American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comment Letter
"Getting Used to It," Helps Prevent Burnout and Distress.
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Randomized Controlled Trial
The Family Navigator: A Pilot Intervention to Support Intensive Care Unit Family Surrogates.
Communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, but few interventions are effective. Nurses have the potential to play an expanded role in ICU communication and decision making. ⋯ Having a fully integrated nurse empowered to facilitate decision making is a feasible intervention in an ICU and is well-received by ICU families and staff. A larger randomized controlled trial is needed to demonstrate impact on important outcomes, such as surrogates' well-being and decision quality.
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Improved recognition of patient-ventilator asynchrony may reduce duration of mechanical ventilation. ⋯ Clinicians' test scores increased significantly after patient-ventilator synchrony lectures. Mean duration of mechanical ventilation decreased by 0.6 days and health evaluation scores were marginally higher after the lectures.
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Despite emphasis on identifying personal and clinical characteristics that place patients at higher risk for posttraumatic stress syndrome after intensive care, the extent of screening for the syndrome in intensive care patients is unknown. ⋯ The majority of intensive care patients most likely are not being screened for posttraumatic stress syndrome despite a higher risk for the syndrome in these patients than in the general population.
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The ABCDE bundle incorporates multidisciplinary measures to improve and/or preserve patients' physical, functional, and neurocognitive status through awakening and breathing coordination, delirium prevention and management, and early physical mobility. ⋯ Implementation of the ABCDE bundle led to significant decreases in the prevalence and duration of delirium in ICU patients.