Fever Management in Patients With Brain Injury

2012 ◽  
Vol 23 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Laura Mcilvoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elevated Temperature ◽  
Brain Injury ◽  
Acute Brain Injury ◽  
Evidence Based ◽  
Medical Opinion ◽  
Lengths Of Stay ◽  
Evidence Based Guidelines ◽  
Fever Management

Elevated temperature in patients with brain injury has been linked to increased hospital and intensive care unit lengths of stay, increased morbidity, greater disability, and higher mortality. The prevailing medical opinion is that maintaining normothermia in patients with acute brain injury is beneficial. However, little evidence exists to support this recommendation. Nurses are responsible for diagnosing and treating fever, but evidence-based guidelines that would govern fever management for these patients do not exist. This article discusses what evidence is available to support the management of fever in patients with brain injury and in what areas evidence is lacking.

Reducing Foley Catheter Device Days in an Intensive Care Unit

2006 ◽  
Vol 17 (3) ◽  
pp. 272-283
Author(s):  
Laura Reilly ◽  
Patty Sullivan ◽  
Sharon Ninni ◽  
Denise Fochesto ◽  
Karen Williams ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Foley Catheter ◽  
Hospital Costs ◽  
Evidence Based ◽  
Tract Infections ◽  
Evidence Based Guidelines ◽  
Hospital Acquired

The prolonged use of indwelling urinary catheters can lead to many complications, the most prevalent being urinary tract infections. These hospital-acquired infections can increase hospital costs, length of stay, and mortality rates. Evidence-based guidelines for the prevention of urinary tract infections are compared and discussed. Minimizing indwelling urinary catheter use is well-recognized in the literature to reduce the risk of these infections. To decrease the incidence of catheter-associated urinary tract infections, the staff of a 22-bed, mixed medical, surgical, and trauma intensive care unit focused on reducing the number of foley catheter device days. A multidisciplinary team was convened to create an evidence-based plan. Staff nurses were engaged in the development and implementation of the plan. Criteria-based foley catheter guidelines, a decision-making algorithm, and a daily checklist were implemented that led to a significant reduction in foley catheter device days and a decrease in catheter-associated urinary tract infections.

scholarly journals Physical Restraint in Adult Intensive Care Unit - Why and how are they used?

2016 ◽  
Vol 4 (2) ◽  
pp. 110-113
Author(s):  
Sushil Khanal ◽  
Subhash Prasad Acharya
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Patient Autonomy ◽  
Physical Restraint ◽  
Evidence Based ◽  
Adult Intensive Care Unit ◽  
Risk Of Injury ◽  
Ensure Patient Safety ◽  
Evidence Based Guidelines

Background: Physical restraint is preferred practice in adult critical care to reduce the risk of injury and ensure patient safety. However, data on the extent of restraint practice intensive care unit is unknown in our setting to develop evidence based guidelines to promote the scientific use of this modalityMethods: This observational study was conducted for determining the prevalence, motives and ongoing practices of physical restraint. Data were collected from direct observation of physically restrained patients, review of patients’ record and from the nursing staff.Results: The results revealed that physical restraint was commonly used to prevent device dislodgment and to ensure patient safety. The results illustrated a lack of documentation on initiation and monitoring of use physical restraint.Conclusion: For a better care of patients, it is very important to develop a restraint policy for rational use of physical restrain respecting the patient autonomy and freedom.Bangladesh Crit Care J September 2016; 4 (2): 110-113

Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

2010 ◽  
Vol 19 (3) ◽  
pp. 272-276 ◽  
Author(s):  
Mohamad F. El-Khatib ◽  
Salah Zeineldine ◽  
Chakib Ayoub ◽  
Ahmad Husari ◽  
Pierre K. Bou-Khalil
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Providers ◽  
Care Experience ◽  
Respiratory Therapists ◽  
Evidence Based Guidelines

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended.Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia.Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia.Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience.Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia.

