Clinical Pearls

Abstract

Body temperature readings provide vital information for accurate diagnoses and required therapies. However, standard practices for measuring body temperature in intensive care units (ICUs) vary and often require invasive methods with limited accuracy in different types of patients.Schell-Chaple and colleagues evaluated a new, noninvasive monitoring system that is applied to the lateral forehead, called SpotOn. They compared temperatures taken with the SpotOn system with rectal and bladder temperatures in febrile adult patients. They found the following:The SpotOn method was accurate. Although the authors recommend further research to test for longer periods, they suggest this noninvasive system be considered for continuous monitoring of core temperature in ICU patients.See Article, pp 43–50Family-centered care (FCC) enables and empowers families through improved communication and involvement in their child’s care. However, recent changes in FCC have incorporated a customer service emphasis that can be challenging for staff.The research team interviewed nurses to explore their perceptions of the benefits and challenges in providing FCC. They found thatWhile acknowledging the benefits of FCC, Coats and colleagues recommend that (1) support systems be available for nurses dealing alone with families, (2) new nurses have a longer mentorship to become comfortable with providing care independently in private rooms, and (3) nurses be involved in the implementation of FCC practices.See Article, pp 52–58Patients who require mechanical ventilation often receive sedative therapy to reduce anxiety and optimize comfort and safety. Although various sedation protocols have been successfully used to facilitate quick weaning from mechanical ventilation, there is no standardized practice despite guidelines from organizations such as the Society of Critical Care Medicine.Borkowska and colleagues surveyed more than 300 nurses from an adult intensive care unit and asked them to evaluate their daily sedation practices. They found the following:Nurses’ perceptions, attitudes, and knowledge are vital to the success of any sedation practice. Organizational and multidisciplinary collaboration is needed to improve sedation practices at regional, national, and international levels.See Article, pp 32–42The influenza A(H1N1) pandemic of 2009 to 2010 caused thousands of deaths across the world and left survivors with significant functional limitations and morbidities. Many patients had acute renal failure requiring continuous renal replacement therapy (CRRT); however, the long-term consequences are unknown.Napolitano and colleagues examined the long-term recovery of adult patients in a surgical intensive care unit (ICU) with acute respiratory distress syndrome (ARDS) who tested positive for H1N1. They found the following:This study is the largest to date to report renal outcomes in ARDS-H1N1 patients. The findings provide clinicians with valuable information needed to optimize future resource use.See Article, pp 67–73