Telenursing in the Intensive Care Unit: Transforming Nursing Practice

2012 ◽  
Vol 32 (6) ◽  
pp. 62-69 ◽  
Author(s):  
Lisa-Mae Williams ◽  
Kenneth E. Hubbard ◽  
Olive Daye ◽  
Connie Barden
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Nursing Practice ◽  
Care Patient ◽  
Critical Care Nursing ◽  
Telecommunication Technology ◽  
Use Of Technology ◽  
The Impact ◽  
Care Nursing

In tele–intensive care units, informatics, telecommunication technology, telenursing, and telemedicine are merged to provide expert, evidence-based, and cutting-edge services to critically ill patients. Telenursing is an emerging subspecialty in critical care that is neither well documented in the extant literature nor well understood within the profession. Documentation and quantification of telenursing interventions help to clarify the impact of the telenurse’s role on nursing practice, enhancement of patient care, patient safety, and outcomes. Tele–intensive care unit nursing will continue to transform how critical care nursing is practiced by enhancing/leveraging available resources through the use of technology.

scholarly journals Monitoring intensive care unit performance—impact of a novel individualised performance scorecard in critical care medicine: a mixed-methods study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019165 ◽  
Author(s):  
Shannon M Fernando ◽  
David Neilipovitz ◽  
Aimee J Sarti ◽  
Erin Rosenberg ◽  
Rabia Ishaq ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Mixed Methods ◽  
Performance Metrics ◽  
Quality Standard ◽  
Care Patient ◽  
Critical Care Medicine ◽  
Resource Utilisation ◽  
The Impact

IntroductionPatients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance is required. Performance scorecards are used by institutions for the purposes of driving quality improvement. There is no widely accepted or standardised scorecard that has been used for overall CCM performance. We aim to improve quality of care, patient safety and patient/family experience in CCM practice through the utilisation of a standardised, repeatable and multidimensional performance scorecard, designed to provide a continuous review of ICU physician and nurse practice, as well as departmental metrics.Methods and analysisThis will be a mixed-methods, controlled before and after study to assess the impact of a CCM-specific quality scorecard. Scorecard metrics were developed through expert consensus and existing literature. The study will include 19 attending CCM physicians and approximately 300 CCM nurses. Patient data for scorecard compilation are collected daily from bedside flow sheets. Preintervention baseline data will be collected for 6 months for each participant. After this, each participant will receive their scorecard measures. Following a 3-month washout period, postintervention data will be collected for 6 months. The primary outcome will be change in performance metrics following the provision of scorecard feedback to subjects. A cost analysis will also be performed, with the purpose of comparing total ICU costs prior to implementation of the scorecard with total ICU costs following implementation of the scorecard. The qualitative portion will include interviews with participants following the intervention phase. Interviews will be analysed in order to identify recurrent themes and subthemes, for the purposes of driving scorecard improvement.Ethics and disseminationThis protocol has been approved by the local research ethics board. Publication of results is anticipated in 2019. If this intervention is found to improve patient- and unit-directed outcomes, with evidence of cost-effectiveness, it would support the utilisation of such a scorecard as a quality standard in CCM.

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.

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.

scholarly journals Evidence characterising skills, competencies and policies in advanced practice critical care nursing in Europe: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031504
Author(s):  
Gudrun Kaldan ◽  
Sara Nordentoft ◽  
Suzanne Forsyth Herling ◽  
Anders Larsen ◽  
Thordis Thomsen ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Scoping Review ◽  
Nursing Practice ◽  
European Countries ◽  
Advanced Practice ◽  
Critical Care Nursing ◽  
Advanced Level ◽  
Intensive Care Nursing ◽  
Care Nursing

IntroductionThe management of critically ill patients is challenged by increasing population age and prevalence of comorbid diseases. High-quality intensive care nursing practice is imperative to accommodate these issues. The roles of the nurse practitioner (NP) and the acute care NP have existed for decades in the USA, Canada and Australia but are still evolving in Europe. Some European countries have introduced the advanced practice nurse (APN), but the current standard of the advanced level of nursing is variable and consensus regarding the framework, role and definition is lacking. Literature and evidence are sparse as well. Identification of skills and competencies required for the APN is warranted. Mapping skills and competencies will enable future educational harmonisation and facilitate mobility of the advanced-level intensive care nursing workforce across Europe. The aim of our scoping review is to identify literature describing skills, competencies and policies characterising advanced nursing practice in intensive care across Europe.Methods and analysisWe will apply a five-stage scoping review methodology with a comprehensive systematic literature search as outlined by Arksey and O’Malley. In collaboration with a research librarian, we will search nine interdisciplinary databases and grey literature for publications originating in European countries in 1992–2018. Using a two-stage screening process with Covidence to remove duplicates, we will first scan the title and abstract and then perform full-text review to determine the eligibility of the papers. Qualitative content analysis will be used to chart the data.Ethics and disseminationOur study is a part of the European Union-funded INACTIC project (International Nursing Advanced Competency-based Training for Intensive Care) with the overall aim of developing a common European curriculum for advanced practice critical care nursing. Results from this scoping review mapping the evidence of APNs in Europe will be presented at national and international conferences and published in a peer-reviewed journal.

