Nurses’ Accuracy in Estimating Backrest Elevation

2002 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Amy Dillon ◽  
Cindy L. Munro ◽  
Mary Jo Grap
Keyword(s):  
Critical Care ◽  
Basic Education ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Demographic Information ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Random Number Table ◽  
The Difference ◽  
The Relationship

• Background Positioning patients is a key component of nursing care and can affect their morbidity and mortality. The Centers for Disease Control and Prevention recommend that patients receiving mechanical ventilation have the head of the bed elevated 30°to 45°to prevent nosocomial pneumonia. However, use of higher backrest positions for critically ill patients is not common nursing practice. Backrest elevation may be affected by the accuracy of nurses’ estimates of patients’ positions. • Objectives To determine the difference between nurses’ estimates of bed angles and measured bed angles and to describe the relationship between nurses’ characteristics and the accuracy of their estimates. • Methods A convenience sample of 67 nurses attending the 1999 American Association of Critical-Care Nurses National Teaching Institute and Critical Care Exposition in New Orleans, La. Each subject provided demographic information and estimated 3 bed angles. The angles were preselected by using a random number table. Summary statistics were used and were categorized according to the demographic information provided by participants. Estimated angles were correlated with measured angles, and accuracies in estimating angles were correlated with demographic characteristics. • Results Nurses were accurate in estimating bed angles (correlation, 0.8488). Demographic information, including sex, age, years of practice, years of critical care practice, basic education, highest educational level, and present position had no relationship to accuracy. • Conclusions Nurses are able to estimate backrest elevation accurately. Other explanations are needed to understand why recommendations for backrest elevation are not used in practice.

A survey of pain assessment and management practices among critical care nurses

1994 ◽  
Vol 3 (2) ◽  
pp. 123-128 ◽  
Author(s):  
MC Gujol
Keyword(s):  
Critical Care ◽  
Pain Assessment ◽  
Management Practices ◽  
Critical Care Nurses ◽  
Opioid Use ◽  
Convenience Sample ◽  
Policy Makers ◽  
Survey Results ◽  
Medication Decisions ◽  
The Relationship

BACKGROUND: Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. PURPOSES: To explore the relationship between two variables in pain assessment (length of time after surgery and ventilator status) and medication decisions made by critical care nurses, and to identify nurses' concerns about opioid use. METHODS: A convenience sample of 71 critical care nurses participated in the survey. RESULTS: Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.

Continuing to Challenge Practice to Be Evidence Based

2015 ◽  
Vol 35 (2) ◽  
pp. 39-50 ◽  
Author(s):  
Mary Beth Flynn Makic ◽  
Carol Rauen ◽  
Kimmith Jones ◽  
Anna C. Fisk
Keyword(s):  
Critical Care ◽  
Daily Practice ◽  
Medication Administration ◽  
Chest Physiotherapy ◽  
Critical Care Nurses ◽  
Current Evidence ◽  
Care Practice ◽  
Evidence Based ◽  
Actual Weight ◽  
Daily Interruption

Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient’s actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice.

Consequences of clinical situations that cause critical care nurses to experience moral distress

2012 ◽  
Vol 19 (4) ◽  
pp. 479-487 ◽  
Author(s):  
Debra L Wiegand ◽  
Marjorie Funk
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
Thematic Analysis ◽  
Moral Distress ◽  
Medical Center ◽  
Critical Care Nurses ◽  
Negative Consequences ◽  
Convenience Sample ◽  
Methodological Rigor ◽  
Descriptive Approach

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families.

Relationship between moral distress and ethical climate with job satisfaction in nurses

2017 ◽  
Vol 26 (2) ◽  
pp. 346-356 ◽  
Author(s):  
Sharareh Asgari ◽  
Vida Shafipour ◽  
Zohreh Taraghi ◽  
Jamshid Yazdani-Charati
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Social Security ◽  
Ethical Climate ◽  
Moral Distress ◽  
Correlation Study ◽  
Critical Care Nurses ◽  
Quality Of Work Life ◽  
Distress Scale ◽  
The Relationship

Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.

Critical Care Nurses’ Perceptions of Clinical Alarm Management on Nursing Practice

2021 ◽  
Author(s):  
Ting-Ting Lee ◽  
Yu-Shan Shih
Keyword(s):  
Critical Care ◽  
Care Quality ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Training Methods ◽  
Multimodal Learning ◽  
Alarm Management ◽  
Negative Impacts ◽  
Group Interviews ◽  
Nurses Perceptions

The management of alarms is a key responsibility of critical care nurses. A qualitative study with focus group interviews were conducted with 37 nurses in Taiwan. Four main themes were derived: the foundation of critical care practice, a trajectory of adjust alarms management, negative impacts on care quality and patient safety, hope for remote control and multimodal learning. Results revealed that diverse training methods may facilitate nursing competency and devices usability to promote critical care.

