Palliation of Thirst in Intensive Care Unit Patients: Translating Research Into Practice

2019 ◽  
Vol 39 (5) ◽  
pp. 21-28
Author(s):  
Ann Leemhuis ◽  
Yuriko Shichishima ◽  
Kathleen Puntillo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rating Scale ◽  
Family Members ◽  
Numeric Rating Scale ◽  
Video Training ◽  
Level Of Satisfaction ◽  
Scale Scores ◽  
Intensive Care Unit Nurses ◽  
Numeric Rating

Background Thirst is prevalent among patients in intensive care units. A research-based “thirst bundle” was shown to significantly decrease thirst in these patients. Objective To implement a research-based thirst intervention performed by intensive care unit nurses and patients’ family members. Methods Nurses and family members were taught the thirst intervention through video training and project team reinforcement. The intervention was performed by nurses for 123 patients and by family members for 13 patients. Thirst was measured with a numeric rating scale of 0 to 10, a word scale of 0 to 3, or “yes/no” answers, whichever was easiest for the patient. Inferential statistics were used to assess changes in thirst scores over time. Also assessed were nurse and family member burden levels, family level of satisfaction, and patient enjoyment. Results Thirst scores on the numeric rating scale decreased significantly: from a mean (SD) of 7.9 (2.0) before to 3.9 (2.7) after the intervention for nurses (P < .001); and from 9.2 (1.5) to 5.3 (2.6) for family members (n = 13; P = .002). Word scale scores also decreased significantly, from a median (interquartile range) of 3 (3-3) before to 2 (1-2) after the intervention for nurses (P < .001). Most patients (96%) reported enjoying the procedure. Median burden levels were less than 2 on a numeric rating scale of 0 to 10. Conclusions The palliative “thirst bundle” significantly alleviated patients’ thirst and resulted in little caregiver burden. Further efforts are warranted to incorporate this intervention into intensive care unit practice.

Limitations of pain numeric rating scale scores collected during usual care: Need for enhanced assessment

2018 ◽  
Vol 19 (3) ◽  
pp. S57-S58
Author(s):  
B. Morasco ◽  
T. Lovejoy ◽  
S. Hyde ◽  
S. Shull ◽  
S. Dobscha
Keyword(s):  
Usual Care ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Scale Scores ◽  
Numeric Rating

Enhancing Communication With Family Members in the Intensive Care Unit: A Mixed-Methods Study

2020 ◽  
Vol 40 (6) ◽  
pp. 23-32
Author(s):  
Karen-leigh Edward ◽  
Alessandra Galletti ◽  
Minh Huynh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Methods ◽  
Care Delivery ◽  
Clinical Care ◽  
Family Members ◽  
Staff Members ◽  
Confidence Levels ◽  
Decision Making Model ◽  
Intensive Care Unit Nurses

Background Nurses in the intensive care unit are central to clinical care delivery and are often the staff members most accessible to family members for communication. Family members’ ratings of satisfaction with the intensive care unit admission are affected more by communication quality than by the level of care for the patient. Family members may feel that communication in the intensive care unit is inconsistent. Objectives To use a shared decision-making model to deliver a communication education program for intensive care unit nurses, evaluate the confidence levels of nurses who undertook the education, and examine changes in family members’ satisfaction with communication from intensive care unit nurses after the nurses received the education. Methods A mixed-methods design was used. Seventeen nurses and 81 family members participated. Results Staff members were overall very confident with communicating with family members of critically ill patients. This finding was likely linked to staff members’ experience in the position, with 88% of nurses having more than 11 years’ experience. Family members were happy with care but dissatisfied with the environment. Conclusions Environmental factors can negatively affect communication with family members in the intensive care unit.

scholarly journals Using Multiple Regressions to Predict (ICU) Intensive Care Unit Nurses Professional Detachment Intent, in Bangalore Multi-Specialty Hospitals, Karnataka.

2020 ◽  
Vol 4 (5) ◽  
pp. 29-38
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stepwise Multiple Linear Regression ◽  
Stress Scale ◽  
Specialty Hospitals ◽  
Nursing Stress ◽  
Scale Scores ◽  
Stress Inventory ◽  
Person Organization Fit ◽  
Intensive Care Unit Nurses

Background/aim: This paper aimsto determine the predictors of ICU nurses intent for professional detachment in Bangalore. It also focuses on identifying the factors which, influence nurses intent to professionally detach from the organization. Materials and methods: A questionnaire survey of 462 nurses employing in multispecialty hospitals in Bangalore was sampled to test the hypothesis. The Health Profession Stress Inventory Scale and the Nursing Stress Scale measures the problem researched. Scale scores were analyzed statistically. Results: The results from Stepwise Multiple Linear Regression showed that nurse person-organization fit, conflict, responsibility & recognition for nurses predict the professional detachment intent of nurses with its standardized β coefficients (β=-0.338; p<0.01), (β=0.142; p<0.05) and (β=-.173; p<0.01) respectively.Conclusion: The present study highlights that there are many factors predicting the professional detachment intent of ICU nurses, more concerned the p-o-f of nurses largely predicts their intent to be professionally detached.

Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients

2019 ◽  
Vol 28 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Michelle VonStein ◽  
Barbara L. Buchko ◽  
Cristina Millen ◽  
Deborah Lampo ◽  
Theodore Bell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Dry Mouth ◽  
Intensive Care Patients ◽  
Frequency Of Use ◽  
Before And After ◽  
Quasi Experimental ◽  
Ice Water

Background Thirst is a common, intense symptom reported by hospitalized patients. No studies indicate frequency of use of ice water and lip moisturizer with menthol to ameliorate thirst and dry mouth. In an audit of 30 intensive care unit patients at a 580-bed community teaching hospital, 66% reported dry mouth with higher thirst distress and intensity scores than in published studies. Objectives To evaluate the effectiveness of scheduled use of ice water oral swabs and lip moisturizer with menthol compared with unscheduled use in relieving thirst and dry mouth for intensive care unit patients. Methods In a quasi-experimental design, adult patients admitted to 2 intensive care units at a community hospital were provided with ice water oral swabs and lip moisturizer with menthol upon request. The intervention was unscheduled in 1 unit and scheduled in the other unit. The scheduled intervention was provided hourly during a 7-hour period (n = 62 participants). The unscheduled intervention consisted of usual care (n = 41 participants). A numeric rating scale (0-10) was used to measure thirst intensity, thirst distress, and dry mouth before and after 7 hours in both groups. Results The scheduled-use group had significant lessening of thirst intensity (P = .02) and dry mouth (P = .008). Thirst distress in the scheduled-use group did not differ from that in the unscheduled-use group (P = .07). Conclusion Scheduled use of ice water oral swabs and lip moisturizer with menthol may lessen thirst intensity and dry mouth in critical care patients.

scholarly journals Interobserver Reliability of Glasgow Coma Scale Scores for Intensive Care Unit Patients

2020 ◽  
Vol 40 (4) ◽  
pp. e18-e26
Author(s):  
Ayda Kebapçı ◽  
Gül Dikeç ◽  
Serpil Topçu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Interobserver Reliability ◽  
Verbal Response ◽  
Coma Scale ◽  
Significant Agreement ◽  
Scale Scores ◽  
Sum Scores ◽  
Intensive Care Unit Nurses

Background Intensive care units frequently use the Glasgow Coma Scale to objectively assess patients’ levels of consciousness. Interobserver reliability of Glasgow Coma Scale scores is critical in determining the degree of impairment. Objective To evaluate interobserver reliability of intensive care unit patients’ Glasgow Coma Scale scores. Methods This prospective observational study evaluated Glasgow Coma Scale scoring agreement among 21 intensive care unit nurses and 2 independent researchers who assessed 202 patients with neurosurgical or neurological diseases. Each assessment was completed independently and within 1 minute. Participants had no knowledge of the others’ assessments. Results Agreement between Glasgow Coma Scale component and sum scores recorded by the 2 researchers ranged from 89.5% to 95.9% (P = .001). Significant agreement among nurses and the 2 researchers was found for eye response (73.8%), motor response (75.0%), verbal response (68.1%), and sum scores (62.4%) (all P = .001). Significant agreement among nurses and the 2 researchers (55.2%) was also found for sum scores of patients with sum scores of 10 or less (P = .03). Conclusions Although the study showed near-perfect agreement between the 2 researchers’ Glasgow Coma Scale scores, agreement among nurses and the 2 researchers was moderate (not near perfect) for subcomponent and sum scores. Accurate Glasgow Coma Scale evaluation requires that intensive care unit nurses have adequate knowledge and skills. Educational strategies such as simulations or orientation practice with a preceptor nurse can help develop such skills.

scholarly journals Family perceptions of intensive care unit nurses’ roles: a Greek perspective

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Maria Malliarou ◽  
Georgia Gerogianni ◽  
Fotoula Babatsikou ◽  
Evaggelia Kotrotsiou ◽  
Sofia Zyga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Demographic Data ◽  
Family Members ◽  
Role Expectation ◽  
Greek Hospital ◽  
Research Questions ◽  
Family Perceptions ◽  
Intensive Care Unit Nurses

This study was done in order to examine the role of the nurse in families with critically ill patients as perceived by family members. A descriptive design was conducted with 93 family members aged 18-53 years from a 6-bed intensive care unit in a Greek Hospital. An anonymous self-completed questionnaire recording demographic data and the questionnaire <em>Family members perception of nurses behavioral role expectation/enactment scale</em> of Hickey and Lewandowski was used. Parametric statistic tests were used to examine the research questions. Intensive care unit (ICU) patients’ family members expect nurses to make them feel they can ask whatever they want whenever they want, placing great emphasis on communicating with one another and on participating in decision making to the progress of patient care. The age seems to correlate with the expectation from nurse to meet the role of training on how to handle the patient. Nurses did well with regard to meeting family members’ expectations. Most family members assessed positively the role of ICU nurse confirming the need for communication, and clear support of families.

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