Understanding Disorders of Consciousness: Opportunities for Critical Care Nurses

2021 ◽  
Vol 41 (6) ◽  
pp. 36-44
Author(s):  
Malissa Mulkey
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Communication Networks ◽  
Critically Ill Patients ◽  
Vegetative State ◽  
Critical Care Nurses ◽  
Disorders Of Consciousness ◽  
Standardized Assessments ◽  
Disorder Of Consciousness ◽  
Irreversible Damage

Background Disorders of consciousness are powerful predictors of outcomes including mortality among critically ill patients. Encephalopathy, delirium, and coma are disorders of consciousness frequently encountered by critical care nurses but often classified incorrectly. Objective To provide a greater understanding of disorders of consciousness and to provide standardized assessments and nursing interventions for these disorders. Methods A literature search was conducted by using the terms consciousness, mental status, awareness, arousal, wakefulness, assessment, disorders of consciousness, delirium, encephalopathy, coma, vegetative state, and minimal consciousness. Articles were published in the past 10 years in CINAHL and PubMed. Articles were excluded if they were not in English or directly related to caring for patients with a disorder of consciousness. The remaining 142 articles were evaluated for inclusion; 81 articles received full review. Results A disorder of consciousness signifies that the threshold for compensation has been surpassed with potentially irreversible damage. Altered thalamocortical interactions and reduced cortical activity impair communication networks across the various parts of the brain, causing a disturbance in consciousness. Discussion The cue-response theory is a model that describes the process and impact of nursing care on recovery from acute brain injury. Appropriate standardized assessments and interventions must be used to manage altered levels of consciousness in critically ill patients. Conclusions Paying close attention to neurological changes and monitoring them with standardized assessments are critical to implementing early measures to prevent complications.

scholarly journals Effect of an educational programme on critical care nurses’ competence at two tertiary hospitals in Malawi

2021 ◽  
Vol 33 (4) ◽  
pp. 236-241
Author(s):  
Rodwell Gundo ◽  
Beatrice Gundo ◽  
Ellen Chirwa ◽  
Annette Dickinson ◽  
Gael Janine Mearns
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Educational Programme ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Nursing Competence ◽  
Competence Scale ◽  
Tertiary Hospitals ◽  
Care Nursing

BackgroundCritical care specialty deals with the complex needs of critically ill patients. Nurses who provide critical care are expected to possess the appropriate knowledge and skills required for the care of critically ill patients. The aim of this study was to assess the effect of an educational programme on the competence of critical care nurses at two tertiary hospitals in Lilongwe and Blantyre, Malawi.MethodsA quantitative pre- and post-test design was applied. The training programme was delivered to nurses (n = 41) who worked in intensive care and adult high dependency units at two tertiary hospitals. The effect of the training was assessed through participants’ self-assessment of competence on the Intensive and Critical Care Nursing Competence Scale and a list of 10 additional competencies before and after the training.ResultsThe participants’ scores on the Intensive and Critical Care Nursing Competence Scale before the training, M = 608.2, SD = 59.6 increased significantly after the training, M = 684.7, SD = 29.7, p <.0001 (two-tailed). Similarly, there was a significant increase in the participants’ scores on the additional competencies after the training, p <.0001 (two-tailed). ConclusionThe programme could be used for upskilling nurses in critical care settings in Malawi and other developing countries with a similar context.

Evidence-based practice: fever-related interventions

1999 ◽  
Vol 8 (1) ◽  
pp. 481-487 ◽  
Author(s):  
R Henker
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
American Association ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Common Phenomenon ◽  
Research Questions ◽  
Research Studies

Fever is a common phenomenon in critically ill patients. Ideally, all decisions about treatment of fever would be based on results of well-developed research studies. Instead, some research questions related to treatment of fever have been studied more extensively than others. This article is an evaluation of the usefulness of the research studies related to treatment of fever in the critically ill. Two questions are addressed: when is treatment of fever most beneficial to a critically ill patient, and how is fever most effectively treated in the critically ill? Evidence related to the treatment of fever is evaluated by using the recommendation levels of the research-based practice protocols of the American Association of Critical-Care Nurses.

Access to Continuing Education for Critical Care Nurses in Rural or Remote Settings

2017 ◽  
Vol 37 (2) ◽  
pp. 66-71 ◽  
Author(s):  
Lori Hendrickx ◽  
Charlene Winters
Keyword(s):  
Critical Care ◽  
Continuing Education ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Care Facilities ◽  
Critical Care Nurses ◽  
Skilled Nursing ◽  
Wide Range

Caring for the critically ill does not occur solely in large medical centers or urban areas. Nurses practicing in rural or remote settings practice as nurse generalists, caring for a wide range of patients, including those needing critical care. As a nurse generalist, the need for a wide variety of skill sets challenges nurses in rural areas to maintain current practice through continuing education across many content areas. They also may not come in contact with critically ill patients or emergent situations as often as their urban counterparts, which can make remaining comfortable with more advanced skills difficult. Because nurses working in rural or remote areas may care for critically ill patients less often, the need to remain vigilant in pursuit of continuing education is increased; however, access to continuing education can be problematic because of geographic isolation, difficulty getting time off from work, limited financial resources, and perceived lack of applicable topics. With advances in technology, critical care nurses working in rural areas have more options for continuing education, which is crucial for maintaining a skilled nursing workforce in rural health care facilities. This article addresses challenges critical care nurses working in remote or rural areas face in pursuing continuing education and provides information about available educational opportunities.

