Critical Care Nursing Quarterly最新文献

Alpha-gal syndrome is a serious, potentially life-threatening allergic reaction to mammalian products that has been linked to the lone star tick. Early recognition and management of alpha-gal syndrome is key for desirable patient outcomes and informed nursing care can make all the difference. The purpose of this article is to provide background information regarding alpha-gal syndrome, review common sources of potential reaction triggers including food and medications, and discuss strategies to detect and avoid allergic reactions from occurring.

The objective of this literature review was to examine and summarize knowledge of best practices for the management of patients suffering traumatic brain injury based on studies using a variety of practices to improve outcomes published 2018 - 2021. From a clinical perspective, when a patient suffers an acute traumatic brain injury, providers and clinicians ask themselves and each other, "What else could we do? What could we have tried to improve the outcome with this patient?" Astute clinicians spend ample time reviewing contemporary studies to improve their patients' outcomes. This project aimed not to find all studies about a specific treatment, but to review all studies about a topic to evaluate the studies for rigor and results to improve bedside patient care in times of crisis. A quality assessment model was used in four domains: design, bias, synthesis, and dissemination with a Quality Assessment Score assigned for each of the four domains. Ten studies met the rigor of the quality assessment evaluation. The highest ranked studies indicate a common theme of prevention of extension of injury.

The aim of this study was to develop a bundle to increase safety of intra-hospital transport in critically ill patients. A qualitative design with Delphi approach was conducted for creation of an intra-hospital transport bundle in 3 steps. First, doctors and nurses were questioned about their encounters with intra-hospital transport incidents. Second, several databases were looked through to find published checklists and recommendations for intra-hospital transport. Third, using this strategy, a bundle was created and reviewed with subject matter experts. The content validity index (CVI), which assesses the degree of expert agreement, was utilized to evaluate each item in the generated bundle. Two evaluation cycles were required before a minimal index could be reached. We looked at the content validity and important weighting of the items. The scale-CVI was calculated using the average of all the elements, and it was 1. The created bundle serves as a framework for directing doctors and nurses during intra-hospital transportation and offers continuity of care to improve patient safety. The techniques suggested in this study can be used to adapt this bundle to the needs of other hospitals.

Hypoglycemia in critical care is a well-documented phenomenon, linking both physiological and clinical evidence to harmful outcomes and an increased risk of mortality. Its implications span medical and non-medical consequences, such as cardiovascular and cerebrovascular complications, and escalated health care expenses and hospitalization duration. Mitigation measures for modifiable risk factors and education for both patients and health care providers on hypoglycemia can effectively prevent the onset of inpatient hypoglycemia. This concise clinical review offers a brief overview of hypoglycemia in critically ill patients, encompassing its pathophysiology, etiology, diagnosis, management, and prevention.

To investigate effectiveness of the ABCDEF bundle to manage and prevent delirium.

Background: ICU delirium is a common hospital problem that 80% of critically ill patients in the ICU experience. The ABCDEF bundle is one of the tools that included in Delirium guidelines to manage critically ill patients.

Research design: Pre- and post intervention a quasi-experimental design was utilized in the present study.

Setting: This study was conducted in the intensive care units of Assiut University Hospital.

Methods: A total of 60 mechanically ventilated patients were recruited using inclusion and exclusion criteria. The ABCDEF bundle was implemented every day for the first 7 days of ICU admission, and patient sedation and delirium status were assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Sedation instrument measures were utilized in data collection.

Results: Significant differences were found in the incidence of delirium: 20% in the study group versus 70% in the control group. The increased mean of days without delirium ICU stay was 4.6333 in the study group and 1.1000 in the control group, with P value = .001.

Conclusion: The mechanically ventilated patients exposed to the implementation of the ABCDE bundle experienced fewer delirium signs than before the ABCDE bundle was implemented.

Arterial puncture is a painful procedure performed to assess patients' respiratory status. Pain is a stressful situation for unconscious patients as they cannot communicate their feeling verbally. To control patients' pain and prevent the adverse effects of painkillers, nonpharmacological pain management strategies have been solicited. The aim of this study is to investigate the effect of cryoanalgesia on unconscious patients' pain during arterial puncture. We adopted a quasi-experimental one-group research design. A sample of 86 unconscious patients in a surgical intensive care unit were recruited in this study. The intervention was applying an ice pack over the puncture site for 5 minutes before the arterial puncture procedure. Pain was assessed for 2 times; before and after application of cryoanalgesia. A statistically significant difference in participants' pain scores between pre-tests and post-tests was noted. For the intubated ventilated participants, the mean pain score before and after applying cryoanalgesia was 5.26 versus 4.00 (P ≤ .05). For the non-intubated or intubated non-ventilated participants, the mean pain score was 6.66 versus 4.63 (P ≤ .05). Cryoanalgesia is a feasible and effective method incorporate during arterial puncture along with standard procedure elements to achieve maximum pain reduction for unconscious patients during arterial punctures.

There have been few reports concerning simulation drills for the relocation of severely ill or injured patients treated in intensive care units (ICUs). We herein report our experience of one such simulation drill. It is a Narrative method. A simulation drill was performed on a weekday 2 weeks prior to the actual relocation. We selected 3 mock patients. The first one was a severely ill and unstable patient, the second had severe stroke, and the third had severe trauma. After the simulation, the average transportation time was 15 minutes. The simulation revealed that mock patients with a percutaneous cardiopulmonary support system and intra-aortic balloon pumping in a standard ICU bed could not be accommodated in the elevator. Furthermore, working the elevator controls resulted in wasted time while transferring the patients. As a result, the number of people, who controlled the elevator, was therefore increased during the actual relocation. During the actual relocation, all patients were transported safely and more quickly than predicted based on the results of the simulation drill. Most physicians and paramedical staff have little experience with relocating ICUs, so a simulation drill was necessary to ensure the safe and prompt transport of patients.

Pressure ulcer is considered a common and costly problem in the care of patients. Prevention and management of pressure ulcer are very important due to the high cost of treatment and the adverse consequences of pressure ulcer. This study aimed to evaluate the effect of implementing "aSSKINg" model in reducing pressure ulcer risk. This study used a before- and after-intervention quasi-experimental design. This study was performed on 60 patients who were not randomly selected and assigned in to control and study group. The data collection tool was a 3-part sheet (Braden scale, skin health assessment, and Pressure ulcer assessment). The incidence of pressure ulcer was 19 (60.0%) in the control group versus 9 (30.0%) in the study group with statistical significant differences. The most common site of pressure ulcer was coccyx (6 [31.6%]) in the control group and Heel (3 [33.3%]) in the study group. The application of "aSSKINg" model in the patients with pressure ulcers is effective in reducing the incidence and severity of pressure ulcers.

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses' intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction.

This article reports a study designed to evaluate the effectiveness of regular oral care protocol developed specifically for adults in intensive care to prevent mucositis. Data were collected using oral mucositis assessment scale, oral cavity assessment tool, and the National Cancer Institute Common Toxicity Criteria. The results indicated that oral mucositis can be reduced through the practice of administering oral care in accordance with oral health care guidelines. Oral care implemented in line with an evidence-based oral care guide and frequent observation of patients is the most important step in preventing oral mucositis.