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Adult Critical Care
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Eugenia Cronin, Mick Nielsen, Martin Spollen, Nigel Edwards
The modernisation programme for critical care11 injected additional resources into NHS trusts for the recruitment and retention of critical care nurses, and called for a balanced skill-mix so that professional staff are able to delegate less skilled and non-clinical tasks. The programme requirements were based on a report by a Department of Health Expert Group,10 which included an in-depth review of adult critical care nursing.
Caring for Dying People in Critical Care
Published in Margaret O’Connor, Sanchia Aranda, Susie Wilkinson, Palliative Care Nursing, 2018
In their emphasis on the precarious nature of the separation between ‘personal’ and ‘professional’ selves, nurses are very much aware that the nature of nursing as a caring occupation is the root cause of such difficulties. In contrast to the lay perception of critical-care nurses as ‘technical experts’, critical-care nursing is perceived by nurses as demanding intimate interpersonal relationships with patients and their families. Although the opportunity to become emotionally involved is welcomed, nurses are conscious of the personal tensions that can emerge in such caring work. Nurses who are more experienced describe strategies of ‘depersonalisation’ which they employ to manage these tensions and protect their ‘personal’ selves. However, such strategies are only partially successful, and require high levels of energy. A nurse expressed it in these terms: I can still do it [caring] on a partially impersonal [level] … I hope they never get the impression of this, but because you’re dealing with so many people all of the time you can’t get totally involved all of the time … you put a bit of a mask on … you’ve got to say: ‘This is a nurse doing her job’. I think that the reason you’re successful is the family thinking that you are wonderful … [laughter] … that’s the impression they get, when really it’s … just acting a part, being a nice person who cares.
Emergency Colectomy
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
By the very nature of their disease, all patients in need of emergency colectomy will be ill and require more preoperative preparation than a typical elective surgery patient. Intravascular volume deficit is common to all these conditions. The extent of this deficit and any accompanying electrolyte and acid/base disturbance should be assessed and corrected as much as possible prior to surgery. The longer a patient has been ill, the longer preoperative preparation should be required. If the patient’s condition permits, both left-and rightsided stoma sites should be marked depending upon the surgery anticipated. Complete laboratory evaluation including coagulation studies should be performed. Blood should be typed and cross-matched. A careful patient history should be obtained for the use of drugs, such as clopidogrel, non-steroidal anti-inflammatory medication, or anticoagulants. Patients treated with corticosteroids require intravenous stress dose coverage. All patients should receive broad-spectrum antibiotics preoperatively with good aerobic and anaerobic coverage. Depending upon the severity of the patient’s illness, preoperative stabilization and monitoring in a critical care nursing unit may be warranted. This must be weighed against the urgency of the intervention required.
The impact of nursing skill-mix on adverse events in intensive care: a single centre cohort study
Published in Contemporary Nurse, 2023
Paul Ross, Carol L. Hodgson, Dragan Ilic, Jason Watterson, Emily Gowland, Kathleen Collins, Tim Powers, Andrew Udy, David Pilcher
The increasing demand for intensive care beds as part of safety culture and pandemic response strategies, means that healthcare systems must ensure admissions for both emergency and elective patients are met whilst maintaining expected quality of care and outcomes (Australian Institute of Health & Welfare [AIHW], 2019; Litton et al., 2020). The highly complex and technological environment of critical care manages the most acutely unwell patients in the hospital system, as such there is a need for highly trained nursing staff to work within the multidisciplinary team (Australian College of Critical Care Nurses, 2016; British Association of Critical Care Nurses, 2010; World Federation of Critical Care Nurses [WFCCN], 2019). The aim of critical care nursing care is to prevent complications and to improve outcomes through assessment, monitoring, escalation, and appropriate interventions (Chamberlain et al., 2018; WFCCN, 2019). International and national nursing workforce guidelines for critical care recognise the importance of skill-mix, nurse-to-patient ratios, and specialised training to ensure safety and needs of the critically ill patient are met (Australian College of Critical Care Nurses, 2017; British Association of Critical Care Nurses, 2010; College of Intensive Care Medicine [CICM], 2016). In Australia, the recommended skill-mix of the critical care nursing workforce holding a post-registration qualification is an optimal 75%, and a minimum of 50% (Australian College of Critical Care Nurses, 2016; CICM, 2016).
Critical Care Flight Nurses' role within secondary aeromedical services and the inter-hospital transfer of patients with acute spinal cord impairment
Published in Contemporary Nurse, 2023
The complexity of care reinforces the need for clinicians who have undertaken post-graduate education and training within the clinical specialty of aeromedical retrieval. Specialist education is one strategy used to mitigate the increased level of risk associated with transporting critically unwell patients in the aeromedical environment (Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines for Transport of Critically Ill Patients, 2015; Rasmussen et al., 2018). In addition to risk management, aeromedical clinicians require knowledge and skills related to altitude physiology, crew resource management, operational procedures and the logistics of aeromedical transport. (Air and Surface Transport Nurses Association (ASTNA), 2018; College of Air & Surface Transport Nurses (COASTN), 2018). The Critical Care Flight Nurse (CCFN) must have a background in critical care nursing, with many maintaining concurrent practice within specialties such as intensive and emergency care.
Attitudes toward the use of low-tech AAC in acute settings: a systematized review
Published in Augmentative and Alternative Communication, 2022
Shaeron Murray, Suzanne C. Hopf
To identify other relevant articles, the content of three journals was hand-reviewed: Aphasiology; Augmentative and Alternative Communication; Dimensions on Critical Care Nursing. These journals were chosen due to their overrepresentation in the initial database search results. A further 54 articles were identified. Three key authors identified in the previous two searches were contacted via email to see if they were aware of any other key research articles (K. Broomfield, personal communication, May 5, 2020; M. E. Happ, personal communication, May 7, 2020; M. Vento-Wilson, personal communication, May 8, 2020). All of the articles they suggested had already been located during the previous search strategies.