American Journal of Critical Care

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Delivery of patient education materials to promote health literacy is a vital component of patient-centered care, which improves patients' decision-making, reduces patients' anxiety, and improves clinical outcomes. OBJECTIVES: To evaluate perceptions of television-based patient education among patients, caregivers, nurses, and other care providers (attending physicians, advanced practice nurses, physician assistants, and resident fellows) in the intensive care unit...

BACKGROUND: Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition. OBJECTIVE: To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb). METHODS: In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70)...

BACKGROUND: Indwelling urinary and vascular catheters are a common cause of health care-associated infections. Interventions designed to reduce catheter use can be ineffective if they are not integrated into the workflow and communication streams of busy clinicians. OBJECTIVES: To characterize communication barriers between physicians and nurses and to understand how these barriers affect appropriate use and removal of indwelling urinary and vascular catheters. METHODS: Individual and small-group semistructured interviews were conducted with physicians and nurses in a progressive care unit of an academic hospital...

BACKGROUND: Early mobility interventions in the intensive care unit can improve patients' outcomes, yet they are not routinely implemented in many intensive care units. In an effort to identify opportunities to implement and sustain evidence-based practice, prior work has demonstrated that understanding the decision-making process of health professionals is critical for identifying opportunities to improve program implementation. Nurses are often responsible for mobilizing patients, but how they overcome barriers and make decisions to mobilize patients in the intensive care unit is not understood...

BACKGROUND: Intensive care unit stays can be stressful for patients' family members. Family-centered communication has 6 components: fostering relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management. Whether these communication components decrease family members' stress is unknown. OBJECTIVE: To describe levels of family-centered communication and associations with acute stress while patients are in the intensive care unit...

BACKGROUND: Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units experience pain and the practices being used to lessen pain. OBJECTIVES: To describe pain assessment and intervention practices in pediatric intensive care units, determine the prevalence of pain and painful procedures, and identify characteristics of children with moderate to severe pain. METHODS: A 24-hour observational cohort study was conducted in 15 units...

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BACKGROUND: Nurses are fundamental to the implementation of sedation protocols for patients receiving mechanical ventilation. A 2005 survey showed that nurses' attitudes toward sedation affected their sedation practices. Since then, updated guidelines on managing pain, agitation, and delirium have been published. OBJECTIVE: To explore nurses' self-reported attitudes and practices related to sedation and determine whether they have changed in the past decade. METHODS: Members of the American Association of Critical-Care Nurses were invited to complete the Nurse Sedation Practices Scale, which measures nurses' self-reported sedation practices and factors that affect them...

Generating evidence for care improvement has characterized my program of research spanning 20 years. Six domains are highlighted to advance the science and practice of critical care nursing in today's complex health care systems. Employee well-being and taking care of team members are key priorities for successful leaders. Understanding that patient and staff outcomes are inextricably linked strengthens the need for care environments to be healing and holistic for staff and patients. The American Association of Critical-Care Nurses' Healthy Work Environment framework empowers staff and optimizes the experience for patients, their families, and care teams...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Excessive electrocardiographic alarms contribute to "alarm fatigue," which can lead to patient harm. In a prior study, one-third of audible electrocardiographic alarms were for accelerated ventricular rhythm (AVR), and most of these alarms were false. It is uncertain whether true AVR alarms are clinically relevant. OBJECTIVES: To determine from bedside electrocardiographic monitoring data (1) how often true AVR alarms are acknowledged by clinicians, (2) whether such alarms are actionable, and (3) whether such alarms are associated with adverse outcomes ("code blue," death)...

BACKGROUND: The unplanned removal of medical devices poses a risk of harm to critically ill patients. OBJECTIVE: To determine rates, causes, and consequences of unplanned medical device removal, as well as factors mitigating harm to patients, in critical care units in the United Kingdom by reviewing patient safety incident reports. METHODS: Incidents of unplanned medical device removal in critical care units in North West England between 2011 and 2016 were retrospectively reviewed and classified...

BACKGROUND: Standards for interfacility transport in the United States recommend that each transport request be triaged to ensure that each patient is transported by an appropriate mechanism and by the appropriate clinicians in order to meet the patient's intratransport needs. No instrument currently exists to meet that need. The Transport Triage Tool, a novel instrument, has been designed to determine the clinician (paramedic, registered nurse, or advanced practice registered nurse) who will best meet the patient's needs during transport...

BACKGROUND: The death of an infant or child has been described as the most stressful life event, but few reports exist on the effects on parents' physical health in the year after the death. OBJECTIVE: To examine acute illnesses, use of health services, and medication changes among parents from 3 racial/ethnic groups 1 to 13 months after the death of an infant or child in the neonatal intensive care unit or pediatric intensive care unit. METHODS: In a longitudinal study, 96 parents (41% black, 32% Hispanic, 27% white) of deceased infants or children were recruited from 4 children's hospitals and death records...