Use of the nursing interventions classification by critical care nurses

1996 ◽  
Vol 16 (4) ◽  
pp. 38-40 ◽  
Author(s):  
MG Titler ◽  
GM Bulechek ◽  
JC McCloskey
Keyword(s):  
Critical Care ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Nursing Interventions ◽  
Practice Education

A survey of 111 critical care nurses was carried out to determine the frequency with which they perform each of the 336 interventions in the NIC. Forty-nine interventions were used at least daily, indicating a set of core interventions unique to critical care practice. These findings have implications for critical care practice, education, and research.

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.

Overview of Family Needs after Critical Illness: From Assessment to Intervention

1991 ◽  
Vol 2 (2) ◽  
pp. 220-226 ◽  
Author(s):  
Jane Stover Leske
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critical Care Nurses ◽  
Nursing Interventions ◽  
Family Needs ◽  
Analysis Of Results ◽  
Family Centered ◽  
Primary Family ◽  
Over Time

Results of numerous independent studies suggest that families of a critically ill hospitalized member have similar needs that they can readily identify as very important. Empirical analysis of results compiled from many studies across patient populations, settings, geographic locations, and over time indicates that families have primary needs for assurance, proximity, and information. These primary family needs provide a research-based framework to guide critical care nurses in implementing and evaluating family-centered nursing interventions

Exertional Heat Stroke in Navy and Marine Personnel: A Hot Topic

2015 ◽  
Vol 35 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Carl W. Goforth ◽  
Josh B. Kazman
Keyword(s):  
Critical Care ◽  
Heat Stroke ◽  
Significant Risk ◽  
Critical Care Nurses ◽  
Body Core Temperature ◽  
Nursing Interventions ◽  
Military Operations ◽  
Exertional Heat Stroke ◽  
Military Nurses ◽  
Extrinsic Risk

Although exertional heat stroke is considered a preventable condition, this life-threatening emergency affects hundreds of military personnel annually. Because heat stroke is preventable, it is important that Navy critical care nurses rapidly recognize and treat heat stroke casualties. Combined intrinsic and extrinsic risk factors can quickly lead to heat stroke if not recognized by deployed critical care nurses and other first responders. In addition to initial critical care nursing interventions, such as establishing intravenous access, determining body core temperature, and assessing hemodynamic status, aggressive cooling measures should be initiated immediately. The most important determinant in heat stroke outcome is the amount of time that patients sustain hyperthermia. Heat stroke survival approaches 100% when evidence-based cooling guidelines are followed, but mortality from heat stroke is a significant risk when care is delayed. Navy critical care and other military nurses should be aware of targeted assessments and cooling interventions when heat stroke is suspected during military operations. (Critical Care Nurse. 2015;35[1]:52–59)

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.

Families Experiencing a Traumatic Accident: Implications and Nursing Management

1990 ◽  
Vol 1 (3) ◽  
pp. 522-534 ◽  
Author(s):  
Sandra R. Schlump-Urquhart
Keyword(s):  
Critical Care ◽  
Traumatic Event ◽  
Critical Care Nurses ◽  
Psychosocial Assessment ◽  
Nursing Interventions ◽  
Dysfunctional Families ◽  
Psychosocial Needs ◽  
Nursing Management ◽  
Emotional Needs ◽  
Limited Experience

Families experiencing a traumatic accident experience significant psychosocial disruption. The traumatic event is sudden and unexpected. Families have no opportunity to prepare themselves emotionally, have limited experience with such catastrophic events, and are overwhelmed by the magnitude of the patient’s injuries. Critical care nurses have an important role in the psychosocial assessment, support, and management of these families. Many critical care nurses are uncomfortable interacting with families with significant psychosocial/emotional needs due to a lack of understanding of their needs, lack of knowledge of how to manage their needs, lack of confidence in communicating with families, and generalized discomfort and awkwardness when confronted with grief and bereavement issues. This article presents important information for critical care nurses to help them understand and manage families psychosocial needs and to feel more confident interacting with these families. Information presented includes (1) impact of the traumatic event, (2) emotional responses, (3) assessment of psychosocial needs, and (4) nursing interventions for the care and management of these families. Special considerations impacting on families’ psychosocial needs, including dysfunctional families, ineffective coping mechanisms, suicide, and the patient’s death, are presented

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.

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.

Learning, Decisions and Transformation in Critical Care Nursing Practice

2008 ◽  
Vol 15 (3) ◽  
pp. 322-331 ◽  
Author(s):  
M Catherine Hough
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Role Model ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Theoretical Concepts ◽  
Education Levels ◽  
High Acuity

Critical care nurses are key providers in a high acuity environment. This qualitative research study explored ethical decision making in a critical care practice setting. Fifteen critical care nurses with varying experience and education levels were purposively sampled to assure the representativeness of the data. The theoretical concepts of experiential learning, perspective transformation, reflection-in-action and principle-based ethics were used as a framework for eliciting information from the participants. A new model of focused reflection in ethical decision making was developed. Findings showed that having a role model or mentor to help guide the ethical decision-making process was critical for focused ethical discourse and the decision making.

Measles pneumonia in the critically ill child: application of alternative ventilation strategies

1995 ◽  
Vol 15 (2) ◽  
pp. 39-39 ◽  
Author(s):  
D Claytor ◽  
L Margherita ◽  
K Penn ◽  
LS Franck
Keyword(s):  
Critical Care ◽  
Measles Virus ◽  
Critical Care Nurses ◽  
Nursing Interventions ◽  
Optimal Care ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
Ventilation Strategies ◽  
Bilateral Lung ◽  
The Impact

Measles pneumonia is a life-threatening complication in children infected with the measles virus. The increased number of reported cases over the last several years suggests a need for heightened awareness of the complication among pediatric critical care nurses. Application of alternative ventilation strategies in the critical care setting continues to be explored in children with ARDS refractory to more conventional ventilation support, because the mortality and morbidity associated with ARDS in children remain high. Patients who present with diffuse, bilateral lung injury, such as in measles pneumonia, may be candidates for alternative ventilation strategies. Few investigators have studied alternative ventilation strategies in the pediatric ICU setting. Therefore, nursing research related to the impact of nursing interventions during alternative ventilation strategies is needed. Specifically, evaluation of ET suctioning practices and other interventions that influence oxygen delivery and consumption are necessary to plan effective care during alternative ventilation strategies and improve patient outcome. Prevention of measles pneumonia is clearly the preferred "treatment." Preventive healthcare is paramount in providing optimal care for children. However, until we can address the environmental factors that predispose children to communicable diseases such as measles, critical care nurses must be knowledgeable about the assessment and management of measles pneumonia.

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.

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