Prolonged Paralysis and Apnea After Receiving a Neuromuscular Blocking Agent: What Nurses Should Know

2009 ◽  
Vol 18 (6) ◽  
pp. 592-588 ◽  
Author(s):  
Kathryn S. Jaramillo ◽  
Elizabeth Scruth ◽  
Eugene Cheng
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agent ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Ventilator Support ◽  
Prolonged Apnea ◽  
Care Nursing

After receiving mivacurium, a short-acting neuromuscular blocking agent used for intubation before surgery, a patient experienced prolonged paralysis and prolonged apnea that required ventilator support. Although this complication is rare, all critical care nurses should be aware of it so they can be competent in managing and providing holistic and comprehensive nursing care to the patient and the patient’s family. Although this complication has been documented in the anesthesia literature, it has received little mention in critical care nursing journals.

Implementation of Structure and Process Standards

1991 ◽  
Vol 2 (1) ◽  
pp. 31-39
Author(s):  
Glenda A. Krum
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Nursing Care ◽  
Critically Ill Patients ◽  
Quality Care ◽  
Quality Assurance Program ◽  
Critical Care Nursing ◽  
Healthcare Organizations ◽  
Policies And Procedures ◽  
Care Nursing

A dilemma in critical care nursing practice is how to develop and implement a practical quality assurance program that incorporates high-quality standards of nursing care for critically ill patients and addresses those aspects of care considered important by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Standards for Nursing Care of the Critically Ill defines and describes structure and process standards and provides a comprehensive guide for the development of a program for the delivery of quality care to critically ill patients. The purpose of this chapter is to discuss practical application of the standards described by the American Association of Critical-Care Nurses (AACN) through the use of policies and procedures that support structure and process standards

The revised JCAHO nursing care standards: areas of emphasis

1991 ◽  
Vol 11 (8) ◽  
pp. 12-12
Author(s):  
JG Alspach
Keyword(s):  
Critical Care ◽  
Nursing Education ◽  
Nursing Care ◽  
Critical Care Nurses ◽  
Nursing Management ◽  
Accreditation Standards ◽  
Nursing Services ◽  
Compliance Requirements ◽  
Fundamental Shift ◽  
Care Nursing

The 1991 JCAHO nursing care standards represent a fundamental shift in the focus of the survey and accreditation processes from specifying the means to clarifying the ends of nursing services and from prescribing structures and processes to clarifying the intended outcomes of nursing care. As critical care nurses prepare to meet the compliance requirements of these new accreditation standards, it will be helpful to keep in mind that our services are nursing care, nursing management, and nursing education or research, but our purpose is quality nursing care.

Determining AACN's research priorities for the 90s

1993 ◽  
Vol 2 (2) ◽  
pp. 110-117 ◽  
Author(s):  
R Lindquist ◽  
J Banasik ◽  
J Barnsteiner ◽  
PC Beecroft ◽  
S Prevost ◽  
...  
Keyword(s):  
Critical Care ◽  
Phase 1 ◽  
Research Priorities ◽  
Consensus Conference ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Research Topics ◽  
Research Committee ◽  
Priority Ranking ◽  
Care Nursing

The American Association of Critical-Care Nurses completed a three-phased process of priority identification for critical care nursing research. In phase 1, a 78-item survey was generated following a comprehensive review of potential research topics. In phase 2, approximately 1000 critical care nurses rated each item on the survey for importance to critical care nursing. Based on these results, the AACN Research Committee formulated a clinical and a nonclinical (contextual) list of research topics. Each list contained 25 topics. In phase 3, topics were given final rankings at a 1-day Consensus Conference on Research Priorities. Both Likert-type and magnitude estimation scaling were used to determine priority ranking of items on each list. As a result, both clinical and contextual research priorities were established for AACN.

