Critical Care Therapy Research Articles

Nurses' knowledge and attitudes about antibiotic therapy in critical care.

To assess critical care nurses' knowledge about antibiotic use in critical care settings, and attitudes concerning the role of the nurse in monitoring response to and appropriate use of antibiotic therapy. 90 critical care nurses from 6 adult critical care units at a 780-bed academic, health sciences centre, completed an investigator-developed survey about their knowledge of antibiotic use and their attitudes concerning the role of the nurse. The majority of respondents worked full time (83%) and were BSN (Bachelor of Science in Nursing) prepared (62%), with an average of 9 years' nursing experience and 7 years' experience in intensive care. Using a 100-mm visual analog scale, mean scores on knowledge and comfort with: (1) interpreting culture and sensitivity; (2) white blood cell (WBC) data; and (3) discussing results and therapy with physicians were all less than 50 mm. However, the mean score for nurses' belief of responsibility related to this collaborative role was 76. A knowledge quiz of lab interpretation and antibiotic therapy revealed a mean score of 53.8%. Beliefs about roles were correlated with comfort in discussing therapies with physicians rather than with knowledge. Although nurses value the collaborative surveillance role, they may lack the knowledge and confidence to enact it.

Music therapy as a nursing intervention for patients supported by mechanical ventilation.

Music therapy is a nonpharmacologic nursing intervention that can be used as a complementary adjunct in the care of patients supported by mechanical ventilation. This article details the theoretical basis of music therapy for relaxation and anxiety reduction, highlights the research testing the intervention in such patients, and discusses areas of needed research to extend further the implementation of music therapy in critical care nursing practice in an effort to promote a healing environment for patients.

Book Review: International Anesthesiology Clinics: A History of Critical Care and Hyperbaric Oxygen Therapy

Book Review: International Anesthesiology Clinics: A History of Critical Care and Hyperbaric Oxygen Therapy

A History of Critical Care and Hyperbaric Oxygen Therapy, Vol. 37, No. 1 of International Anesthesiology Clinics.

A History of Critical Care and Hyperbaric Oxygen Therapy, Vol. 37, No. 1 of International Anesthesiology Clinics.

A History of Critical Care and Hyperbaric Oxygen Therapy, Vol. 37, No. 1 of International Anesthesiology Clinics.

A History of Critical Care and Hyperbaric Oxygen Therapy, Vol. 37, No. 1 of International Anesthesiology Clinics.

Music therapy in critical care: indications and guidelines for intervention

Music therapy is an effective intervention for critically ill patients for such purposes as anxiety reduction and stress management. The therapy is readily accepted by patients and is an intervention patients thoroughly enjoy. The MAIT is one resource that nurses caring for critically ill patients can use to implement music therapy in clinical practice. Patients can be given the opportunity to select a musical tape they prefer and to negotiate with the nurse for uninterrupted music-listening periods. Allowing patients control over music selection and providing uninterrupted time for music listening gives the patients an enhanced sense of control in an environment that often controls them.

Renal replacement therapy in critical care: implementation of a unit-based continuous venovenous hemodialysis program

Implementing a program as complex as continuous venovenous hemodialysis without the involvement of nephrology nurses is a challenge. However, with proper planning, appropriate staff support, and the ability to make changes as implementation proceeds, a successful program can be developed. Our reward is that we are now able to offer a therapy that is important and potentially lifesaving to those critically ill patients with renal failure who are unable to tolerate intermittent hemodialysis.

Efficacy and limitation of apheresis therapy in critical care.

Apheresis therapy such as plasma exchange and plasma adsorption has become therapeutic tools in critical care. The indications for apheresis therapy in ICU patients include fulminant hepatic failure, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), autoimmune disease, and sepsis. During the past 11 years, 150 patients with various kinds of critical illnesses were treated with apheresis therapy in our ICU, and the overall survival rate was 50%. Apheresis therapy is especially useful in the treatment of a patient with fulminant hepatic failure because liver transplantation is seldom performed in Japan; therefore, the patient should be treated with artificial liver support. When plasma exchange is performed on the critically ill, continuous hemodiafiltration should be performed simultaneously to overcome the adverse effects of plasma exchange such as hypernatremia, metabolic alkalosis, and abrupt changes in colloid osmotic pressure and to enhance the removal rate of the causative middle molecular weight substances of hepatic failure or hepatic coma.

A Pocket Guide to Intravenous Therapy

A reference work based on recognized standards of practice for nurses working with diverse patient care settings and varying clinical preparation. The guide explores the principles of IV therapy and details the steps for administration of intravenous medications. Features include; blood administration guidelines, chapters on peripherally inserted central venous (PICC) catheters, on critical care and paediatric therapy. Each chapter concludes with multiple choice questions.

