Elderly Patients in Critical Care: An Overview

1992 ◽  
Vol 3 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Mickey Stanley
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Elderly Patients ◽  
Nursing Care ◽  
Care Setting ◽  
Critical Care Setting ◽  
Care Planning ◽  
Care Needs

Elderly patients who enter the critical care setting have special nursing care needs based on the physiologic changes of aging. An overview of the changes of aging associated with the immunologic, cardiovascular, integumentary, musculoskeletal, and renal systems provides the basis for care planning to meet the needs of older adults in the intensive care unit

Compatibility of Intravenous Drugs in a Coronary Intensive Care Unit

1986 ◽  
Vol 20 (5) ◽  
pp. 349-352 ◽  
Author(s):  
Joseph F. Dasta ◽  
Frederick P. Zeller ◽  
Robert J. Anders
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Setting Time ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Accessible Information ◽  
The Stability ◽  
Physical And Chemical

In a coronary intensive care unit (CCU) it is often necessary to utilize extensive pharmacologic interventions and multiple intravenous medications in order to stabilize a critically ill patient. However, the necessity of several intravenous infusions often presents the problem of compatibility of these medications when infused within a common line. The pharmacist must possess adequate skill to identify potential incompatibilities by retrieving information on the physical and chemical compatibilities of various intravenous medications. In a critical care setting, time is an important factor, and information that can be obtained rapidly and reliably is vital for the pharmacist to prevent the administration of an irritating substance or a medication that has undergone deterioration as a result of chemical inactivation. A compatibility table containing the most commonly used drugs in a CCU has been developed based on currently available literature, including standard reference texts, about these medications. The table outlines the potential for interactions, within a single intravenous line, when several drugs are infused concurrently. In addition, a review of the concepts of physical and chemical incompatibility is presented. The stability of an admixture is defined utilizing requirements established in the USP NF monographs and manufacturers' specifications. The resulting table concisely organizes vital information in a form that allows rapid, accessible information to the pharmacist in a critical care setting, where it is most needed.

Valvular stenosis

2020 ◽  
pp. 195-206
Author(s):  
Ana Martinez-Naharro ◽  
Susanna Price
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Multimodality Imaging ◽  
Clinical Status ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Valvular Stenosis ◽  
Echocardiographic Parameters

Evaluation of valve stenosis in the critical care setting can be challenging, as the clinical status of the patient may preclude the gold standard for assessment (multimodality imaging), demanding reliance on echocardiographic parameters that are not well-validated in the intensive care unit. Valve stenosis is common, and where it precipitates intensive care admission is likely to be severe, and affecting the left-sided valves. On occasion, however, stenosis may be an incidental finding in a critically ill patient with a variable impact on their clinical status. Right-sided lesions are rare (outside the grown-up congenital patient population) and only very infrequently lead to acute haemodynamic deterioration. Echocardiography is indicated in any intensive care unit (ICU) patient where there is suspicion of valvular heart disease. This chapter outlines how to assess valvular stenosis and define its severity in the critical care setting according to integrated echocardiographic parameters. It highlights how critical care pathophysiology may complicate this evaluation, and any potential pitfalls that may exist.

scholarly journals ASSISTÊNCIA DE ENFERMAGEM NOS CUIDADOS PALIATIVOS AO PACIENTE IDOSO EM UNIDADE DE TERAPIA INTENSIVA / NURSING CARE IN PALLIATIVE CARE FOR ELDERLY PATIENTS IN AN INTENSIVE CARE UNIT

2020 ◽  
Vol 6 (12) ◽  
pp. 102261-102281
Author(s):  
Airton César Leite ◽  
Jaiciane Jorge da Silva ◽  
Maria Merciane Medeiros do nascimento Ferreira ◽  
Vanessa Bonfim Mendes ◽  
Lianna Emanuelli Carvalho Silva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Elderly Patients ◽  
Nursing Care ◽  
Terapia Intensiva

Examining the Relationship between Older Adults’ Readiness for Discharge after Surgery and Satisfaction with Nursing Care and the Associated Factors

2021 ◽  
pp. 105477382110117
Author(s):  
Altun Baksi ◽  
Hamdiye Arda Sürücü ◽  
Hale Turhan Damar ◽  
Meltem Sungur
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Nursing Care ◽  
Associated Factors ◽  
Cross Sectional ◽  
Care Satisfaction ◽  
Cross Sectional Design ◽  
The Relationship

This study aimed to examine the relationship between older adults’ readiness for discharge after surgery and satisfaction with nursing care and effects factors, using a descriptive, cross-sectional design that included 204 older adults. Examining the state of readiness for the discharge of older adults who underwent surgery in terms of the expected support sub-dimension of patients revealed that the presence of someone to support home care, the existence of health insurance, living with someone, undergoing emergency surgery, and being illiterate were statistically significant predictors. Thought of improvement in terms of nursing care between prior hospitalization and the latest hospitalization, use of intensive care unit, male, nursing care satisfaction, and the existence of health insurance were statistically significant predictors of the readiness for discharge in older adults after surgery in terms of personal status sub-dimension. Accordingly, an individual approach that takes these characteristics/variables into account is recommended when planning discharge.

