Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Feb 2018
Observational StudyValidation of two Chinese-version pain observation tools in conscious and unconscious critically ill patients.
To compare the construct validities of the Chinese-versions Critical-Care Pain Observation Tool and Behavioural Pain Scale as measures of critically ill patients' pain by (a) discriminant validation of behavioural scales and vital signs (e.g. heart rate and mean arterial pressure) during a non-nociceptive procedure (noninvasive blood pressure] assessment) and a nociceptive procedure (endotracheal suctioning), (b) criterion validation of behavioural scales and vital signs with patients' self-reported pain and (c) testing the interrater reliability of both scores. ⋯ The Chinese-versions of the Critical care Pain Observation Toll and Behavioural Pain Score have good construct validity and can sensitively discriminate when critically ill patients experience pain or no pain.
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Intensive Crit Care Nurs · Feb 2018
The Critical care Pain Observation Tool is reliable in non-agitated but not in agitated intubated patients.
The Critical-Care Pain. ⋯ Discriminant and criterion validity, confirmatory factor analysis and internal reliability showed good validity and reliability in the critical care pain observation tool in all groups except agitated patients. The results showed that, in general, the CPOT has good version of the critical care pain observation tool has good psychometric properties to evaluate pain in non-verbal patients admitted to intensive care units who have a RASS score ranging from -3 to +1, but it is not a good tool to evaluate pain in patients who are agitated according to RASS.
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Intensive Crit Care Nurs · Feb 2018
Does good critical thinking equal effective decision-making among critical care nurses? A cross-sectional survey.
A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia. ⋯ While this small-scale study has shown a relationship exists between critical care nurses' critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses' perceived high level of critical thinking and decision-making also needs further investigation.
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Intensive Crit Care Nurs · Feb 2018
ReviewBarriers to delirium assessment in the intensive care unit: A literature review.
Delirium is a common syndrome that has both short and long-term negative outcomes for critically ill patients. Many studies over several years have found a knowledge gap and lack of evidence-based practice from critical care personnel, but there has been little exploration of the reasons for this. ⋯ Many barriers exist to prevent effective assessment and management of delirium, but several of these are due to a lack of understanding or unfamiliarity with the condition and the assessment tools as well as lack of medical prioritisation of the results. Further research is needed on this topic.
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Intensive Crit Care Nurs · Feb 2018
A qualitative study of factors that influence active family involvement with patient care in the ICU: Survey of critical care nurses.
Family caregiver involvement may improve patient and family outcomes in the intensive care unit. This study describes critical care nurses' approaches to involving family caregivers in direct patient care. ⋯ Patient care demands, the professional practice environment and a lack of resources for families hindered nursing family caregiver involvement. Greater attention to these barriers as they relate to family caregiver involvement and clinical outcomes should be a priority in future research.