scholarly journals Metode Penyapihan Ventilasi Mekanik Di Intensive Care Unit: Studi Literatur

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Sarinti Sarinti ◽  
Reni Sulung Utami ◽  
Awal Prasetyo
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Care Nursing ◽  
Literature Study ◽  
Ventilation Weaning ◽  
Mechanical Ventilation Weaning ◽  
Google Search ◽  
Care Nursing

Latar belakang : Pasien di ICU ( Intensive Care Unit ) yang membutuhkan bantuan ventilasi mekanik hampir mencapai 30% dari total pasien. Ventilasi mekanik yang digunakan dalam jangka panjang dapat meningkatkan resiko terjadinya mortalitas, dan ventilator associated pneumonia sehingga diperlukan perencanaan penyapihan yang tepat.  Tujuan : Studi literatur ini bertujuan untuk mengidentifikasi metode penyapihan pasien dari ventilasi mekanik di ICU. Metode : Penelusuran literatur dilakukan melalui database Google scholar dan Google search dengan menggunakan kata kunci weaning mechanical ventilation, weaning protocol, critical care nursing. Literatur yang digunakan dari tahun 1997-2015 dalam bentuk full text. Literatur yang sesuai kriteria inklusi dan eksklusi dianalisis secara narasi. Hasil: Penelusuran mendapatkan 7 artikel penelitian yang menunjukkan metode penyapihan pasien dari ventilasi mekanik. Metode penyapihan dari ke 7 artikel tersebut adalah metode protokol dan non protokol. Metode non protokol misalnya physician direct weaning ( PDW ) dan collaboration weaning plan ( CWP ). Metode penyapihan dengan protokol antara lain : nurse` protokol directed weaning ( NPDW ) dan protokol base weaning ( PBW ). Kesimpulan : Metode penyapihan protokol menunjukkan hasil lebih efektif dibandingkan metode non protokol. Kata Kunci: Penyapihan Ventilasi Mekanik, Protokol Penyapihan, Keperawatan Kritis Methode of Weaning from Mechanical Ventilation in Intensive Care Unit : Study Literature ABSTRACT Back ground : patients in the ICU who require mechanical ventilation assistance almost 30% of the total patients. Mechanical ventilation is used in the long term can increase the risk of mortality and ventilator associated pneumonia so that proper planning is necessary weaning. Objectives : the literature study aims to identify methods of weaning patients from mechanical ventilation in the ICU. Methods : the literature study search pass through by Google scholar and Google search using keywords weaning mechanical ventilation, weaning protocol, critical care nursing. Literature is used from the year 1997-2015 in the form of full text. Appropriate literature inclusion and exclusion criteria were analyzed narrative. Results : search get 7 articles studies showing methods of weaning patients from mechanical ventilation. Method of weaning to the article 7 is the method protocol and non-protocol. Methods of non protocols eg physician-direct weaning ( PDW ) and collaboration weaning plan ( CWP ). Methods of weaning protocols include: nurse` protocol directed weaning (NPDW) and protocols base weaning ( PBW ). Conclusion : the method of weaning protocol shows the results more effective than non - protocol methods Key word : weaning mechanical ventilation; weaning protocol; critical care nursing

Thinking about strengths in end-of-life nursing practice: the case of intensive care unit nurses

2019 ◽  
Vol 25 (8) ◽  
pp. 378-385
Author(s):  
Brandi Vanderspank-Wright ◽  
David Kenneth Wright ◽  
Kim McMillan
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Nursing Practice ◽  
Critical Care Nurses ◽  
Life Care ◽  
Ethical Practice ◽  
Care Nursing

Background: The intensive care unit (ICU) is a care context that is sometimes described as being unconducive to the values and ideals of a good death in end-of-life care. Such assumptions render the ICU emblematic of a troubling discourse about end-of-life care in this clinical context. Aim: To stimulate a reflective examination of intensive care nursing practice with respect to end-of-life care. Methods: The work of contemporary nursing scholar Laurie Gottlieb is used to perform a strengths-based relational ethical examination of previously published literature that describes critical care nurses' experiences of providing end-of-life care in the ICU. Findings: This literature suggests that the relational ethical value of authentic engagement, which is fundamental to the disciplinary ethos of expert palliative care nursing, is reflected in the everyday practice of intensive care nurses whose patients die while under their care. Conclusion: A strengths-based approach can make visible the relational ethical practice of critical care nurses who care for dying patients and their families in the ICU.

scholarly journals The Impact of Implementing Critical Care Team on Open General Intensive Care Unit

2012 ◽  
Vol 73 (2) ◽  
pp. 100 ◽  
Author(s):  
Ick Hee Kim ◽  
Seung Bae Park ◽  
Seonguk Kim ◽  
Sang-Don Han ◽  
Seung Seok Ki ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Care Team ◽  
General Intensive Care Unit ◽  
The Impact ◽  
Critical Care Team
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