scholarly journals Nutrition in the intensive care unit

2015 ◽  
Vol 3 (10) ◽  
pp. 10 ◽  
Author(s):  
Chase C. Hansen ◽  
Sharmila Dissanaike
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Enteral Feeding ◽  
Surgical Patients ◽  
Evidence Based ◽  
Timing Of Initiation ◽  
Evidence Based Guidelines

Nutrition has evolved into an integral part of modern critical care for both medical and surgical patients. Multiple international societies now issue evidence-based guidelines to help clinician optimize their patients’ Nutrition. However, adherence to these guidelines throughout the country is poor, and education in nutrition is still lagging in medical school.  The authors also highlight four key areas where evidence-based recommendations exist – timing of initiation of enteral feeding, calculating and meeting total daily requirements, use of gastric residual volumes to guide delivery, and interuption of feeding for procedures – but are currently often not followed.  Reasons for this lack of adherence are explored, and potential solutions discussed.

scholarly journals 1147 Sleep Correlates With Improved Functional Outcome In The Intensive Care Unit

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A437-A437
Author(s):  
L C Markun ◽  
A Sampat ◽  
R Dutta ◽  
G A Palchik ◽  
M Chow ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Injury ◽  
Critical Illness ◽  
Functional Outcome ◽  
Critically Ill ◽  
Acute Brain Injury ◽  
Subdural Hemorrhage ◽  
Neurological Patients ◽  
Chi Square Analysis

Abstract Introduction Disruption of sleep may have significant implications in acute brain injury, functional recovery, and critical illness. Few data exist characterizing sleep architecture in patients admitted to an intensive care unit (ICU). We aim to describe sleep and clinical characteristics in patients with acute brain injury and critical illness. Methods Retrospective analysis was performed in ICU patients who underwent continuous electroencephalographic (EEG) monitoring from 2018-2019. Sleep was scored based on AASM-defined EEG criteria. Clinical variables, EEG characteristics, and modified Ranking Scale (mRS) were collected. Good outcome was defined as mRS<3. Differences were assessed using chi-square analysis and t-test. Results 205 patients were reviewed with a mean age of 57 years (range 18-91) and a majority (57%) were male. Patients carried a primary neurologic/neurosurgical (61%) or medical/surgical (39%) diagnosis. Status epilepticus, subdural hemorrhage, traumatic brain injury, encephalopathy and cardiac arrest accounted for the majority of diagnoses encountered. Only 58 patients (28%) achieved N1 sleep; of these 76.4% achieved N2, 2.8% N3, and none achieved REM. Of those achieving any sleep, 43% had good outcomes versus only 23% in those who did not (t=-7.45, p<0.001). Neurological patients were more likely to attain sleep compared to those with other primary diagnoses (χ 2 (1)=7.08, p=0.008). Centrally acting anesthetics did not account for sleep differences between neurologic and non-neurologic patients (χ² (1)=2.01, p=0.16). However, those with primary brain injury reached sleep more often in the absence of anesthetic use (χ 2 (1)=4.82, p=0.03). The overall mortality was 32% in this cohort. Conclusion Most critically ill patients do not achieve electrophysiologic sleep. Of those who do, N1/N2 stages are seen most often. Neurological patients were more likely to sleep, and achieving any sleep was associated with improved functional outcome. Further studies are needed to determine whether sleep augmentation in the critically ill impacts functional outcome. Support N/A.

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.

scholarly journals PIN156 Knowledge of Intensive Care Nurses about the Evidence-Based Guidelines of Preventing Centralvenous Catheter Related Infection

2020 ◽  
Vol 23 ◽  
pp. S569-S570
Author(s):  
V. Pacsai ◽  
B. Szabó ◽  
E. Kalamár-Birinyi ◽  
L. Horváth ◽  
I. Boncz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Evidence Based ◽  
Catheter Related Infection ◽  
Intensive Care Nurses ◽  
Evidence Based Guidelines
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