Hematologic Complications of Critical Illness

2009 ◽  
Vol 20 (2) ◽  
pp. 145-154
Author(s):  
Nancy Munro
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Blood Cell ◽  
Cell Lines ◽  
Red Blood Cell ◽  
Critically Ill Patients ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Care Nurse ◽  
Critical Care Nurse

All critically ill patients are at risk for hematological complications during their hospitalization. It is essential that critical care nurses understand the hematological system and common complications. The purpose of this article is to briefly review some basic hematologic concepts involving each of the 3 cell lines: the white blood cell, the red blood cell, and platelets. The content focuses on how to assess these cell lines when there is dysfunction. Examples of disease processes involving the increased and decreased production of each cell line as well as destruction processes are discussed from a critical care perspective. The critical care nurse needs to continually incorporate this information into practice as research continues to formulate critical care practice.

Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

2021 ◽  
Vol 30 (6) ◽  
pp. 435-442
Author(s):  
David C. Mohr ◽  
Lakshmana Swamy ◽  
Edwin S. Wong ◽  
Meredith Mealer ◽  
Marc Moss ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Outcomes ◽  
Employee Satisfaction ◽  
Veterans Health Administration ◽  
Critical Care Nurses ◽  
Veterans Health ◽  
Health Administration ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Nurse Burnout

Background Critical care nurses have a burnout rate among the highest of any nursing field. Nurse burnout may impact care quality. Few studies have considered how temporal patterns may influence outcomes. Objective To test a longitudinal model of burnout clusters and associations with patient and clinician outcomes. Methods An observational study analyzed data from annual employee surveys and administrative data on patient outcomes at 111 Veterans Health Administration intensive care units from 2013 through 2017. Site-level burnout rates among critical care nurses were calculated from survey responses about emotional exhaustion and depersonalization. Latent trajectory analysis was applied to identify clusters of facilities with similar burnout patterns over 5 years. Regression analysis was used to analyze patient and employee outcomes by burnout cluster and organizational context measures. Outcomes of interest included patient outcomes (30-day standardized mortality rate and observed minus expected length of stay) for 2016 and 2017 and clinician outcomes (intention to leave and employee satisfaction) from 2013 through 2017. Results Longitudinal analysis revealed 3 burnout clusters among the 111 sites: low (n = 37), medium (n = 68), and high (n = 6) burnout. Compared with sites in the low-burnout cluster, those in the high-burnout cluster had longer patient stays, higher employee turnover intention, and lower employee satisfaction in bivariate models but not in multivariate models. Conclusions In this multiyear, multisite study, critical care nurse burnout was associated with key clinician and patient outcomes. Efforts to address burnout among nurses may improve patient and employee outcomes.

Quality assurance and the critical care nurse

1991 ◽  
Vol 11 (9) ◽  
pp. 34-40
Author(s):  
P Brown-Stewart
Keyword(s):  
Quality Assurance ◽  
Critical Care ◽  
Critically Ill ◽  
Monitoring And Evaluation ◽  
Critical Care Nurses ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Appropriateness Of Care ◽  
External Sources ◽  
The Way

Care of the critically ill has become increasingly challenging due to demands from external sources to measure the quality and appropriateness of care provided. Quality assurance is the responsibility of every critical care nurse and requires vigilance as well as a knowledge of the principles of standards, monitoring and evaluation. Through quality assurance activities, the contribution of critical care nurses in the achievement of patient outcomes can be measured. Quality assurance challenges us to evaluate the way we practice, and assists us to continuously improve the way we provide care to critically ill patients.

Perceptions and significance of patient deaths for pediatric critical care nurses

1992 ◽  
Vol 12 (3) ◽  
pp. 72-75 ◽  
Author(s):  
SW Benica ◽  
CB Longo ◽  
JH Barnsteiner
Keyword(s):  
Critical Care ◽  
Stress Management ◽  
Critical Care Nurses ◽  
The Other ◽  
Recruitment Strategies ◽  
Pediatric Critical Care ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Hospital Administrator ◽  
Dying Patients

This study provides nursing administrators with data regarding stressors of the pediatric critical care nurse in order of priority. Death of patients was the only item isolated and compared to the other stress categories. It is suggested that death of patients be compared to all other items on the audit. The authors recommend expanding this study by asking two additional questions: Does the amount of time spent caring for dying patients correlate with the nurses' estimate of patient deaths and is there a relationship between the time spent caring for patients who die and perception of death as a stressor? This information can be utilized at the unit level in the development of stress management activities. At the hospital administrator level, this information can assist in the expansion of retention and recruitment strategies.

