Evidence-based practice: fever-related interventions

1999 ◽  
Vol 8 (1) ◽  
pp. 481-487 ◽  
Author(s):  
R Henker
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
American Association ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Common Phenomenon ◽  
Research Questions ◽  
Research Studies

Fever is a common phenomenon in critically ill patients. Ideally, all decisions about treatment of fever would be based on results of well-developed research studies. Instead, some research questions related to treatment of fever have been studied more extensively than others. This article is an evaluation of the usefulness of the research studies related to treatment of fever in the critically ill. Two questions are addressed: when is treatment of fever most beneficial to a critically ill patient, and how is fever most effectively treated in the critically ill? Evidence related to the treatment of fever is evaluated by using the recommendation levels of the research-based practice protocols of the American Association of Critical-Care Nurses.

scholarly journals Expressive writing as an intervention to decrease distress in pediatric critical care nurses

2018 ◽  
Vol 6 (3) ◽  
pp. 96 ◽  
Author(s):  
Julie Ann Perry ◽  
Peggy Ward-Smith
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Nursing Staff ◽  
Critically Ill Patients ◽  
Expressive Writing ◽  
Cost Effective ◽  
Critical Care Nurses ◽  
Common Phenomenon ◽  
Staff Satisfaction ◽  
Pediatric Critical Care

Experiencing distress is a common phenomenon among pediatric critical care nurses. Expressive writing provides a cost-effective and easily implemented intervention nurses can utilize to address distress as a consequence of providing care for critically ill patients. This intervention may decrease the array of consequences of distress and improve nursing staff satisfaction and retention.

Rights of the Critically Ill Patient: Position Statement of the World Federation of Critical Care Nurses

2019 ◽  
Vol 13 (2) ◽  
pp. 58-70
Author(s):  
Susan Yeager ◽  
Elizabeth Papathanassoglou ◽  
Laura Brooks ◽  
Lori Delaney ◽  
Sarah Livesay ◽  
...  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Position Statement ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
World Federation ◽  
Critical Care Nursing ◽  
The World ◽  
Care Nursing

Critical care nursing involves the specialised nursing care of critically ill patients who are vulnerable and may be unable to voice their needs or have their human rights recognized or addressed. The World Federation of Critical Care Nurses (WFCCN) accepts and supports the Universal Declaration of Human Rights and the need for critically ill patients to be cared for with humanity, and to advocate for the rights of their families and communities. In the above context, WFCCN determined the need to create a document that was focused more specifically on the rights of critically ill patients. To this end, in August 2007, the WFCCN released its first Position Statement on the Rights of the Critically Ill Patient - The Declaration of Manila (WFCCN, 2007). The fundamental aim of this Declaration was to inform and assist critical care nursing associations, health services, educational facilities, and other interested parties to realize the rights of critically ill patients. Due to changes in critical care worldwide, as well as increased global migration, the WFCCN Board of Directors commissioned a review of the 2007 Declaration. As a result of this review, revisions were undertaken. This document represents the 2019 revised WFCCN Position Statement on the Rights of the Critically Ill Patient.

Fever

2007 ◽  
Vol 18 (1) ◽  
pp. 76-87
Author(s):  
Richard Henker ◽  
Karen K. Carlson
Keyword(s):  
Critically Ill ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Patient Morbidity ◽  
Salient Points ◽  
Assessment And Treatment ◽  
Fever Management ◽  
Planning Intervention

Fever occurs frequently in critically ill patients and requires knowledgeable assessment and treatment by critical care nurses. Fever can result from infection or inflammation and should be differentiated from simple hyperthermia. Although temperature measurement and fever management are not often priorities in the management of a critically ill patient, the physiologic consequences of fever may affect patient morbidity. This article defines and describes fever and its pathophysiology. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with fever is outlined, using levels of recommendation based on the strength of the available evidence. A case study is presented to illustrate application to clinical practice. Commentary about the case is provided to review the salient points of care.

Transport of the critically ill patient

2017 ◽  
Author(s):  
Laura Flutter ◽  
Christoph Melzer-Gartzke ◽  
Claudia Spies ◽  
Julian Bion
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Best Practice ◽  
Ad Hoc ◽  
Critically Ill Patient ◽  
National Guidelines ◽  
Specialist Services ◽  
Hospital Transfer ◽  
Safe Transport

The safe transport of critically ill patients is recognized internationally as a key competency for clinicians working in anaesthesia, critical care, and emergency medicine. This includes inter- and intra-hospital, land, and air transport. The centralization of specialist services and growing demand for critical care beds have increased pressure on hospitals to provide transfer support for critically ill patients. A variety of systems have emerged to facilitate the increasing need for both inter- and intra-hospital transfer of patients, ranging from a national coordinated retrieval service to the ad hoc utilization of on-call teams. The potential for complications during all types of transfer has been well documented. In order to improve safety, a number of national guidelines and courses have been developed to provide a standardized approach to transfer medicine. This chapter reviews the current literature on the subject and provides a summary of best practice for the transfer of the critically ill patient.