Intrahospital transports of critically ill patients: critical care nurses' perceptions

2015 ◽  
Vol 21 (3) ◽  
pp. 178-184 ◽  
Author(s):  
Mona Ringdal ◽  
Wendy Chaboyer ◽  
Margareta Warrén Stomberg
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Nurses ◽  
Nurses Perceptions

Effect of emergency critical care nurses and emergency department boarding time on in-hospital mortality in critically ill patients

2021 ◽  
Vol 41 ◽  
pp. 120-124
Author(s):  
Jason Nesbitt ◽  
Tsuyoshi Mitarai ◽  
Garrett K. Chan ◽  
Jennifer G. Wilson ◽  
Kian Niknam ◽  
...  
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Nurses

Critical Care Nurses’ Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients

2016 ◽  
Vol 25 (3) ◽  
pp. 206-211 ◽  
Author(s):  
Christina Canfield ◽  
Debi Taylor ◽  
Kimberly Nagy ◽  
Claire Strauser ◽  
Karen VanKerkhove ◽  
...  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Spiritual Care ◽  
Critically Ill Patients ◽  
Further Education ◽  
Critical Care Nurses ◽  
Spiritual Needs ◽  
Individual Interviews ◽  
Perceived Need ◽  
Working Definition

Background The term spirituality is highly subjective. No common or universally accepted definition for the term exists. Without a clear definition, each nurse must reconcile his or her own beliefs within a framework mutually suitable for both nurse and patient. Objectives To examine individual critical care nurses’ definition of spirituality, their comfort in providing spiritual care to patients, and their perceived need for education in providing this care. Methods Individual interviews with 30 nurses who worked in a critical care unit at a large Midwestern teaching hospital. Results Nurses generally feel comfortable providing spiritual care to critically ill patients but need further education about multicultural considerations. Nurses identified opportunities to address spiritual needs throughout a patient’s stay but noted that these needs are usually not addressed until the end of life. Conclusions A working definition for spirituality in health care was developed: That part of person that gives meaning and purpose to the person’s life. Belief in a higher power that may inspire hope, seek resolution, and transcend physical and conscious constraints.

scholarly journals Expressive writing as an intervention to decrease distress in pediatric critical care nurses

2018 ◽  
Vol 6 (3) ◽  
pp. 96 ◽  
Author(s):  
Julie Ann Perry ◽  
Peggy Ward-Smith
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Nursing Staff ◽  
Critically Ill Patients ◽  
Expressive Writing ◽  
Cost Effective ◽  
Critical Care Nurses ◽  
Common Phenomenon ◽  
Staff Satisfaction ◽  
Pediatric Critical Care

Experiencing distress is a common phenomenon among pediatric critical care nurses. Expressive writing provides a cost-effective and easily implemented intervention nurses can utilize to address distress as a consequence of providing care for critically ill patients. This intervention may decrease the array of consequences of distress and improve nursing staff satisfaction and retention.

Rights of the Critically Ill Patient: Position Statement of the World Federation of Critical Care Nurses

2019 ◽  
Vol 13 (2) ◽  
pp. 58-70
Author(s):  
Susan Yeager ◽  
Elizabeth Papathanassoglou ◽  
Laura Brooks ◽  
Lori Delaney ◽  
Sarah Livesay ◽  
...  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Position Statement ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
World Federation ◽  
Critical Care Nursing ◽  
The World ◽  
Care Nursing

Critical care nursing involves the specialised nursing care of critically ill patients who are vulnerable and may be unable to voice their needs or have their human rights recognized or addressed. The World Federation of Critical Care Nurses (WFCCN) accepts and supports the Universal Declaration of Human Rights and the need for critically ill patients to be cared for with humanity, and to advocate for the rights of their families and communities. In the above context, WFCCN determined the need to create a document that was focused more specifically on the rights of critically ill patients. To this end, in August 2007, the WFCCN released its first Position Statement on the Rights of the Critically Ill Patient - The Declaration of Manila (WFCCN, 2007). The fundamental aim of this Declaration was to inform and assist critical care nursing associations, health services, educational facilities, and other interested parties to realize the rights of critically ill patients. Due to changes in critical care worldwide, as well as increased global migration, the WFCCN Board of Directors commissioned a review of the 2007 Declaration. As a result of this review, revisions were undertaken. This document represents the 2019 revised WFCCN Position Statement on the Rights of the Critically Ill Patient.

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