Clinical Pearls.

Abstract

Burnout affects approximately one-third of all critical care nurses and has long been known to contribute to poor mental health and adversely affect patient care. The impact of workplace climate on burnout has been studied but not in a comprehensive manner that includes objective organizational characteristics.Swamy and colleagues combined survey data with site characteristics to examine risk factors for burnout in VA intensive care unit nurses. They found that The authors acknowledge that workplace climate is a complex concept, with various aspects such as perceptions of teamwork, patient experience, workload, supervisors, and senior leadership all affecting burnout. They suggest interventions not only be focused on the individual but also on improving local site climate.See Article, pp 380–389Caring for a loved one after discharge from the intensive care unit can cause physical and psychological problems such as acute stress, anxiety, and posttraumatic stress disorder for months to years. Providing care to a loved one may be a significant burden for the family member, yet the relationship between caregiver burden and depression is not known.Beesley and colleagues explored the association of caregiver burden with depression, as well as the impact on employment status and quality of life 3 months after discharge. They found Findings suggest an association between caregiver burden and depression, but factors affecting this relationship are unclear. Further research is needed to identify how health care staff can reduce adverse outcomes in family caregivers. See Article, pp 350–357Nurses in the intensive care unit (ICU) are continually exposed to hundreds of alarms during a single shift. Desensitivity to false alarms can cause alarm fatigue, which can decrease patient safety and quality of care. The American Association of Critical-Care Nurses’ Practice Alert on ways to reduce false alarms includes improved skin preparation and electrode replacement; however, the effectiveness of these interventions requires further study.Leigher and colleagues compared 2 groups of patients: (1) an intervention group that received skin preparation and daily electrode changes and (2) a control group that received usual care (changing electrodes as needed). They found that Findings show a simple nursing intervention can be effective in reducing false alarms, thus lessening the occurrence of alarm fatigue. The authors recommend further research with patients in different clinical settings throughout a full 24-hour period.See Article, pp 390–395Many survivors experience long-term cognitive impairment after discharge from the intensive care unit. The reference standard for cognitive assessment is comprehensive face-to-face neuropsychological testing. However, many hospitals do not have access to neuropsychological experts, which limits the testing of interventions to preserve cognitive functioning.Han and colleagues tested the feasibility of videophone-assisted neuropsychological testing using an inexpensive high-definition web camera and a laptop computer. They found Findings support the feasibility of videophone-assisted technology for conducting accessible and comprehensive cognitive testing for use in multicenter studies. It was convenient, cost-effective, easy to use, and has the potential to allow home testing of participants.See Article, pp 398–402