Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

scholarly journals Nutrition in the intensive care unit

2015 ◽  
Vol 3 (10) ◽  
pp. 10 ◽  
Author(s):  
Chase C. Hansen ◽  
Sharmila Dissanaike
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Enteral Feeding ◽  
Surgical Patients ◽  
Evidence Based ◽  
Timing Of Initiation ◽  
Evidence Based Guidelines

Nutrition has evolved into an integral part of modern critical care for both medical and surgical patients. Multiple international societies now issue evidence-based guidelines to help clinician optimize their patients’ Nutrition. However, adherence to these guidelines throughout the country is poor, and education in nutrition is still lagging in medical school.  The authors also highlight four key areas where evidence-based recommendations exist – timing of initiation of enteral feeding, calculating and meeting total daily requirements, use of gastric residual volumes to guide delivery, and interuption of feeding for procedures – but are currently often not followed.  Reasons for this lack of adherence are explored, and potential solutions discussed.

Visitation in the Pediatric Intensive Care Unit: Controversy and Compromise

1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
The Family ◽  
Centered Care ◽  
Family Centered

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

The Department of Health and Human Services (DHHS) Sickle Cell Disease (SCD) Initiative: Increasing Access and Improving Care

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4834-4834
Author(s):  
Susan B. Shurin ◽  
Hani Atrash ◽  
Coleen Boyle ◽  
R. Lorraine Brown ◽  
Janet L. Collins ◽  
...  
Keyword(s):  
Health Care ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Health Care Providers ◽  
The United States ◽  
Evidence Based ◽  
Care Providers ◽  
Cell Disease ◽  
Evidence Based Guidelines ◽  
Support Research

Abstract Abstract 4834 Over the past half century, the course of sickle cell disease has been transformed in the United States through the conduct of rigorous biomedical research and broad application of the results. Universal newborn screening with comprehensive medical care has dramatically reduced death and disability in childhood, and increased the numbers of patients surviving into adulthood. However, access to health care has not kept up with the changing demographics of those affected by sickle cell disease. Health care often becomes fragmented when patients transition from pediatric to adult health care providers. Access to comprehensive care has impeded both conduct of clinical and implementation of research results. To address these needs in this changing environment, HHS Secretary Kathleen Sebelius has charged six agencies of HHS – NIH, CDC, HRSA, FDA, AHRQ and CMS – and the Offices of Minority Health and Planning and Evaluation, to improve the health of people with SCD. The agencies are coordinating their programs and collaborating with the Office of the Secretary, to achieve the following goals:create a comprehensive database of individuals with SCD to facilitate the monitoring of health outcomes and clinical research;improve the care of adults and children through development and dissemination of evidence-based guidelines, which are anticipated in Spring, 2012, with broad implementation plans;identify measures of quality of care for individuals with SCD and incorporate them into quality improvement programs at HHS;increase the availability of medical homes to improve patient access to quality primary and specialty care;provide State Medicaid officials, health care providers, patients, families and advocacy groups with information about resources related to SCD care and treatment;work with the pharmaceutical industry and academic investigators to increase the development of effective treatments for patients with SCD;support research to improve health care for people with SCD;support research to understand the clinical implications of SC trait;engage national and community-based SCD advocacy organizations and experts in ongoing discussions to ensure that issues of importance to persons affected are addressed. Organizational and strategic actions are being taken at each agency to enhance implementation of research advances; provide evidence-based guidelines to families, health care providers, and payers; facilitate new drug development; and provide public health data to impact both the health care delivery and research agendas. The enthusiastic support of the American Society of Hematology and its members is essential for long-term success of this endeavor. Disclosures: No relevant conflicts of interest to declare.

Reducing Foley Catheter Device Days in an Intensive Care Unit

2006 ◽  
Vol 17 (3) ◽  
pp. 272-283
Author(s):  
Laura Reilly ◽  
Patty Sullivan ◽  
Sharon Ninni ◽  
Denise Fochesto ◽  
Karen Williams ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Foley Catheter ◽  
Hospital Costs ◽  
Evidence Based ◽  
Tract Infections ◽  
Evidence Based Guidelines ◽  
Hospital Acquired

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

Mothers’ Stories about Their Experiences in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Family Factors ◽  
Parental Role ◽  
Parental Distress ◽  
Care Providers

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

scholarly journals Facilitating Posttraumatic Growth After Critical Illness

2020 ◽  
Vol 29 (6) ◽  
pp. e108-e115
Author(s):  
Abigail C. Jones ◽  
Rachel Hilton ◽  
Blair Ely ◽  
Lovemore Gororo ◽  
Valerie Danesh ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Posttraumatic Growth ◽  
Posttraumatic Stress ◽  
Intensive Care Unit Stay ◽  
Traumatic Experience ◽  
Care Providers ◽  
Functional Impairments

The theory of posttraumatic growth arose from accounts of various trauma survivors experiencing not only distress but also growth and change. An intensive care unit admission is an unplanned, sudden, and traumatic experience, and many survivors have posttraumatic stress that can lead to posttraumatic stress disorder. Survivors leave the intensive care unit with new functional impairments that drive depression, and they frequently experience anxiety. Amidst the stress of understanding the trauma of an intensive care unit admission, survivors can grow in their world views, relationships, and sense of self. Understanding posttraumatic growth in intensive care unit survivors will inform health care providers on how to help survivors understand their new difficulties after an intensive care unit stay and facilitate growth. This article is a conceptual review of posttraumatic growth, identifiers of posttraumatic growth, and how the tenets of the posttraumatic growth theory apply to intensive care unit survivors. Health care professionals, specifically nurses, can incorporate practices into their care during and after the intensive care unit stay that encourage understanding and positive accommodation of new difficulties brought on by the intensive care unit hospitalization to support survivor growth. Opportunities for research include incorporating posttraumatic growth assessments into post–intensive care unit clinics, self-help materials, and various programs or therapies. Outcomes associated with posttraumatic growth are listed to suggest directions for research questions concerning posttraumatic growth in intensive care unit survivors.

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