American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses

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No abstract text is available yet for this article.

BACKGROUND: Subjecting patients to stress has potentially detrimental effects on their physical and psychological recovery. OBJECTIVE: To identify stress-generating experiences that occur in an intensive care unit for patients after cardiac surgery. METHODS: A sample of 16 patients in a 14-bed cardiovascular intensive care unit at a university hospital in upstate New York completed a questionnaire (based on an established survey) asking them to rate 23 experiences on a Likert scale of 0 to 4...

BACKGROUND: Family-witnessed resuscitation is not consistently practiced in critical care despite the fact that it is recommended and research shows that it supports the emotional needs of families and patients and improves decision-making, care, and communication. Nurses support the idea of family-witnessed resuscitation but may not believe it should be standard practice. OBJECTIVES: To examine the attitudes of American community hospital critical care nurses about family-witnessed resuscitation and to identify differences in attitudes between nurses who have and have not experienced it...

BACKGROUND: Septic shock is one of the main causes of mortality in intensive care units worldwide. Nutritional support can affect the survival of patients with sepsis. OBJECTIVE: To evaluate whether resting energy expenditure, respiratory quotient, and oxygen consumption and carbon dioxide production (measured by indirect calorimetry) differ between critically ill patients with vs without sepsis. METHODS: A total of 205 patients receiving mechanical ventilation were evaluated consecutively within the first 48 hours of admission...

Delirium, one of the most common manifestations of acute brain dysfunction, is a serious complication in patients receiving care throughout the hospital and a strong predictor of worse outcome. Although delirium monitoring is advocated in numerous evidence-based guidelines as part of routine clinical care, it is still not widely and consistently performed at the bedside in different patient care settings. In a debate on delirium monitoring in hospitalized patients at the 7th American Delirium Society meeting in Nashville, Tennessee, June 2017, areas related to the feasibility, acceptability, and effectiveness of routine delirium monitoring of hospitalized patients were identified, and arguments both for (pro) and against (con) the practice were presented...

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BACKGROUND: Prehospital frailty has been associated with adverse hospital outcomes in critically ill adults. Although frailty assessment in intensive care units depends on patients' surrogates, frailty assessments by surrogates and researchers have not been compared. OBJECTIVES: To compare agreement and validity between surrogates' and researchers' assessments of frailty in critically ill older adults. METHODS: An observational cohort study of adults (aged ≥ 50 years) admitted to a medical/surgical intensive care unit was conducted...

BACKGROUND: Although electrocardiographic monitoring is common in hospitalized patients, many patients receive unnecessary monitoring, contributing to patients' inconvenience, clinicians' alarm fatigue, and delayed admissions. OBJECTIVE: To evaluate the impact of implementation of an electronic order set based on the American Heart Association practice standards for electrocardiographic monitoring on the occurrence of appropriate monitoring. METHODS: The sample for this preintervention-to-postintervention quasi-experimental study consisted of 297 adult patients on medical, surgical, neurological, oncological, and orthopedic patient care units that used remote electrocardiographic monitoring in a 627-bed hospital in Minneapolis, Minnesota...

BACKGROUND: Early mobilization of patients in the intensive care unit can be beneficial, but evidence is insufficient to indicate whether allowing patients with an indwelling pulmonary artery catheter to walk is safe. OBJECTIVE: To describe the physiological and emotional responses to ambulation in patients with heart failure and a pulmonary artery catheter. METHODS: This prospective, descriptive study included 19 patients with heart failure monitored with a pulmonary artery catheter in a cardiac intensive care unit...

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.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Education opportunities for night shift nurses are limited compared with those for their day-shift counterparts. However, patients remain critically ill regardless of shift and require intensive nursing care at all hours. Overnight, this care is often provided with fewer resources. These challenges can lead to disengagement and high turnover on the night shift. OBJECTIVES: To see whether initiation of an informal education series called "Coffee Talk" could improve accessibility to learning for night shift nurses and elevate perception of support from administrators and overall job satisfaction...

Acute respiratory distress syndrome is associated with long-term physical impairments. Although readmission is common, little is known about the impact of readmissions on the physical status of this population. The purpose of this study was to evaluate the association between hospital readmission, with or without an intensive care unit stay, and physical status in survivors of acute respiratory distress syndrome. The exposure was hospital readmission, categorized as (1) no readmission, (2) readmitted 1 or more times without an intensive care unit stay, or (3) readmitted 1 or more times with an intensive care unit stay...

BACKGROUND: Although telemedicine intensive care unit (tele-ICU) nurses are integral to the tele-ICU model of care, few studies have explored the influence of tele-ICU nursing interventions on preventing failure to rescue in critically ill patients. OBJECTIVE: To determine how tele-ICU nurses characterize their interventions to prevent failure to rescue. METHODS: This qualitative interpretive study recruited a purposive sample from 11 tele-ICU centers across the United States for structured open-ended interviews...