Clinical Pearls

Abstract

Why is it important to identify dysphagia in patients who have recently suffered a stroke, and what tools are available to best screen for this disorder? Edmiaston and colleagues note the following:—Karen McQuillan, RN, MS, CCRN, CNRNSee Article, pp 357–364Withholding or withdrawing life support is now more prevalent in the intensive care unit (ICU), but has our understanding of cultural differences in how or when patients and families choose this improved?Johnson and colleagues reviewed 1072 ICU deaths over 8 years to identify factors associated with level-of-care preference at the end of life and found the following:What can we do to understand the cultural differences and help the black population improve their end-of-life care?—Allie Sment, RN, BSN, CCRN-CSCSee Article, pp 335–344Pain assessment in nonverbal critically ill patients presents a challenge for health care providers. Topolovec-Vranic and colleagues evaluated the adult Nonverbal Pain Scale (NVPS) in a neurosurgical and trauma ICU while also assessing staff satisfaction, patient satisfaction, and pain documentation. They noted the following:Although these improvements were found, physicians’ conservative practice of prescribing pain medication was acknowledged as a barrier to adequate pain management for ICU patients.—Rochelle Armola, RN, MSN, CCRNSee Article, pp 345–355Research is essential for evidence-based practice in critical care nursing, but how do you begin?Mary Lou Sole, recipient of the 2010 AACN Distinguished Research Lectureship, detailed the principles for her successful research program in the critical care basics of airway, breathing, and circulation. Several principles helped guide her clinical research.—Maureen Seckel; RN, MSN, APN, APRN-BC, CCRN, CCNSSee Article, pp 326–334Cardiac index (CI) measurement practices vary related to the temperature and amount of injectate. Walsh et al studied another variable that impacts accuracy of CI measurements through a closed-delivery system: the patient’s temperature. They found the following:These authors recommend using iced temperature injectate for CI measurement—Betsy George, RN, PhDSee Article, pp 365–372