American journal of critical care : an official publication, American Association of Critical-Care Nurses
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During the past year, studies were published that will lead to practice change, address challenges at the bedside, and introduce new care strategies. This article summarizes some of this important work and considers it in the context of previous research and practice. ⋯ Care challenges addressed include ethical considerations in light of the Ebola epidemic, infection prevention associated with chlorhexidine bathing, bedside alarm management, evidence to enhance moral courage, and interventions to mitigate thirst in critically ill patients. Research that portends future care includes a discussion of fecal microbiota transplant for patients with refractory infection with refractory infection with Clostridium difficile.
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Comparative Study Observational Study
Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures.
To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock. ⋯ The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.
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Supporting family resilience, the ability of families to rebound from stressful events, is a goal of family nursing. Critical care nurses act as liaisons between patients' families and other clinicians and thus are uniquely situated to promote family resilience. ⋯ Nurses note unique stresses faced by families of patients in surgical intensive care units. Using the family resilience model, nurses can identify and enhance key family resilience factors.
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Comparative Study
Harris-Benedict Equation and Resting Energy Expenditure Estimates in Critically Ill Ventilator Patients.
In routine practice, assessment of the nutritional status of critically ill patients still relies on traditional methods such as anthropometric measurements, biochemical markers, and predictive equations. ⋯ For measuring REE in critically ill patients undergoing mechanical ventilation, calculation via the Harris-Benedict equation, regardless of the source of body weight, cannot be substituted for indirect calorimetry.