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

Examining the Evidence to Guide Practice: Challenging Practice Habits

2014 ◽  
Vol 34 (2) ◽  
pp. 28-45 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Robin Watson ◽  
Ann Will Poteet
Keyword(s):  
Critical Care ◽  
Current Practice ◽  
American Association ◽  
Daily Practice ◽  
Feeding Tube ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Evidence Based ◽  
Health Care Workforce ◽  
In Infants And Children

Nurses are the largest segment of the nation’s health care workforce, which makes nurses vital to the translation of evidence-based practice as a practice norm. Critical care nurses are in a position to critically appraise and apply best evidence in daily practice to improve patients’ outcomes. It is important for critical care nurses to continually evaluate their current practice to ensure that they are applying the current best evidence rather than practicing on the basis of tradition. This article is based on a presentation at the 2013 National Teaching Institute of the American Association of Critical-Care Nurses. Four practice interventions that are within the realm of nursing are critiqued on the basis of current best evidence: (1) turning critically ill patients, (2) sleep promotion in the intensive care unit, (3) feeding tube management in infants and children, and (4) prevention of venothromboembolism…again. The related beliefs, current evidence, and implications for practice associated with each topic are described.

scholarly journals Vancomycin Dosing Practices among Critical Care Pharmacists: A Survey of Society of Critical Care Medicine Pharmacists

2020 ◽  
Vol 13 ◽  
pp. 117863372095207
Author(s):  
Alexander H Flannery ◽  
Drayton A Hammond ◽  
Douglas R Oyler ◽  
Chenghui Li ◽  
Adrian Wong ◽  
...  
Keyword(s):  
Critical Care ◽  
Infectious Diseases ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Online Survey ◽  
Critical Care Medicine ◽  
Guideline Recommendation ◽  
Critically Ill Patient ◽  
Critically Ill Adults ◽  
Monitoring Protocols

Introduction: Critically ill patients and their pharmacokinetics present complexities often not considered by consensus guidelines from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Prior surveys have suggested discordance between certain guideline recommendations and reported infectious disease pharmacist practice. Vancomycin dosing practices, including institutional considerations, have not previously been well described in the critically ill patient population. Objectives: To evaluate critical care pharmacists’ self-reported vancomycin practices in comparison to the 2009 guideline recommendations and other best practices identified by the study investigators. Methods: An online survey developed by the Research and Scholarship Committee of the Clinical Pharmacy and Pharmacology (CPP) Section of the Society of Critical Care Medicine (SCCM) was sent to pharmacist members of the SCCM CPP Section practicing in adult intensive care units in the spring of 2017. This survey queried pharmacists’ self-reported practices regarding vancomycin dosing and monitoring in critically ill adults. Results: Three-hundred and sixty-four responses were received for an estimated response rate of 26%. Critical care pharmacists self-reported largely following the 2009 vancomycin dosing and monitoring guidelines. The largest deviations in guideline recommendation compliance involve consistent use of a loading dose, dosing weight in obese patients, and quality improvement efforts related to systematically monitoring vancomycin-associated nephrotoxicity. Variation exists regarding pharmacist protocols and other practices of vancomycin use in critically ill patients. Conclusion: Among critical care pharmacists, reported vancomycin practices are largely consistent with the 2009 guideline recommendations. Variations in vancomycin dosing and monitoring protocols are identified, and rationale for guideline non-adherence with loading doses elucidated.

scholarly journals Methods Used by Critical Care Nurses to Verify Feeding Tube Placement in Clinical Practice

2015 ◽  
Vol 35 (1) ◽  
pp. e1-e7 ◽  
Author(s):  
Annette M. Bourgault ◽  
Janie Heath ◽  
Vallire Hooper ◽  
Mary Lou Sole ◽  
Elizabeth G. Nesmith
Keyword(s):  
Critical Care ◽  
American Association ◽  
Feeding Tube ◽  
Critical Care Nurses ◽  
Tube Placement ◽  
Evidence Based ◽  
Clinical Practices ◽  
Feeding Tubes ◽  
Verification Methods ◽  
Feeding Tube Placement

BACKGROUNDThe American Association of Critical-Care Nurses practice alert on verification of feeding tube placement makes evidence-based practice recommendations to guide nursing management of adult patients with blindly inserted feeding tubes. Many bedside verification methods do not allow detection of improper positioning of a feeding tube within the gastrointestinal tract, thereby increasing aspiration risk.OBJECTIVESTo determine how the expected practices from the American Association of Critical-Care Nurses practice alert were implemented by critical care nurses.METHODSThis study was part of a larger national, online survey that was completed by 370 critical care nurses. Descriptive statistics were used to analyze the data.RESULTSSeventy-eight percent of nurses used a variety of methods to verify initial placement of feeding tubes, although 14% were unaware that tube position should be confirmed every 4 hours. Despite the inaccuracy of auscultation methods, only 12% of nurses avoided this practice all of the time.CONCLUSIONSImplementation of expected clinical practices from this guideline varied. Nurses are encouraged to implement expected practices from this evidence-based, peer reviewed practice alert to minimize risk for patient harm.

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