Managing Spaghetti Syndrome in Critical Care With a Novel Device: A Nursing Perspective

2015 ◽  
Vol 35 (6) ◽  
pp. 38-45 ◽  
Author(s):  
Jay Haynes ◽  
Kelly Bowers ◽  
Richard Young ◽  
Trudy Sanders ◽  
Karen E. Schultz
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Novel Device ◽  
Frequency Of Contact ◽  
Before And After ◽  
Nurses Perceptions ◽  
Critical Care Patients

Background Managing “spaghetti syndrome,” the tangle of therapeutic cables, tubes, and cords at patients’ bedsides, can be challenging. Objectives To assess nurses’ perceptions of the effectiveness of a novel banding device in management of spaghetti syndrome. Methods A simple color-coded elastomeric banding strap with ribbed flaps was attached to bed rails of adult critical care patients to help organize therapeutic cables, tubes, wires, and cords. Nurses were surveyed before and after use of the bands and after the nursing shift to assess the burden of spaghetti syndrome and the effectiveness of using the bands. Results Use of the bands decreased the time spent untangling cords, reduced the frequency of contact of tubing with the floor, and diminished disruptions in care. Conclusions Use of a simple flexible latex-free elastomeric band may help organize therapeutic tubing at patients’ bedsides and may promote improvements in nursing care.

Efficacy of Epidural Analgesia for Pain Management of Critically Ill Patients and the Implications for Nursing Care

1991 ◽  
Vol 2 (4) ◽  
pp. 729-740 ◽  
Author(s):  
Jeanne F. Slack ◽  
Margaret Faut-Callahan
Keyword(s):  
Critical Care ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Critically Ill ◽  
Nursing Care ◽  
Critically Ill Patients ◽  
Continuous Epidural Analgesia ◽  
Analgesic Agents ◽  
Care Problems ◽  
Critical Care Patients

Management of pain for critically ill patients has been shown to be inadequately controlled and can have serious deleterious effects on a patient’s recovery. Continuous epidural analgesia can be used to control pain in critical care patients. This mode of analgesia administration provides pain relief without the delays inherent in the as-needed administration of analgesics. Fifteen critical care unit patients were part of a multidisciplinary, prospective, randomized, double-blind study of various epidural analgesic agents in 43 thoracic and 66 abdominal surgery patients. The purpose of the study was to identify the benefits and problems associated with continuous epidural analgesia administration and the implications for the nursing care of critically ill patients. Evaluation of the effectiveness of the analgesia was based on the following measures: 1) pain measured at regular intervals in the 72-hour period with a visual analog; 2) pain as measured after 72 hours with the word descriptor section of the McGill pain questionnaire; 3) amount of supplemental systemic narcotic analgesic needed; 4) recovery of ambulatory and respiratory function, including ability to perform coughing and deep-breathing exercises; 5) occurrence of adverse effects, and 6) the type and distribution of nursing care problems associated with continuous epidural infusions. The results of this study showed that the level of pain relief and recovery of postoperative function was superior to that provided by the more widely used as-needed systemic administration of narcotics. Although some nursing care problems were identified, continuous epidural analgesia can be used for pain relief in critical care patients, if the analgesia is administered by accurate reliable infusion systems and carefully monitored by nursing staff who are knowledgeable about the pharmacologic considerations of epidural analgesic agents and the management of patient care

Measuring Change in Nurses’ Perceptions About Family Nursing Competency Following a 6-Day Educational Intervention

2018 ◽  
Vol 24 (4) ◽  
pp. 508-537 ◽  
Author(s):  
Susanne Broekema ◽  
Marie Louise A. Luttik ◽  
Gabriëlle E. Steggerda ◽  
Wolter Paans ◽  
Petrie F. Roodbol
Keyword(s):  
Educational Intervention ◽  
Nursing Care ◽  
Family Intervention ◽  
Assessment Model ◽  
Paired Samples ◽  
Family Nursing ◽  
Positive Attitudes ◽  
Before And After ◽  
Nurses Perceptions ◽  
Depth Interviews

This study describes nurses’ perspectives about their experience of being involved in a 6-day educational intervention which focused on the development of competency in family nursing practice with a particular emphasis on family nursing conversations. The foundational knowledge of the educational intervention was based on the Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM). A research design incorporating quantitative and qualitative measurement was used. Before and after the family nursing educational intervention, nurse participants ( n = 18) completed the Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) instrument. The outcomes were analyzed using paired-samples t tests. FINC-NA scores increased by 6.94 points ( SD = 5.66, p < .001). To complement the quantitative findings, in-depth interviews were conducted with all of the participants. Participants reported increased awareness of the importance of families in nursing care. In addition to an increase in positive attitudes about families, participants perceived that their knowledge and skills regarding family nursing conversations were more comprehensive. A 6-day educational intervention with a focus on reflection appears useful in helping nurses to “think family” and encouraging perceptions of increased competence in family nursing conversations.

