Clinical Pearls.

Abstract

Injuries from medical devices account for about 30% of all hospital-acquired pressure injuries. Although several professional organizations prioritize early identification and treatment of pressure injuries, those caused by endotracheal tubes (ETTs) continue to occur.Moser and colleagues examined the current evidence to identify the reported incidence of ETT-related pressure injuries and evaluate the effectiveness of prevention methods. They found Although further study with standardized measures in various patient populations is warranted, the authors recommend use of Anchor-Fast and nasal barrier dressings to reduce the incidence of pressure-related ETT injuries.See Article, pp 416-424Research has shown that use of a checklist during intensive care patient rounds can improve quality of care and reduce the incidence of adverse events. However, difficulties with interprofessional communication during rounds may contribute to differences in patients’ plans of care.Alves and colleagues developed and validated a checklist of care to improve interprofessional communication during rounds in a pediatric intensive care unit (PICU). After multiple phases of evaluation with many expert clinicians—physicians, nurses, and pharmacists—their findings include Findings suggest that a PICU checklist supports standardization of interprofessional rounds, improving communication between professionals from different disciplines to provide consensus on patients’ plans of care.See Article, pp 383-389Communication is a challenge for patients receiving mechanical ventilation. Although various nonverbal methods of communication are possible, these are challenging and often stressful for patients. Use of a speaking valve with patients who have a tracheostomy can restore the voice; however, information on the effectiveness of this device during invasive ventilation is limited.Sutt and colleagues evaluated the use of a speaking valve on successful communication with adult patients with a tracheostomy who are receiving mechanical ventilation. They found The authors suggest that restoring airflow to the upper airway with the speaking valve may improve patients’ progress toward decannulation. They recommend use of a speaking valve for better communication with adults receiving mechanical ventilation who have a tracheostomy.See Article, pp 411-415Critical access hospitals (CAHs) were established in the late 1990s to improve health care access for rural patients. Often CAHs have limited services and technology to care for the critically ill; however, end-of-life (EOL) care does occur in these settings. As EOL care is 1 of the 5 national nursing research priorities of the National Institute for Nursing Research, it is important to understand EOL care in CAHs.Beckstrand and colleagues surveyed nurses from 39 CAHs to understand their perceptions of the obstacles and helpful behaviors in EOL care. They found The findings show that CAH nurses believe they provide high-quality EOL care. The authors recommend further research to develop effective educational tools for CAH families.See Article, pp 375-382