American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Assessing depression in patients hospitalized with coronary heart disease is clinically challenging because depressive symptoms are often confounded by poor somatic health. ⋯ Clinicians should be alert for clinical depression in hospitalized patients with coronary heart disease who have the cognitive/affective symptom cluster.
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Randomized Controlled Trial
Arterial catheter setup for glucose control in critically ill patients: a randomized controlled trial.
Use of an arterial catheter to obtain hourly blood samples for intensive insulin therapy monitoring avoids causing patients the discomfort of repeated fingersticks. Returning the clearing volume may decrease procedure-related blood loss by 50% and minimize the risk of anemia. ⋯ Use of blood obtained via an arterial catheter is safe and effective for glucose monitoring in patients undergoing intensive insulin therapy, with no increase in complications of catheterization.
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Clinical practice guidelines are intended to bridge the research-practice gap, yet little is known about how critical care nurses adopt guidelines. Feeding tube verification practices remain variable and have led to patient harm and death. ⋯ Personal and organizational factors influenced implementation of practices associated with an AACN practice alert. Although a research-practice gap exists, the practice alert was a significant source of information for 2 of the clinical practices.
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Observational Study
Patient predictors of dexmedetomidine effectiveness for sedation in intensive care units.
Dexmedetomidine, a selective α2-adrenergic receptor agonist, is increasingly used as a sedative in intensive care despite variations in patients' responses. ⋯ Effective sedation with dexmedetomidine is variable.