Hearing Loss in Older Critical Care Patients: Participation in Decision Making

2012 ◽  
Vol 32 (6) ◽  
pp. 43-50 ◽  
Author(s):  
Sonya R. Hardin
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Hearing Loss ◽  
Critical Care ◽  
Critical Care Unit ◽  
Critical Care Nurses ◽  
Noisy Environment ◽  
Optimal Outcomes ◽  
Participation In Decision Making ◽  
Critical Care Patients

Older adults with hearing loss who receive care in the noisy environment of a critical care unit can be disadvantaged in their ability to understand speech, thus limiting their participation in decision making. Providing optimal outcomes for such patients can be understood through use of the American Association of Critical-Care Nurses Synergy Model. When older adults are admitted to a critical care unit, their spouses, children, and friends are in positions to participate in the patients’ care. The AACN Synergy Model patient characteristic of participation in care is useful in enhancing optimal outcomes for older patients.

Engaging Families to Participate in Care of Older Critical Care Patients

2012 ◽  
Vol 32 (3) ◽  
pp. 35-40 ◽  
Author(s):  
Sonya R. Hardin
Keyword(s):  
Older Adults ◽  
Critical Care ◽  
American Association ◽  
Significant Others ◽  
Critical Care Nurses ◽  
Older Patient ◽  
Critical Care Units ◽  
Optimal Outcomes ◽  
The Family ◽  
Critical Care Patients

Provision of optimal outcomes for older adults can be understood through the use of the American Association for Critical-Care Nurses Synergy Model. These outcomes can be enhanced if strategies are designed to improve the characteristics of patients and families as described in the Synergy Model. When older adults are admitted to critical care units, spouses, children, and friends are in a position to participate in care. This column examines the Synergy Model’s patient characteristic of participation in care relative to involvement of the family and significant others of the older patient as a method of enhancing optimal outcomes.

Hidden Obligatory Fluid Intake in Critical Care Patients

2016 ◽  
Vol 32 (3) ◽  
pp. 223-227 ◽  
Author(s):  
Muhammad Umair Bashir ◽  
Anan Tawil ◽  
Vishnu R. Mani ◽  
Umer Farooq ◽  
Michael A. DeVita
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Critical Care ◽  
Medical Records ◽  
Critical Care Unit ◽  
Fluid Intake ◽  
Icu Patients ◽  
Critical Care Admission ◽  
The Mean ◽  
Critical Care Patients

Introduction: In addition to the fluid intake in the form of intravenous maintenance or boluses in intensive care unit (ICU) patients, there are sources of fluids that may remain unrecognized but contribute significantly to the overall fluid balance. We hypothesized that fluids not ordered as boluses or maintenance infusions—“hidden obligatory fluids”—may contribute more than a liter to the fluid intake of a patient during any random 24 hours of critical care admission. Methods: Patients admitted to the Harlem Hospital ICU for at least 24 hours were included in this study (N = 98). Medical records and nursing charts were reviewed to determine the sources and volumes of various fluids for the study patients. Results: The mean hidden obligatory volume for an ICU patient was calculated to be 978 mL (standard deviation [SD]: 904, median: 645) and 1571 mL (SD: 1023, median: 1505), with enteral feeds compared to the discretionary volume of 2821 mL (SD: 2367, median: 2595); this obligatory fluid volume was affected by a patient’s need for pressor support and renal replacement therapy. Conclusion: Hidden obligatory fluids constitute a major source of the fluid intake among patients in a critical care unit. Up to 1.5 L should be taken into account during daily decision making to effectively regulate their volumes.

Thrombotic thrombocytopenic purpura: pathophysiology, treatment, and related nursing care

1995 ◽  
Vol 15 (6) ◽  
pp. 44-52
Author(s):  
M Kajs-Wyllie
Keyword(s):  
Critical Care ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Nursing Care ◽  
Critical Care Unit ◽  
Family Members ◽  
Vital Role ◽  
Critical Care Nurses ◽  
Thrombocytopenic Purpura ◽  
Rare Syndrome ◽  
Life Threatening

The patient diagnosed with TTP presents to the critical care unit with myriad life-threatening problems. Knowledge of the pathophysiology and treatment of this rare syndrome is essential to plan care appropriately. However, despite immediate diagnosis and intervention, the outcome may not be successful. Critical care nurses play a vital role in caring for these patients, as well as helping family members deal with this devastating disease.

Falls Resulting in Traumatic Injury Among Older Adults

2011 ◽  
Vol 22 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Dawn Grimm ◽  
Lorraine C. Mion
Keyword(s):  
Older Adults ◽  
Critical Care ◽  
Care Setting ◽  
Traumatic Injury ◽  
Critical Care Nurses ◽  
Community Dwelling ◽  
Cervical Fractures ◽  
Cord Injury ◽  
The Us ◽  
Community Dwelling Older Adults

Falls among community-dwelling older adults are common and dangerous, often leading to traumatic brain injury, cervical fractures, and spinal cord injury. Physical and physiologic changes with aging, preexisting diseases, and treatments result in increased morbidity and mortality for this population. Trauma critical care nurses can expect to see increasing numbers of older adults in intensive care units as the US population of those older than 65 years increases to 53 million by 2020. Older adults pose additional dilemmas in care. This article reviews falls, mechanism of injury, and nursing care issues of particular significance to this vulnerable population in the critical care setting.

Geropharmacology

2008 ◽  
Vol 19 (2) ◽  
pp. 134-151
Author(s):  
Catherine G. Ferrario
Keyword(s):  
Older Adults ◽  
Critical Care ◽  
Continuing Education ◽  
Adverse Reactions ◽  
Critical Care Nurses ◽  
Potentially Inappropriate Medications ◽  
Advanced Practice ◽  
Medication Therapy ◽  
Life Threatening ◽  
Inappropriate Medications

In the first part of this 2-part continuing education series, sources of medication errors were discussed. A predominant source of errors was the prescribing of potentially inappropriate medications for older adults. In this second part, drug classifications and drugs posing problems for older adults and cautions for advanced practice acute care and critical care nurses in their medication therapy management are highlighted. Cautions are advanced for anticholinergics, antihypertensives, analgesics, and psychotropics because of the severity of adverse reactions, including anticholinergic symptoms; mental status changes (especially confusion, sedation, delirium, and cognitive impairment); orthostatic hypotension; gastrointestinal tract problems (especially hemorrhage); depression; and neurobehavioral disturbances (agitation and aggressiveness). Risks of life-threatening outcomes associated with medications and adverse reactions are highlighted.

Understanding critical care nurses’ autonomy in Jordan

2017 ◽  
Vol 30 (4) ◽  
pp. 432-442 ◽  
Author(s):  
Mahmoud Maharmeh
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Critical Care Nurses ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Content Type

Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

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