Cardiopulmonary Arrest and Resuscitation—Emergency Nurses' Knowledge in Croatia

BackgroundHealthcare workers' education is one of the most important factors in quality improvement and efficiency of caring for patients with cardiopulmonary arrest. Nurses with high-quality training are important members of the resuscitation team and have great influence on the quality of the resuscitation process and outcome.AimTo determine the level of knowledge of cardiopulmonary resuscitation of nurses in emergency medicine centers by level of education; and to determine the relationship between knowledge level and additional training and work experience.Material and MethodsA cross-sectional descriptive multicenter study was conducted. The participants were nurses from Emergency Departments in three University Hospitals in Croatia. Overall, the sample was comprised of 91 emergency room nurses. Data were collected by a questionnaire specifically prepared for this study.ResultsKnowledge of nurses in emergency room was not adequate in general. There was no relationship between the level of knowledge of cardiopulmonary resuscitation and nurses' educational level, but there was a statistically significant positive relationship between knowledge level and additional training (p = .028) and work experience (p = .038).ConclusionThe results of this study show the need for re-evaluation of the educational curricula for nurses in emergency medicine, aimed at standardizing formal educational models. Remodeling of nurse education is the key issue in ensuring good quality education and clinical skills for nurses in the field of emergency medicine and safe nursing care.

Patient Satisfaction in Postanesthesia Unit: Matched Study Participant Methodology

ObjectivesThe aim of this study is to determine patient satisfaction compared to nurse perception of patient satisfaction in Peri-anesthesia unit.BackgroundIn 2014 American Society of Anesthesiology published guidelines stating standards for care for hypervigilance during perioperative patient assessments. Other policy publications focus on equipment and practices in this clinical setting. However, none of these sources provide an account of patient experience.MethodsThis is a Prospective, convenience paired matched sampling study using Three multichoice questionnaires were distributed to patients and nurses in this unit. Both nurse and patient questionnaires were distributed simultaneously and paired.Results200 patients and total staff 30 nurses, 26 participated in the study-response rate 87%. Patients' perception showed highest level of satisfaction in nurses' listening. The nurses rated patients' satisfaction with communication and environmental conditions highest compared to other categories. The only significant difference between the nurses and patients' perceptions was in specific symptom communication, patients rated this lower satisfaction compared to nurses ranking this domain.ConclusionIn conclusion, similarity was found between nurses' and patients' ratings. This knowledge is relevant in raising awareness that nurses should be more vigilant evaluating and inquiring about peri-operative patients' symptoms.

Impact of Clinical Nurse Specialist Roles on COVID-19 Pandemic Care

Advanced practice nurses including nurse practitioners, clinical nurse specialists (CNS), certified registered nurse anesthetists, and certified nurse midwives contribute in many ways to improve care in the intensive care unit. This article reports on the roles of the CNS at an academic medical center and how they contribute to improving patient outcomes and support critical care nursing practice during the COVID-19 pandemic.

Implementing Prone Positioning in Your Unit: What Do You Need to Know?

Prone positioning for patients with acute respiratory distress syndrome (ARDS) has been occurring for over 30 years. A recent randomized control trial showing significant impact on 30- and 90-day mortality has placed it into international guidelines as a strongly recommended therapy. The current coronavirus pandemic shined a light on prone positioning as a lifesaving technique to improve oxygenation. This has resulted in worldwide implementation in intensive care units (ICUs). To incorporate prone positioning into moderate and severe ARDS patients' routine practice, the multiprofessional team must address many factors. They include: Understanding why prone positioning works and the evidence to supports its use with moderate to severe ARDS patients.Identify screening strategies to determine which patients the position should be initiated early in the course of their disease.Multiprofessional development of a protocol is required to address indications for use, methods, frequency of prone positioning, contraindications, equipment needed, preparation of the patient to prevent injury, and care of the patient while in the prone position as indications for stopping the procedure.Development of education and implementation plans to ensure the successful integration of the new practice.

Understanding Acute Care Usage by Adult Chronically Critically Ill Ventilated Patients: A Chart Review

ObjectivesTo better understand the rationale for acute care usage among long term care ventilated residents.BackgroundChronically critically ill ventilated individuals experience complex health challenges, with many not surviving one year post initial hospitalization discharge. Recent research reports high acute care readmission rates for chronically critically ill patients, yet most studies have not examined the reasons patients are readmitted, nor the treatment and care provided during these stays.MethodA retrospective medical chart reviews of all emergency department visits and acute care admissions, occurring from August 2014 to August 2016, of chronically critically ill ventilated individuals living in a residential care facility in the province of British Columbia, Canada was conducted.ResultsThere were 49 emergency department visits and 56 acute care admissions over a 2 year period by 20 chronically critically ill ventilated residential care patients. The majority of acute care admissions were related to pneumonia, whereas the majority of emergency department visits were not specified.ConclusionChronically critically ill ventilated long term care residents are high users of acute care resources, frequently admitted for pneumonia.

Critical Care in Critical Times of COVID-19 in Argentina: A Viewpoint

The world is experiencing an unparalleled COVID-19 pandemic which highlighted the important role and contribution of critical care nurses worldwide.Argentinean health authorities and critical care organizations have delivered country wide education and support strategies to upskill the critical care nursing workforce.The challenges include to tailor a pandemic response in a context of a weak and fragmented health system and shortage of critical care nurses.Argentina needs to invest in expanding specialty education, enhancing critical care nursing leadership, and improving working conditions of critical care nurses.

Synthesis of Intensive Care Nurses' Experiences of Caring for Patients With Delirium

BackgroundThere is a paucity of studies synthesizing intensive care nurses' experiences of taking care of patients with delirium. A better understanding of nurses' experiences provides an opportunity to identify areas that can be strengthened to improve care.AimTo gain insight into intensive care nurses' experiences of caring for patients with delirium through summarizing the existing qualitative studies in the area.MethodsDatabases of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL) Plus, PubMed, and ProQuest Dissertations & Theses Global were searched for qualitative or mixed-method primary research studies, resulting in 269 records screened for eligibility. A three-stage thematic synthesis was followed.FindingsNine studies were included in the review. Twelve descriptive themes emerged outlining critical care nurses' experiences in the four aspects of delirium care. For prevention, the common nursing themes were using holistic nursing care to promote nighttime sleep, orientate patients through human interaction, and promote early mobilization. Intensive care nurses' experience of delirium assessment included their perceived utility of screening, their understanding of using a screening tool, and their impression of integrating nursing assessment. In terms of treatment, nurses' experience focused on pharmacological and nonpharmacological methods, as well as their attitude toward the use of physical restraints and chemical sedation. Nurses' overall experience of caring for patients with delirium in intensive care units includedemotional exhaustion, physical fatigue, and the perceived low priority and inconsistency of delirium management.ConclusionsIntensive care nurses' complex experiences of caring for patients with delirium revolved around delirium prevention, assessment, treatment, and the overall process of care. Implications for practice include: multicomponent delirium prevention strategies, integrating the use of screening tools and nursing assessment for delirium detection, focusing on nonpharmacological interventions, and offering on-job support to nurses who care for delirious patients.