ethical dilemmas are issues that all Intensive Care Units (ICUs) throughout the world have to face and address. In the Current Opinion in Critical Care‚ Vol 16‚ No 6‚ December 2010‚ p. 640‚ Dixon-Woods and Bosk‚ writing on the topic of “Death‚ dying and other ethical dilemmas” under the journal’s section of ‘Ethical‚ legal and organizational issues in the ICU’‚ have stated that “Recent ethnographic work suggests that ethical dilemmas associated with end-of-life care in ICU clearly persist‚ even if clinicians
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Outcomes Kelly Adams McCann Drexel University The Impact of Nurse Staffing on Patient Outcomes When my daughter was in the Neonatal Intensive Care Unit (NICU) 11 years ago‚ I was I was blissfully ignorant of patient-to-nurse ratios and budget constraints. I had confidence in the competence of the nurses and believed that they had the time and the tools necessary to care for my child. Now that I’m a nurse myself and I see my support staff numbers cut and my patient load rise‚ I wonder what my patients
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in medicine in the twenty first century contains ceasing life-supports. Certain end-of-life choices consist of never commencing life-supports once it is well-defined that starting the patient on a ventilator will only lengthen the method of dying (Lotto‚ 2012). Loved ones involved in this end-of-life decision will probably decide not to prolong the process of dying (Efstathiou‚ 2011). Reasonable people usually agree that
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Crit Care Nurs Q Vol. 35‚ No. 3‚ pp. 299–313 Copyright c 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Experiences and Needs of Families Regarding Prognostic Communication in an Intensive Care Unit Supporting Families at the End of Life Karen M. Gutierrez‚ PhD‚ RN This article reports the results of a study designed to explore the experiences and needs of family members for prognostic communication at end of life in an intensive care unit (ICU). Subjects in this qualitative study
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ventilated patients will develop VAP and of these patients the mortality rate is between 20% and 70% (Craven & Steger‚ 1998). A patient that develops VAP while mechanically ventilated adds days to his recovery as well as thousands of dollars to the care costs. Numerous studies have been conducted across the county in an effort to understand VAP‚ however very few of those studies focus on the nursing interventions that can prevent this deadly and costly nosocomial infection. Many of these studies
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Crit Care Clin 20 (2004) 435 – 451 Principles and practice of withdrawing life-sustaining treatments Gordon D. Rubenfeld‚ MD MSc Harborview Medical Center‚ Division of Pulmonary and Critical Care Medicine‚ University of Washington‚ 325 Ninth Avenue‚ Seattle‚ WA 98104-2499‚ USA Most deaths in intensive care units occur after decisions to limit or withdraw life support [1‚2]. Despite an extensive literature on whether to withdraw life support‚ little attention has been given to how to withdraw
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diagnosis and treatment of sepsis are complex and the barriers to improving these things are even more intricate but the fact remains that improvement of sepsis care begins in the ED. Early recognition of sepsis using the SIRS criteria followed by multidisciplinary rapid response diagnostic testing and treatment are the keys to improvement of sepsis care in the ED. Introduction Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together
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ARTICLE 44 Prevention and management of ventilator-associated pneumonia – the Care Bundle approach Department of Anaesthesia and Critical Care‚ Groote Schuur Hospital and University of Cape Town R Gillespie‚ MSc (Nursing) Ventilator-associated pneumonia (VAP)‚ defined as pneumonia occurring >48 - 72 hours after endotracheal intubation‚ is the most common and fatal nosocomial infection of intensive care. Risk factors include both impaired host immunity and the introduction of an endotracheal
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registered nurses who have provided end-of-life care within an intensive care unit Natalie Holms‚ Stuart Milligan‚ Angela Kydd T his paper details a qualitative study to explore the lived experiences of registered intensive care unit (ICU) nurses who have provided end-of-life care (EOLC) to dying patients and their families within an ICU. Providing EOLC in the ICU can be stressful for ICU nurses‚ who are rapidly confronted with the fast transition from curative care to EOLC (Puntillo et al‚ 2001; Hopkinson
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NJ249 NURSING CRITICALLY ILL ADULTS: HIGH DEPENDANCY All nurses should possess critical care skills to enable them to impact positively on their patients care (DH 2000). The Higginson and Jones (2009) state‚ in BJN‚ that the initial assessment of the critically ill patient vary but should follow a pattern based on assessing A‚ B‚ C‚ D and E‚ in other words airway‚ breathing‚ circulation‚ disability and environment. This essay is concerned with the altered physiology
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