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 Effect of an educational programme on critical care nurses’ competence at two tertiary hospitals in Malawi

2021 ◽  
Vol 33 (4) ◽  
pp. 236-241
Author(s):  
Rodwell Gundo ◽  
Beatrice Gundo ◽  
Ellen Chirwa ◽  
Annette Dickinson ◽  
Gael Janine Mearns
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Educational Programme ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Nursing Competence ◽  
Competence Scale ◽  
Tertiary Hospitals ◽  
Care Nursing

BackgroundCritical care specialty deals with the complex needs of critically ill patients. Nurses who provide critical care are expected to possess the appropriate knowledge and skills required for the care of critically ill patients. The aim of this study was to assess the effect of an educational programme on the competence of critical care nurses at two tertiary hospitals in Lilongwe and Blantyre, Malawi.MethodsA quantitative pre- and post-test design was applied. The training programme was delivered to nurses (n = 41) who worked in intensive care and adult high dependency units at two tertiary hospitals. The effect of the training was assessed through participants’ self-assessment of competence on the Intensive and Critical Care Nursing Competence Scale and a list of 10 additional competencies before and after the training.ResultsThe participants’ scores on the Intensive and Critical Care Nursing Competence Scale before the training, M = 608.2, SD = 59.6 increased significantly after the training, M = 684.7, SD = 29.7, p <.0001 (two-tailed). Similarly, there was a significant increase in the participants’ scores on the additional competencies after the training, p <.0001 (two-tailed). ConclusionThe programme could be used for upskilling nurses in critical care settings in Malawi and other developing countries with a similar context.

Evolving trends in critical care nursing practice: results of a certification role delineation study

1999 ◽  
Vol 8 (5) ◽  
pp. 285-290 ◽  
Author(s):  
M Biel ◽  
JA Eastwood ◽  
P Muenzen ◽  
S Greenberg
Keyword(s):  
Critical Care ◽  
Focus Groups ◽  
Large Scale ◽  
Nursing Practice ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Role Delineation ◽  
Practice Methods ◽  
The Impact ◽  
Care Nursing

BACKGROUND: In 1997, the AACN Certification Corporation, in conjunction with Professional Examination Service, undertook a role delineation study as 1 component of a large-scale, comprehensive, and systematic study of practice to update previous data. Focus groups made up of practicing critical care nurses were used to determine trends and changes in adult, pediatric, and neonatal critical care nursing practice. METHODS: Sixteen focus groups (6 adult, 5 pediatric, and 5 neonatal) used specially prepared protocols to guide discussions. Questions were designed to elicit descriptions of changes in critical care nursing practice in the preceding 5 years. Qualitative comments of the participants were analyzed across all the focus groups, rather than separately for the adult, pediatric, and neonatal focus groups. Then data for the focus groups for each patient-age range were aggregated and reviewed to abstract themes. RESULTS: Trends and changes in practice for adult, pediatric, and neonatal critical care nurses were determined. Common themes include ethical and legal issues, changes in the population of patients, psychosocial factors, and the impact of managed care. CONCLUSIONS: The results of these focus groups can be used to update the test blueprints that underlie the CCRN certification examination programs for adult, pediatric, and neonatal critical care nurses. Critical care nursing practice is changing. Specific knowledge of the changes is important for educators, managers, and clinicians. The results of this role delineation study can be used to teach, adapt systems, and validate practice.

Critical care nursing in the 21st century

1990 ◽  
Vol 10 (9) ◽  
pp. 8-16 ◽  
Author(s):  
JG Alspach
Keyword(s):  
Critical Care ◽  
21St Century ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Care Nursing

This paper has explored some of the major trends that we can anticipate encountering as we enter the 21st century. Critical care nurses who wish to participate proactively in shaping their professional destiny will listen closely to what futurists have to say about life in the decades ahead. The more we know about what to anticipate, the more informed our decisions will be, and the more likely we will make our desired future a reality.

Grief and Critical Care Nursing: Occurrence and Resolution

2005 ◽  
Vol 59 (3) ◽  
pp. 237-246 ◽  
Author(s):  
Silas M. Weir
Keyword(s):  
Critical Care ◽  
Management Education ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Patient Death ◽  
Critical Care Units ◽  
University Of Colorado ◽  
The University ◽  
Grief Ministry ◽  
Care Nursing

This article reports on research designed to assess the level of grief and the mechanisms of resolution experienced by critical care nurses as they relate to patient death. This prospective exploratory, descriptive study surveyed Registered Nurses (N=92) assigned to Critical Care Units at the University of Colorado Hospital in Denver, Colorado. Based on the findings, the author offers suggestions for ways to provide grief management education to staff as well as timely grief ministry by chaplains.

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.

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