Clinical Pearls

Abstract

Family-centered care is an innovative approach to planning, delivering, and evaluating health care that is governed by mutually beneficial partnerships among health care providers, patients, and families. In this issue Mitchell et alA good resource for implementation of this model is The Institute for Family-Centered Care, a nonprofit organization founded in 1992 to advance the understanding and practice of patient- and family-centered care in hospitals and other health care settings. This group is endorsed by AACN. The Institute for Family-Centered Care provides a Web site with helpful resources for health care providers and educators at http://www.familycenteredcare.org/index.html.See Article, pp 543–553Do emotions directly affect cardiac disease or outcomes of therapy? In this issue Song et al describe the effects of hostility and anger as well as homocysteine levels on the incidence of recurrent cardiac events after percutaneous coronary intervention (PCI). They note the following:Patients with CAD who have a high level of anger and homocysteine are at increased risk for recurrent cardiac events after PCI. Nurses should identify patients who experience intense and frequent anger and assist in the identification of interventions to reduce anger to improve post-PCI outcomes.See Article, pp 554–561What type of oral care protocol is used in your unit? Oropharyngeal bacterial colonization plays a significant role in the development of ventilator-associated pneumonia (VAP). Garcia et al used a comprehensive oral-dental care system to reduce the VAP rate in their unit that included the following:These authors showed that oral care can be maintained over time with protocol compliance rates of 80% and results that were sustained for 12 months beyond the original 12-month intervention phase. Implementation of the protocol resulted not only in decreased VAP, but also reduced duration of mechanical ventilation, ICU length of stay, and mortality.See Article, pp 523–532Is there a procedure to evaluate urinary catheter use in your unit? Elpern et al implemented and evaluated a process to limit use of catheters and reduce urinary tract infections (UTIs).A team of medical intensive care unit clinicians developed catheter use criteria that included conditions in which use was deemed inappropriate, such as incontinence, diuresis, or diarrhea without other reasons for use, and frequent but nonessential urine output determination.See Article, pp 535–542