scholarly journals Providing critical care in ethical way. Traditions and ethics should go hand in hand

2020 ◽  
Vol 24 (6) ◽  
pp. 582-585
Author(s):  
Abdus Salam Khan ◽  
Abdul Sattar ◽  
Hafsa Khan

Ethics are at the core of healthcare provision. Good medical practice reflects ethics and professionalism in action and ethics should drive our behavior when providing medical care. The patients trust their treating doctor to be competent and ethical in their communication and also in the clinical decision-making. The expectations from the doctors are even more during the times when patients are critical. For the doctors and nurses providing the care, it may be very challenging, as those critical times are highly stressful for patients and attendants and can result in less than optimal outcome. Under these trying moments we face issues in communication and care provision which may look to be not conforming to the ethical standards. This editorial highlights the importance to adhere to the rules of ethics in many different critical situations, which may arise in emergency departments or in critical care units. But the principles outlined deserve to be learned by every healthcare staff member. Key words: Critical Illness; Health Status; Humans; Intensive Care; Intensive Care Units; Critical Care / ethics; Decision Making / ethics; Dissent and Disputes; Physicians / ethics; Terminal Care / ethics Citation: Khan AS, Sattar A, Khan H. Providing critical care in ethical way. Traditions and ethics should go hand in hand. Anaesth. pain intensive care 2020;24(6):568-571. Received – 3 September 2020, Reviewed – 13 September 2020, Accepted – 31 October 2020

Author(s):  
Ali Sanaei ◽  
Mohammad Mehdi Sepehri

Background: Quality of Intensive care has got more attention in case of the high cost of healthcare and the potential for harm. Poor-quality care causes high cost and quality improvement initiatives in the ICU lead to an improvement in outcomes as well as a decrease in costs. One of the crucial tools that allow physicians and nurses to monitor change in a quality improvement effort is the development of an electronic database for data collection and reporting. The objective of Intensive Care Registries is to create a high-quality registry of patients through a collaboration of academic health centers performing uniform data collection with the purpose of improving the quality and accuracy of healthcare decisions and provide a data-driven clinical decision support system for critical care medicine. Methods: This article reviews real-world data sources in healthcare and considers registry as the main tool to address health services and outcomes research questions in critical care, and briefly describes objective, inputs and outputs of intensive care registries. As it can be comprehended from library research, the combination of patient clinical care data, quality parameters, and ICU operating costs, integrated into an electronic database, provides a valuable tool for quality improvement and overall efficiency of offered care. Results: Using Big Data effectively within ICUs for supporting clinical decision making can lead to predict numerous diseases and help to discover new patterns in healthcare. The ability to process multiple high-speed clinical data streams from multiple centers could dramatically improve both healthcare efficiency and patient outcomes. Conclusion: To gain this goal, developing reliable and standardized health analytics platforms as well as quality improvement processes that translate analytical results into new clinical guidelines, is recommended.


2019 ◽  
Vol 2 (1) ◽  
pp. 1-14
Author(s):  
Indah Mei Rahajeng ◽  
Faridatul Muslimah

Background Intensive Care Unit (ICU) is the hospital setting in which applied specific application of clinical decision making and judgement. The critical patient conditions in ICU may drive nurses to make decision and clinical judgement in short period of time. The approach of clinical decision making which appropriate to be applied in the critical circumstances is important to be identified, thus it could become a guidance for novice and expert critical nurses. Aim The aim of this study was to explain how clinical decision making is applied in Intensive Care Unit (ICU)  Method A systematic review of 22 articles was carried out, articles were retrieved from CINAHL, MEDLINE, PUBMED and DISCOVERED databases. The articles were critically reviewed and analized to answer this study’s aim. Result The critically review of the articles were categorized in themes: 1) application of Tanner’s clinical judgment model  in ICU, 2) Types of decisions in ICU, 3) Theoretical approach: implementation of decision-making in ICU, 4) Case illustration of decision-making scheme in ICU, 5) Influencing factors of decision-making in ICU, 6) Supporting tools for clinical decision-making in ICU, 7) Understanding of attributes and concepts may enhance the quality of the clinical decision-making process in ICU, 8) Implications for nursing education and practice of understanding clinical decision making in ICU. Conclusions Critical care nurses usually combine different techniques in making decisions; analytical methods including the hypothetic-deductive method, pattern recognition, intuition, narrative thinking, and decision analysis theory are potentially applied. Clinical decision activities in ICU appear in many clinical situations, such as intervention decisions, communication decisions, and evaluation decisions. There are several factors influencing clinical decision-making in intensive care units, including nurses’ experience, the patient’s situation, the layout of the ICU, shift work, inter-professional collaboration practice, physical and personnel resources. The application of clinical decision making could be supported by systematic tools, and the nurses’ knowledge about the concepts and attributes used in ICUs affect their clinical decision-making abilities.     Keywords: clicinal decision making, critical care nurse, ICU


2021 ◽  
Vol 010 (1) ◽  
pp. 124-131
Author(s):  
Abeer Abdelgawad ◽  
Fatma Mohamed ◽  
Safaa Abdelrahman ◽  
Amira Fahmy

2016 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Kristi J. Stinson

Completed as part of a larger dissertational study, the purpose of this portion of this descriptive correlational study was to examine the relationships among registered nurses’ clinical experiences and clinical decision-making processes in the critical care environment. The results indicated that there is no strong correlation between clinical experience in general and clinical experience in critical care and clinical decision-making. There were no differences found in any of the Benner stages of clinical experience in relation to the overall clinical decision-making process.


2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.


Sign in / Sign up

Export Citation Format

Share Document