American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Continuous renal replacement therapy (CRRT) is a therapeutic technique used to support critically ill patients with acute renal failure in intensive care units. CRRT is preferred over hemodialysis for patients who cannot tolerate the rapid fluid and electrolyte shifts associated with hemodialysis because of their tenuous hemodynamic state. ⋯ This case study chronicles the successful mobilization of a patient undergoing CRRT. This experience suggests that CRRT patients who are appropriate candidates may be mobilized safely and therefore should not automatically be excluded from mobilization therapies.
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Sleep deprivation leads to reduced vigilance and potentially impairs work performance. Nurses may work long shifts that may contribute to sleep deprivation. ⋯ Critical care nurses obtain reduced amounts of sleep between consecutive work shifts, particularly between consecutive night shifts. Whether this degree of sleep deprivation adversely affects patients' safety needs further study.
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Policies of flexible and open visiting in intensive care units benefit both patients and patients' families. In Greek intensive care units, gaps exist between evidence and practice for family visitation, resulting in restricted visiting policies. ⋯ Nurses' beliefs about and attitudes toward visitation are important factors in the implementation of more flexible visiting policies in Greek intensive care units. Well-staffed units with experienced nurses and fewer shifts per week may affect nurses' negative attitude toward open visitation.
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Comparative Study
Traditional/Restrictive vs Patient-Centered Intensive Care Unit Visitation: Perceptions of Patients' Family Members, Physicians, and Nurses.
Patient-centered intensive care units (ICUs) are advocated by professional organizations for critical care nursing and medicine. The patient-centered ICU paradigm recognizes the patient-family unit as inseparable and supports visitation designed to meet the needs of patients and patients' families. ⋯ Patient-centered care is an expectation among patients, patients' families, and health quality advocates. These exploratory methods increased understanding of the powerful perceptions of family members, physicians, and nurses involved with patient care and provided direction to plan interventions to implement patient-centered, family-supportive ICU services.