Anticonvulsants: Pharmacotberapeutic Issues in the Critically Ill Patient

1991 ◽  
Vol 2 (4) ◽  
pp. 639-656 ◽  
Author(s):  
Robert E. Dupuis ◽  
Jorge Miranda-Massari
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Epilepsy Treatment

Critically ill patients often have or develop conditions that make them susceptible to seizures and epilepsy. Treatment frequently involves the use of anticonvulsants. In order to use these effectively, the critical care nurse must be aware of the indications and controversies surrounding their use, the pathophysiologic conditions that impact on the disposition, and appropriate dosing and monitoring of these agents in the critical care setting

Critical Care Nursing in Sri Lanka: Brief History and Recent Advances

2019 ◽  
Vol 13 (3) ◽  
pp. 110-117
Author(s):  
Gerald Williams ◽  
P. N. Sajeewani
Keyword(s):  
Critical Care ◽  
Sri Lanka ◽  
Critical Care Nurses ◽  
Policy Support ◽  
Critical Care Nursing ◽  
Nurse Training ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Career Development Plan ◽  
Care Nursing

This article summarizes the development of critical care nursing in Sri Lanka. After years of development, Sri Lanka steadily progresses to establish critical care medicine as a separate specialty with fully trained Intensivists and nurses playing pivotal roles. However, courses of critical care nurse training are still lacking. Other barriers in developing critical care nursing in Sri Lanka include lacking career development plan, financial and policy support. The formulation of the Sri Lanka Society of Critical Care Nurses is helpful to fill this gap and to build up a local critical care nursing community in Sri Lanka.

scholarly journals Ensuring Breathing Comfort at the End of Life: The Integral Role of the Critical Care Nurse

2018 ◽  
Vol 27 (4) ◽  
pp. 264-269 ◽  
Author(s):  
Margaret L. Campbell
Keyword(s):  
Critical Care ◽  
Respiratory Distress ◽  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Subjective Experience ◽  
Self Report ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Assessment And Treatment

This article describes the author’s program of clinical research focused on assessment and treatment of respiratory distress among critically ill patients at the end of life. Dyspnea is a subjective experience of breathing discomfort that occurs in the presence of cardiopulmonary and neuromuscular diseases. Dyspnea is one of the most common and most distressing symptoms experienced by critically ill patients. Many critically ill patients, particularly those not expected to survive, become cognitively impaired or unconscious and lose the ability to report symptoms, although dyspnea can be known only from a patient’s report. When self-reporting ability is lost, the critical care nurse must rely on signs indicative of a patient’s respiratory distress. The critically ill patient unable to self-report is vulnerable to under-recognition of symptom distress and subsequent over-treatment or undertreatment. When the patient is dying, there is only 1 chance to optimize the assessment and treatment of symptoms.

Alcohol and trauma: the critical link

1994 ◽  
Vol 14 (2) ◽  
pp. 82-86 ◽  
Author(s):  
MS Sommers
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Problem Drinking ◽  
Traumatic Injury ◽  
Nursing Interventions ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Critical Care Units ◽  
Critical Link

The link between traumatic injury and alcohol consumption is strong. Although statistics vary, from one half to one third of trauma victims admitted to critical care units have an alcohol-related injury. The initial role of the critical care nurse is to identify the presence of alcohol by monitoring the patient's BAC. Once the presence of alcohol is confirmed, its effects impact directly on the plan of care that evolves during the critical illness. Nursing interventions focus on four specific areas affected by alcohol: the ability of alcohol to mask injury, the effects of alcohol on medications, alcohol withdrawal, and rehabilitation from alcoholism. By incorporating these four areas into the plan of care, the critical care nurse assists the patient not only to recover from a traumatic injury but also to deal with a problem drinking pattern.

scholarly journals Critical Care Nurse Work Environments 2018: Findings and Implications

2019 ◽  
Vol 39 (2) ◽  
pp. 67-84 ◽  
Author(s):  
Beth Ulrich ◽  
Connie Barden ◽  
Linda Cassidy ◽  
Natasha Varn-Davis
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Nurse Outcomes

BACKGROUNDThe health of critical care nurse work environments affects patient and nurse outcomes. The results of the 2018 Critical Care Nurse Work Environment Study are reported here with comparisons to previous studies and recommendations for continued improvement.OBJECTIVETo evaluate the current state of critical care nurse work environments.METHODSAn online survey was used to collect quantitative and qualitative data for this mixed-methods study. A total of 8080 American Association of Critical-Care Nurses (AACN) members and constituents responded to the survey.RESULTSThe health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement. Key findings include documented absence of appropriate staffing by more than 60% of participants; an alarming number of physical and mental well-being issues (198 340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards.CONCLUSIONEvidence of the relationship between healthy nurse work environments and patient and nurse outcomes continues to increase. The results of this study provide evidence of the positive relationship between implementation of the AACN Healthy Work Environment standards and the health of critical care nurse work environments, between the health of critical care nurse work environments and job satisfaction, and between job satisfaction and the intent of critical care nurses to leave their current positions or stay.

Endocrine Responses to the Stress of Critical Illness

1992 ◽  
Vol 3 (2) ◽  
pp. 379-391 ◽  
Author(s):  
Pamela J. Sikes
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Hormonal Changes ◽  
Posterior Pituitary ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Clinical Interventions ◽  
Psychologic Stress

The physiologic and psychologic stress of critical illness produces systemic endocrine responses that affect the body’s ability to achieve and maintain homeostasis. Regardless of the nature of the stress or illness, specific hormonal changes occur in thyroid, adrenal, and posterior pituitary activity. This article describes the physiologic and pathophysiologic basis underlying endocrine responses to the stress of critical illness. The critical care nurse is challenged by the complexity of this patient and needs to be familiar with the endocrine responses to critical illness for assessment and clinical interventions to be meaningful

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