American journal of critical care : an official publication, American Association of Critical-Care Nurses
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To document the impact of routine daily chest radiographs on treatment decisions in a medical ICU. ⋯ Routine daily chest radiographs may be justified in critically ill patients in a medical ICU because for a large proportion of these patients management decisions are made on the basis of information obtained from the chest radiograph. This observation may be applicable only to ICUs that have a high turnover of patients who are in the unit for a short time.
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Although nurse educators and nurse managers have disagreed about which clinical competencies are necessary for new graduates to begin working in critical care, the competencies are in need of revision and reassessment. ⋯ The agreement between nurse educators and nurse managers supports a competency list for baccalaureate nursing curricula and hospital inservice programs to integrate new graduates into critical care.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination.
Evaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients. ⋯ Among patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.
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Long-term ICU patients who require prolonged mechanical ventilation are a growing segment of the in-hospital population. Despite recognition that this population is costly to care for no systematic research has been done on the characteristics, outcomes, and disposition of these patients after they leave the hospital. ⋯ A large percentage of ICU patients who require 5 days or more of mechanical ventilation die in the hospital, and many of those who live spend considerable time in an extended-care facility before they are discharged to their homes. These likely outcomes of patients who require long-term ventilation should be discussed with patients and their families to assist them in making informed decisions.
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Clinical Trial Controlled Clinical Trial
Preoperative ICU tours: are they helpful?
Although preoperative education decreases the anxiety of patients and family members, the usefulness of a preoperative tour of the ICU has not been studied. In this study, the effect of an ICU tour on the anxiety levels of patients (n = 92) and family members (n = 91) before and after cardiac surgery was examined. ⋯ ICU tours are included in many cardiac surgery educational programs. The majority of patients in this study perceived a benefit or a future benefit from an ICU tour, even though the tour did not significantly reduce the anxiety of the patients or family members.