THE ASSOCIATION BETWEEN TOBACCO SMOKING AND REPORTED PSYCHIATRIC SYMPTOMS IN AN ADOLESCENT POPULATION IN THE UNITED ARAB EMIRATES

2003 ◽  
Vol 31 (5) ◽  
pp. 461-465 ◽  
Author(s):  
Feisal A. Younis ◽  
Talaat Mattar ◽  
Akram K. Wilson
Keyword(s):  
Secondary School ◽  
United Arab Emirates ◽  
Psychiatric Symptoms ◽  
Psychiatric Morbidity ◽  
Demographic Information ◽  
School Students ◽  
The Difference ◽  
Self Reporting Questionnaire ◽  
The Relationship ◽  
The City

In this study the relationship between cigarette smoking and certain elements of psychiatric morbidity, especially anxiety and depressive symptoms, was investigated among a sample of adolescents in the United Arab Emirates (UAE). The sample of the study consisted of 473 male secondary school students in the city of Ras Al-Kheima, UAE. Mean age of participants was 16.67 (SD=1.07). They completed the Arabic version of the Self-Reporting Questionnaire (SRQ-20) as well as other demographic information. Data analysis, using oneway ANOVA, revealed significantly higher reported symptoms by smokers compared with those who never smoked and those who started and stopped. The difference between those who smoked and stopped and those who never smoked was also significant.

The relationship between ethical conflict and nurses’ personal and organisational characteristics

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2427-2437 ◽  
Author(s):  
Zahra Saberi ◽  
Mohsen Shahriari ◽  
Ahmad Reza Yazdannik
Keyword(s):  
Critical Care ◽  
Ethics Education ◽  
Organizational Factors ◽  
Educational Status ◽  
Clinical Situation ◽  
Critical Care Nurses ◽  
Ethical Conflict ◽  
Stressful Environment ◽  
Wide Range ◽  
The Relationship

Introduction: Critical care nurses work in a complex and stressful environment with diverse norms, values, interactions, and relationships. Therefore, they inevitably experience some levels of ethical conflict. Aim: The aim of this study is to analyze the relationship of ethical conflict with personal and organizational characteristics among critical care nurses. Methods: This descriptive-correlational study was conducted in 2017 on a random sample of 216 critical care nurses. Participants were recruited through stratified random sampling. Data collection tools were a demographic and professional characteristics questionnaire, the Ethical Conflict in Nursing Questionnaire-Critical Care Version, and the Organizational and Managerial Factors Questionnaire. The data were analyzed using the SPSS software (v. 22.0). Ethical considerations: All participants were informed about the study’s aim and were assured that participation in and withdrawal from the study would be voluntary. Findings: The mean score of exposure to ethical conflict was 201.91 ± 80.38. The highest-scored conflict-inducing clinical situation was “working with professionally incompetent nurses or nurse assistants.” Married nurses, nurses with official employment, nurses with master’s degree, and nurses with the history of attending ethics education programs had significantly higher exposure to ethical conflict than the other nurses (p < 0.05). The significant predictors of exposure to ethical conflict were marital status, educational status, reward system, organizational culture, manager’s conduct, and organizational structure and regulations (p < 0.05). These predictors accounted for 37.2% of the total variance of exposure to ethical conflict. Conclusion: Critical care nurses experience moderate levels of exposure to ethical conflict. A wide range of personal and organizational factors can contribute to such exposure, the most significant of which is the professional incompetence of nursing colleagues, nurse assistants, and physicians. Therefore, many improvements at personal and organizational levels are needed to reduce critical care nurses’ exposure to ethical conflict.

Changing the Work Environment in Intensive Care Units to Achieve Patient-Focused Care: The Time Has Come

2006 ◽  
Vol 15 (6) ◽  
pp. 541-548 ◽  
Author(s):  
Kathleen McCauley ◽  
Richard S. Irwin
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
American Association ◽  
Care Delivery ◽  
Professional Community ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Practice ◽  
Healthy Work ◽  
Healthy Work Environments

The American Association of Critical-Care Nurses Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians Patient-Focused Care project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive. Healthy work environments are so influential that failure to address the issue would result in deleterious effects for every aspect of acute and critical care practice. Skilled communication and true collaboration are crucial for transforming work environments. The American College of Chest Physicians project on patient-focused care was born out of a realization that medicine as currently practiced is too fragmented, too focused on turf battles that hinder communication, and too divorced from a real understanding of what patients expect and need from their healthcare providers. Communication as well as continuity and concordance with the patients’ wishes are foundational premises of care that is patient-focused and safe. Some individuals may achieve some level of genuine patient-focused care even when they practice in a toxic work environment because they are gifted communicators who embrace true collaboration. At best, most likely those efforts will be hit-or-miss and such heroism will be impossible to sustain if the environment is not transformed into a model that reflects standards and initiatives set out by the American Association of Critical-Care Nurses and the American College of Chest Physicians. Other innovative models of care delivery remain unreported. The successes and failures of these models should be shared with the professional community.

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