Using Pocket PCs for Nurses' Shift Reports and Patient Care

2011 ◽  
pp. 313-329
Author(s):  
Karen Chang ◽  
Kyle D. Lutes ◽  
Melanie L. Braswell ◽  
Jacqueline K. Nielsen
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Nursing Care ◽  
Patient Information ◽  
Easy Access ◽  
Access To Information ◽  
Significant Difference ◽  
Pocket Pc ◽  
Before And After ◽  
Nurses Perceptions

Nurses working in hospitals with paper-based systems often face the challenge of inefficiency in providing quality nursing care. Two areas of inefficiency are shiftto- shift communication among nurses, and access to information related to patient care. An integrated IT system, consisting of Pocket PCs and a desktop PC interfaced to a hospital’s mainframe system, was developed. The goal was to use mobile IT to give nurses easier access to patient information. This chapter describes the development of this system and reports the results of a pilot study: a comparison of time spent in taking and giving shift reports before and after the study and nurses’ perceptions of the mobile IT system. Results showed a significant difference in taking shift reports and no significant difference in giving shift reports. Nurses stated that quick and easy access to updated patient information in the Pocket PC was very helpful, especially during mainframe downtime.

Glucocorticoid Rescue for Late-Phase Acute Respiratory Distress Syndrome in Trauma/Surgical Critical Care Patients

2006 ◽  
Vol 72 (7) ◽  
pp. 644-648
Author(s):  
Curt S. Koontz ◽  
K. Kye Higdon ◽  
Troy L. Ploger ◽  
Benjamin W. Dart ◽  
Charles M. Richart ◽  
...  
Keyword(s):  
Critical Care ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Critically Ill ◽  
Distress Syndrome ◽  
High Dose ◽  
Surgical Critical Care ◽  
Before And After ◽  
Critical Care Patients

High-dose glucocorticoid therapy (GCT) for the late fibroproliferative phase of acute respiratory distress syndrome (ARDS) is controversial and has shown mixed results in medical patients. No studies have evaluated GCT in trauma/surgical critical care patients. The purpose of this study is to review the outcomes of trauma/surgical critical care patients with refractory ARDS treated with GCT. From January 2001 through September 2005, a pharmacy log was used to identify critically ill trauma/surgical patients in refractory ARDS (7 males and 2 females) who received GCT in an attempt to salvage them. GCT consisted of 200 mg intravenous methylprednisolone bolus for one dose and then 3 mg/kg per day divided every 6 hours for 6 weeks or until weaned off the ventilator. All patients as well as the survivors were analyzed. Outcome data was analyzed with SPSS (Chicago, IL) and the paired sample test. A P value ≤0.05 was considered significant. Data is presented as mean ± standard deviation. The Institutional Review Board approved this retrospective chart review. Seven patients (6 males and 1 female; age, 31 ± 16 years) survived (78%), weaned off of the ventilator, and were discharged from the hospital. The 2 deaths were secondary to refractory respiratory failure as well as cardiac arrest (n = 1) and anoxic brain injury from septic hypotension (n = 1). In survivors (n = 7), hospital length of stay (LOS) and intensive care unit LOS was 71 ± 30 days and 53 ± 16 days, respectively. Duration of GCT administration was 17 ± 6.4 days (range, 11–30 days). Ventilator time before GCT, during GCT, and after GCT was 22 ± 8.4, 15 ± 7.5, and 1.6 ± 6.0 days, respectively. During GCT, 8 patients developed pneumonia, 5 had urinary tract infection, and 3 had bacteremia. All infections were effectively treated with broad-spectrum antibiotics, except in one patient who died of sepsis. PaO2/FIO2 ratio just before and after GCT was 100 ± 36 and 247 ± 56, respectively (n = 7; P < 0.001). Sequential organ failure assessment score just before and after GCT was 9.1 ± 2.3 and 5.0 ± 1.6, respectively (n = 7; P < 0.001). GCT rescue may have a role in salvaging critically ill trauma/surgical critical care patients in late-stage ARDS. More patients, however, need to be studied.