What criteria should be used for pet therapy in critical care? Are you aware of any hospitals doing this?

Articles| April 01 1993 What criteria should be used for pet therapy in critical care? Are you aware of any hospitals doing this? S Martin S Martin Search for other works by this author on: This Site PubMed Google Scholar Crit Care Nurse (1993) 13 (2): 74. https://doi.org/10.4037/ccn1993.13.2.74 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Cite Icon Cite Get Permissions Citation S Martin; What criteria should be used for pet therapy in critical care? Are you aware of any hospitals doing this?. Crit Care Nurse 1 April 1993; 13 (2): 74. doi: https://doi.org/10.4037/ccn1993.13.2.74 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentCritical Care Nurse Search Advanced Search You do not currently have access to this content.

New approaches to diagnosis and therapy in pediatric critical care

New approaches to diagnosis and therapy in pediatric critical care

Oxygen transport in the critically ill patient

The traditional view of oxygen transport as the product of haemoglobin, oxygenation and cardiac output holds up well, but because the efficiency of oxygen delivery (the extraction ratio) is sometimes a fixed parameter in the critically ill, absolute values for each determinant are difficult to define and seem to have a large range for adequate function. The main factor in effective delivery to the tissues is cardiac output when extraction is limited. In most acute circumstances the blood volume is not easy to estimate without direct measurement. Hypovolaemia may influence the distribution of oxygen transport unfavourably away from splanchnic and renal circulations. Monitoring of the oxygen transport variables may be indirect, looking at the compensations for inadequate delivery, such as comparing transcutaneous oxygen tension to arterial oxygen tension, intramural gastric pH or lactate concentrations. The direct monitoring of oxygen delivery and uptake can be done with conventional intensive care unit monitoring (cardiac output, and arterial and mixed venous blood gases). The direct airway measurement of oxygen uptake also includes pulmonary oxygen utilization, which can be high in ARDS and pneumonia. Prehospital emergency management should maintain oxygenation and blood volume, and aim to reduce additional burdens of pain, agitation and shivering. This can then be developed into full critical care monitoring and therapy in the emergency department. The chief priority for any emergency department should be to develop the organization and protocols to maximize survival.

Folkes ME. Transfusion therapy in critical care nursing

Folkes ME. Transfusion therapy in critical care nursing

Transfusion therapy in critical care nursing

Transfusion therapy in critical care nursing

Critical care and physical therapy

Critical care and physical therapy

Anesthesiologists in North Carolina: A survey reflecting emerging subspecialization

This North Carolina case study addresses the migration of anesthesiologists into subspecialty, clinical areas of anesthesiology over a 4 year period (1984 to 1987). Three hundred fourteen members of the North Carolina Society of Anesthesiologists (NCSA) were surveyed using a one-page questionnaire. The response rate was 93.6%. The questionnaire elicited data to characterize the magnitude of change in anesthesiologist manpower, to assess emerging subspecialization, to describe the flux of anesthesiologists entering and leaving practice, and to detail evolving modes of practice. Results indicated a net increase in manpower averaging 8.8% per year in academic programs, whereas clinical community practitioners increased physician positions at a rate three times the former (27% increase per year). Of 184 anesthesiologists recruited to North Carolina over 4 years, 75 different residency programs were represented; 48% of new anesthesiologists were from southern educational programs and 44% entered practice with fellowships (i.e., postgraduate year 4 to 5). The principal fellowship was cardiac (33%). Subspecialty areas were represented in all 53 reporting clinical practices. The principal practice mode emerging was hospital-based, same day surgery (85%) followed by pediatric anesthesia (81 %), perioperative pain management (68%), obstetric anesthesia (63%), and an anesthesia “clinic” (54%). Respondents expected additional practice options over the next 3 years with anesthesia for ambulatory diagnostic and therapeutic modalities projected to emerge at the fastest rate. In conclusion, anesthesiologists in North Carolina seem to be filling unmet needs in obstetric and cardiac anesthesia, critical care, ambulatory surgery, and pain therapy units. These observations may represent a vignette of the national scene.

The ethics of intensive care

An explanation is provided of the logical steps taken before assigning patients to critical care therapy in a major multidisciplinary intensive care unit of the University of Paris at the Hospital Henri Mondor. The factors considered by the staff in deciding to terminate intensive therapy are also enumerated. This system has not been influenced by the major legal pressures found in the United States but has been shaped by more chronic fiscal constraints.

Critical Care Complications in the Trauma Patient

Critical care therapy of the multiply injured patient results in multiple potential complications. Nosocomial infections, gastrointestinal complications, and pulmonary complications are reviewed. Complications that are anticipated can often be avoided by prophylactic therapy. Early intervention, once complications have occurred, may result in decreased morbidity and mortality.