Clinical Pearls

Abstract

There are more than 1½ million hospital admissions each year attributed to sepsis, with nearly one-third of those patients dying. Although many seek outpatient care before their hospitalization, little is known about the circumstances surrounding these clinic visits.Miller and colleagues conducted retrospective chart reviews and found 10% of adult patients admitted with sepsis sought clinic care on the day of or the day before their hospital admission, and of those: With the aim to improve sepsis care, the authors recommend development of algorithms to assist outpatient providers in identifying high-risk patients who would benefit from accelerated transfer to the emergency department.See Article, pp 135–139Telemedicine is the electronic sharing of medical information between sites. This technology now includes real-time management of critical events involving patients in intensive care units (ICUs) by off-site clinicians. Although telemedicine research shows positive patient outcomes, findings on staff acceptance of this technology have been mixed.Kaplow and Zellinger examined nurses’ perceptions of telemedicine, comparing nurses who had only medical-surgical experience with nurses who had at least 5 years of critical care experience. They found The authors suggest that sharing successful telemedicine outcomes with staff as part of the system implementation process to show how the technology supplements but does not replace bedside critical thinking and interventions.See Article, pp 122–127Patients in the intensive care unit (ICU) are 5 times more likely than non-ICU patients to have hospital-acquired pressure injuries (HAPIs) develop. Although the Braden skin risk assessment scale has been widely used for years, it lacks predictive validity with critically ill patients. The Cubbin- Jackson scale was specifically developed for the ICU, yet little research has compared the 2 scales in the same set of patients.Delawder and colleagues evaluated the construct validity of the Cubbin-Jackson scale, meaning how well it assesses for HAPIs, and also compared its predictive validity with that of the Braden scale. They found Findings suggest that the Cubbin-Jackson scale may be a suitable alternative to the Braden scale for assessment of HAPIs in the adult ICU population.See Article, pp 140–144Professional quality of life is a balance between compassion fatigue, in particular burnout and secondary trauma, and compassion satisfaction. Although various professional organizations, including the American Association for Critical- Care Nurses and the National Academy of Medicine, have developed initiatives and standards for addressing compassion fatigue, burnout remains an ongoing issue.Kelly and colleagues surveyed nurses from adult intensive care units (ICUs) to examine the relationship between their perceptions of work environment and outcomes on the Professional Quality of Life instrument. They found The authors recognize burnout not as an individual phenomenon but an organizational one that can be prioritized and modified with strategies such as nurse well-being assessments, formal reward and recognition programs, and stronger support for early- career nurses.See Article, pp 113–120