Level of satisfaction of critical care patients regarding the nursing care received: Correlation with sociodemographic and clinical variables

2019 ◽  
Vol 32 (6) ◽  
pp. 486-493 ◽  
Author(s):  
Marta Romero-García ◽  
Pilar Delgado-Hito ◽  
Laura de la Cueva-Ariza ◽  
Maria Antonia Martínez-Momblan ◽  
Maria Teresa Lluch-Canut ◽  
...  
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Clinical Variables ◽  
Level Of Satisfaction ◽  
Critical Care Patients

Nurses' Perceptions of Using a Pocket PC for Shift Reports and Patient Care

2011 ◽  
pp. 799-810
Author(s):  
Karen Chang
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Nursing Care ◽  
Patient Information ◽  
Easy Access ◽  
Access To Information ◽  
Significant Difference ◽  
Pocket Pc ◽  
Before And After ◽  
Nurses Perceptions

Nurses working in hospitals with paper-based systems often face the challenge of inefficiency in providing quality nursing care. Two areas of inefficiency are shift-to-shift communication among nurses and access to information related to patient care. An integrated IT system, consisting of Pocket PCs and a desktop PC interfaced to a hospital’s mainframe system, was developed. The goal was to use mobile IT to give nurses easier access to patient information. This paper describes the development of this system and reports the results of a pilot study: a comparison of time spent in taking and giving shift reports before and after the study and nurses’ perceptions of the mobile IT system. Results showed significant difference in taking shift reports and no significant difference in giving shift reports. Nurses stated that quick and easy access to updated patient information in the Pocket PC was very helpful, especially during mainframe downtime.

scholarly journals Auditing of enteral nutrition nursing care in critical care patients

2019 ◽  
Author(s):  
Tahereh Al-Jalil ◽  
Golbahar Gray ◽  
Maryam Rasouli ◽  
Tooba Hoseini-Azizi ◽  
Sima-Sadat Hejazi
Keyword(s):  
Critical Care ◽  
Enteral Nutrition ◽  
Nursing Care ◽  
Sampling Methods ◽  
Gastric Residual Volume ◽  
Critical Care Units ◽  
Post Feeding ◽  
Nutrition Standards ◽  
Critical Care Patients

Background & Aim: Enteral nutrition standards noncompliance is one of the factors that threatens patient safety.  Auditing is an important part in quality improvement processes. The aim of this study was to determine enteral nutrition nursing care conformity rate with standards in the critical care units. Methods & Materials: In this descriptive study, 400 enteral feeding nursing care were assessed via time and event sampling methods. The tool was a researcher made check list in three fields: pre-feeding, feeding, and post feeding nursing care. Content validity and inter-rater coefficient reliability were calculated for checklist. The obtained data were analyzed using descriptive statistics. Results: The most conformity rate with standards was in feeding (86%), pre-feeding (3/8 %) and post feeding (2/3%) field, respectively. Determination of PH (100%) and accurate gastric residual volume (99.8%) in pre-feeding field, disconnection of the syringe from catheter after feeding, in feeding filed and accurate documentation of the care (99.3%) in post feeding field, were not implemented in the most of cases. Conclusion: Enteral nutrition nursing care is far from standards in the pre and post feeding fields. Lack of the clear clinical guidelines, shortage of nursing staff and equipment and inadequate training are relating factors.

Nurses’ perceptions about the dignity of intubated patients

2021 ◽  
pp. 096973302098526
Author(s):  
Nasreen Rafiq ◽  
David Arthur ◽  
Shirin Rahim ◽  
Yasmin Amarsi ◽  
Eunice Ndirangu
Keyword(s):  
Critical Care ◽  
Nursing Care ◽  
Tertiary Care ◽  
Well Being ◽  
Ethical Review ◽  
Care Hospital ◽  
Care Providers ◽  
Critical Care Units ◽  
High Dependency ◽  
Nurses Perceptions

Background: The intensive and critical care units are high-dependency areas, with patients requiring complex care. The intubated status of the intensive and critical care patients makes them dependent on healthcare providers not only for acute care, but also for intimate care, imposing a threat to their dignity. Nurses, being the central care providers, become the stakeholders for dignity promotion. The incorporation of dignity in patient care improves the quality of care, and promotes the health and well-being of intubated patients. Objective: The purpose of the study was to explore nurses’ perceptions about the dignity of intubated patients in the intensive and critical care units. Research design: A qualitative descriptive exploratory study design was used to explore the nurses’ perceptions about the dignity of intubated patients. Participants and research context: The intensive and critical care nurses of a tertiary care hospital were recruited using the purposive sampling technique. The data were collected through in-depth individual interviews, using a semi-structured interview guide. The findings were manually analyzed into themes and categories through content analysis. Ethical consideration: The study was conducted after the approval from the Ethical Review Committee of the Aga Khan University. Findings: Four major themes emerged from the data analysis: (1) two sides of the contemporary nursing practice; (2) benefits of dignified nursing care; (3) challenges to the dignity of intubated patients; and (4) strategies for promoting the dignity of intubated patients. Discussion: Dignity incorporates both the science and the art of nursing. The provision of dignified care is the core component of the quality nursing care and patient well-being in the high-dependency units. Conclusion: This is the first exploratory and descriptive study conducted in Pakistan that explored the nurses’ perceptions about the dignity of intubated patients, and also generated contextual understanding about the phenomenon.

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