 hours (h). During observations of practice, no patient received mouth care every 2 h, nor had documentation of such. Inconsistent adherence to standard precautions and hand hygiene during respiratory care provision was observed. Chart audit indicated that nurses varied in the frequency of suctioning consistent with documented clinical assessment findings. Conclusion: Although nurses had good knowledge for the management of artificial airways, this was not consistently translated into practice. Gaps were identified in relation to respiratory related infection prevention, the prevention of micro-aspiration of oropharyngeal secretions and in the provision of mouth care.

Blind Insertion of Feeding Tubes in Intensive Care Units: A National Survey

2012 ◽  
Vol 21 (5) ◽  
pp. 352-360 ◽  
Author(s):  
Norma A. Metheny ◽  
Barbara J. Stewart ◽  
Andrew C. Mills
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
National Survey ◽  
National Level ◽  
Feeding Tube ◽  
Critical Care Nurses ◽  
Feeding Tubes ◽  
Blind Insertion ◽  
Pencil And Paper

Background Although most critically ill patients experience at least 1 blind insertion of a feeding tube during their stay in an intensive care unit, little is known about the types of health care personnel who perform these insertions or about methods used to determine proper positioning of the tubes. Objectives To describe results from a national survey of critical care nurses about feeding tube practices in their adult intensive care units. The questions asked included who performs blind insertions of feeding tubes and what methods are used to determine if the tubes are properly positioned. Methods Data were collected from members of the American Association of Critical-Care Nurses via pencil-and-paper and online surveys. Results from both forms were combined for data analysis and were compared with practice recommendations of national-level organizations. Results A total of 2298 responses were obtained. Physicians perform more blind insertions of styleted feeding tubes than do nurses; in contrast, nurses place more nonstyleted tubes. Radiographic confirmation of correct position is mandated more often for blindly inserted styleted tubes (92.3%) than for nonstyleted tubes (57.5%). The 3 most commonly used bedside methods to determine tube location are auscultation for air injected via the tube, appearance of feeding tube aspirate, and observation for indications of respiratory distress. Conclusions Recommendations from multiple national-level organizations to obtain radiographic confirmation that each blindly inserted feeding tube is correctly positioned before the first use of the tube are not adequately implemented. Auscultation is widely used despite recommendations to the contrary.

Nurses' beliefs and attitudes toward visiting in adult critical care settings

1993 ◽  
Vol 2 (3) ◽  
pp. 238-245 ◽  
Author(s):  
KT Kirchhoff ◽  
E Pugh ◽  
RM Calame ◽  
N Reynolds
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Reasoned Action ◽  
Care Delivery ◽  
Critical Care Nurses ◽  
Attitudes And Beliefs ◽  
Negative Consequences ◽  
Beliefs And Attitudes

OBJECTIVE: To assess the beliefs and attitudes of critical care nurses about the effects of visiting on patients, staff and family. DESIGN: Both interviews and questionnaires were used to gather data on nurses' attitudes and beliefs about visiting and open visiting according to the format of Ajzen and Fishbein's Theory of Reasoned Action. SETTING: Five Utah intensive care units and three Ohio intensive care units. SAMPLE: Critical care nurses in Utah (N = 29) and Ohio (N = 41) were interviewed to assess their beliefs about the effects of visiting on patients, families, nurses and nursing care delivery. RESULTS: Nurses believed the consequence of visiting was more positive for the patient from a psychological perspective than from a physiological perspective but that the effects might differ depending on the patient, the visitor and the circumstances. They believed that visiting had negative consequences for families, because they became exhausted, and that visiting was disruptive for nursing care delivery. Their attitudes about effects of visiting on nursing staff were consistently more negative than were attitudes about the effects on the patient and the family. CONCLUSION: To provide an optimal situation for visiting, its negative consequences must be minimized and nurses' attitudes and beliefs about visiting must be assessed and addressed.

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