scholarly journals Delirium in the Intensive Care Unit: Is Dexmedetomidine Effective?

2019 ◽  
Vol 39 (4) ◽  
pp. e8-e21
Author(s):  
Joelle Ungarian ◽  
James A. Rankin ◽  
Karen L. Then
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Care Nurses ◽  
Screening Tools ◽  
Evidence Based ◽  
Antipsychotic Medications ◽  
Delirium Management ◽  
Atypical Antipsychotic Medications ◽  
Published Research ◽  
Evidence Based Nursing

Delirium in the intensive care unit affects approximately 30% of patients despite vigorous efforts to encourage the use of effective screening tools and preventive strategies. The success of pharmacological treatment of delirium remains equivocal; moreover, a paucity of research supports the use of atypical antipsychotic medications. However, dexmedetomidine appears to have a promising role in delirium management. This review includes an overview of the pathophysiology and types of delirium and describes 2 established tools used to screen for delirium. Published research related to the use of dexmedetomidine in the management of delirium is also discussed. The authors make recommendations for critical care nurses on dexmedetomidine use in the context of providing evidence-based nursing care to intensive care unit patients with delirium.

Practice Patterns and Opinions on Current Clinical Practice Guidelines Regarding the Management of Delirium in the Intensive Care Unit

2016 ◽  
Vol 30 (2) ◽  
pp. 162-171 ◽  
Author(s):  
Yoonsun Mo ◽  
Anthony E. Zimmermann ◽  
Michael C. Thomas
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Large Scale ◽  
Online Survey ◽  
Early Mobilization ◽  
Screening Tools ◽  
Delirium Management ◽  
New Guidelines ◽  
Pharmacologic Agents

Objective: The aim of this study was to determine current delirium practices in the intensive care unit (ICU) setting and evaluate awareness and adoption of the 2013 Pain, Agitation, and Delirium (PAD) guidelines with emphasis on delirium management. Design, Setting, and Participants: A large-scale, multidisciplinary, online survey was administered to physician, pharmacist, nurse, and mid-level practitioner members of the Society of Critical Care Medicine (SCCM) between September 2014 and October 2014. A total of 635 respondents completed the survey. Measurements and Main Results: Nonpharmacologic interventions such as early mobilization were used in most ICUs (83%) for prevention of delirium. A majority of respondents (97%) reported using pharmacologic agents to treat hyperactive delirium. Ninety percent of the respondents answered that they were aware of the 2013 PAD guidelines, and 75% of respondents felt that their delirium practices have been changed as a result of the new guidelines. In addition, logistic regression analysis of this study showed that respondents who use delirium screening tools were twice more likely to be fully aware of key components of the updated guidelines (odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.20-3.60). Conclusions: Most critical care practitioners are fully aware and knowledgeable of key recommendations in the new guidelines and have changed their delirium practices accordingly.

scholarly journals Effectiveness of implementing evidence based practices guidelines regarding blood transfusion on quality of nursing care and patients' safety in Pediatric Units

2020 ◽  
Vol 10 (10) ◽  
pp. 33
Author(s):  
Orban Ragab Bayoumi ◽  
Nahed Saied Mohamed El-Nagger
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Transfusion ◽  
Nursing Care ◽  
Evidence Based ◽  
Before And After ◽  
Evidence Based Nursing ◽  
Quality Of Nursing ◽  
Nurses Knowledge

Background and objective: The new trend that widely accepted in health care institutions is to implement an evidence-based practice. Health facilities frequently integrate standards of practice that reveal current best evidence to increase patients’ outcomes and consequently decrease hospital cost. Transfusion of blood is a cornerstone in managing many critically ill children. However, nurses have a chief role in transfusing blood and their knowledge and performance are important for them to transfuse blood safely and efficiently. Aim: Evaluate the effectiveness of implementing evidence based nursing practices guidelines on quality of nursing care and patients' safety as regards blood transfusion to improve transfusion practices and ensure safety.Methods: A quasi-experimental design. Settings: This study was conducted at Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, Emergency Room, Medical and Surgical Wards, Hematology/Oncology Units in Children Hospital affiliated to Ain Shams University Hospitals. Sample: A convenience sample composed of 95 pediatric nurses, whom were willingness to participate in the study and 78 children whom were receiving blood transfusion. Tools: I. A Self-Administered Questionnaire Sheet to assess nurses’ knowledge regarding blood transfusion; II. Child’s Medical Record to collect data about child’s health status; III. An Observational Competence Checklist to assess the quality of actual nurses’ practices about Blood Transfusion; and IV. Evidence Based Nursing Practices Guidelines of Blood Transfusion that was described the EBNP guidelines that provide a standardized approach for transfusion (before and after).Results: The studied nurses’ knowledge and practices regarding to blood transfusion were improved and reflected a highly significant differences before and after guidelines implementation.Conclusions: The present study concluded that studied nurses showed an improvement in their knowledge and practices regarding blood transfusion after implementation of evidence based nursing practices guidelines. Recommendation: It is essential that all nurses who administer blood transfusion for children should complete periodic in-services training programs to keep them up to date regarding to safe and efficient administration of blood transfusion.

Empowering critical care nurses to improve Compliance with protocols in the intensive care unit

2007 ◽  
Vol 16 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Gerald Plost ◽  
Delores Privette Nelson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Compliance Rate ◽  
Critical Care Nurses ◽  
Evidence Based ◽  
Audit Tool ◽  
Adult Intensive Care Unit ◽  
Improve Compliance ◽  
Intensive Care Unit Nurses

•Background Practitioners often do not comply with evidence-based protocols. •Objective To improve compliance with evidence-based protocols in an intensive care unit. •Methods A baseline compliance range was obtained by using a sampling of 9 protocols for a 100% audit of 35 beds in an adult intensive care unit. Nurses were given positive rewards to promote an initiative to improve compliance with protocols. The original audit tool was used to assess compliance at intervals during a trial period and for a follow-up audit 3 years after implementation of the initiative. •Results One month after the initiative was started, compliance with protocols increased from a range of 62% to 77% to a compliance of almost 90%. Within 4 months, the compliance rate increased to a mean of more than 95%. Three years later, the compliance rate was greater than 90%. •Conclusion Extrinsic rewards improved compliance with protocols and resulted in a change in the culture in the intensive care unit that had a cumulative outcome.

scholarly journals Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 578
Author(s):  
Dorota Ozga ◽  
Sabina Krupa ◽  
Paweł Witt ◽  
Wioletta Mędrzycka-Dąbrowska
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill Patients ◽  
Current Knowledge ◽  
Personalised Medicine ◽  
Nursing Interventions ◽  
Evidence Based ◽  
Current State ◽  
Scientific Disciplines ◽  
Reliable Methods

It has become a standard measure in recent years to utilise evidence-based practice, which is associated with a greater need to implement and use advanced, reliable methods of summarising the achievements of various scientific disciplines, including such highly specialised approaches as personalised medicine. The aim of this paper was to discuss the current state of knowledge related to improvements in “nursing” involving management of delirium in intensive care units during the SARS-CoV-2 pandemic. This narrative review summarises the current knowledge concerning the challenges associated with assessment of delirium in patients with COVID-19 by ICU nurses, and the role and tasks in the personalised approach to patients with COVID-19.

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