Predictors of Adverse Events in Patients After Discharge From the Intensive Care Unit

2008 ◽  
Vol 17 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Wendy Chaboyer ◽  
Lukman Thalib ◽  
Michelle Foster ◽  
Carol Ball ◽  
Brent Richards
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Events ◽  
Nursing Care ◽  
Univariate Analysis ◽  
Vital Signs ◽  
Chart Audit ◽  
Care Needs ◽  
Adult Intensive Care Unit ◽  
Vein Thrombosis

Background Patients discharged from the intensive care unit may be at risk of adverse events because of complex care needs. Objective To identify the types, frequency, and predictors of adverse events that occur in the 72 hours after discharge from an intensive care unit when no evidence of adverse events was apparent before discharge. Methods A predictive cohort study of 300 patients from an adult intensive care unit was undertaken. An internationally accepted protocol for chart audit was used. Frequency of adverse events was calculated, and logistic regression was used to determine independent predictors of adverse events. Results A total of 147 adverse events, 17 (11.6%) of which were defined as major, were incurred by 92 patients (30.7%). The 3 most common adverse events, hospital-incurred infection or sepsis (n = 32, 21.8%), hospital-incurred accident or injury (n = 17, 11.6%), and other complication such as deep vein thrombosis, pulmonary edema, or myocardial infarction (n = 17, 11.6%) accounted for 44.9% (n = 66) of all adverse events. Two predictors, respiratory rate less than 10/min or greater than or equal to 25/min and pulse rate exceeding 110/min, were significant independent predictors; requiring a high level of nursing care at the time of discharge was a significant predictor in univariate analysis but not in multivariate analysis. Conclusion Taking, recording, and reporting vital signs are important. Nursing care requirements of patients at discharge from the intensive care unit may be worthy of further investigation in studies of patients after discharge.

Liaison Psychiatry: A Role on the Medical Intensive Care Unit

1982 ◽  
Vol 11 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Nathan Billig
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Setting ◽  
Medical Intensive Care Unit ◽  
Holistic Approach ◽  
Separate Entity ◽  
Liaison Psychiatry ◽  
Case Conferences ◽  
Medical Intensive Care

A psychiatric liaison program on a medical intensive care unit is described. The principle elements of the program include the psychiatrist becoming a member of the MICU “team” via: 1) attendance at morning medical rounds; 2) conducting case conferences; 3) availability to the nursing staff as a separate entity; 4) consulting with the unit directors; and 5) supervising a resident in psychiatry in his consultative work on the unit. The liaison psychiatrist's presence on the team facilitates an holistic approach to the patient and deals with intra-staff and patient-staff reactions in the critical care setting.

scholarly journals Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Riitta-Liisa Lakanmaa ◽  
Tarja Suominen ◽  
Marita Ritmala-Castrén ◽  
Tero Vahlberg ◽  
Helena Leino-Kilpi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Nursing Care ◽  
Critical Care Nursing ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Competence Scale ◽  
Intensive Care Unit Nurses ◽  
Care Nursing

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.

scholarly journals Sleep and Delirium in Pediatric Critical Illness: What Is the Relationship?

2018 ◽  
Vol 6 (4) ◽  
pp. 90 ◽  
Author(s):  
Amy Calandriello ◽  
Joanna Tylka ◽  
Pallavi Patwari
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Care Setting ◽  
Pediatric Intensive Care ◽  
Critical Care Setting ◽  
Pediatric Critical Care ◽  
Disturbed Sleep ◽  
Potential Risk Factors

With growing recognition of pediatric delirium in pediatric critical illness there has also been increased investigation into improving recognition and determining potential risk factors. Disturbed sleep has been assumed to be one of the key risk factors leading to delirium and is commonplace in the pediatric critical care setting as the nature of intensive care requires frequent and invasive monitoring and interventions. However, this relationship between sleep and delirium in pediatric critical illness has not been definitively established and may, instead, reflect significant overlap in risk factors and consequences of underlying neurologic dysfunction. We aim to review the existing tools for evaluation of sleep and delirium in the pediatric critical care setting and review findings from recent investigations with application of these measures in the pediatric intensive care unit.

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