American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
Post-Intensive Care Syndrome: Educational Interventions for Parents of Hospitalized Children.
Targeted education to help parents and caregivers recognize the signs and symptoms of post-intensive care syndrome may increase their awareness and willingness to seek support during their child's admission. The optimal strategy for this education has not been established. ⋯ Simple, low-cost education can improve caregivers' knowledge of post-intensive care syndrome and can be well supported by nursing staff. To ensure sustainable implementation, the characteristics of the unit should be considered when selecting an educational program.
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Readmission for ventilator support in tracheostomy patients with primary brain injury is often attributed to failure of airway protection and aspiration pneumonia. Data regarding the incidence of intensive care unit readmissions and associated factors in these patients are limited. ⋯ Tracheostomy patients with primary brain injury may have central nervous system-mediated respiratory compromise associated with reduced Glasgow Coma Scale score, increased atelectasis, and shorter duration of ventilator dependency.
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Acute respiratory distress syndrome is associated with long-term physical impairments. Although readmission is common, little is known about the impact of readmissions on the physical status of this population. The purpose of this study was to evaluate the association between hospital readmission, with or without an intensive care unit stay, and physical status in survivors of acute respiratory distress syndrome. ⋯ Multivariable logistic regression models indicated that readmission without an intensive care unit stay versus no readmission was not significantly associated with decline. Readmission with an intensive care unit stay versus no readmission was associated with physical decline. Clinicians and researchers should consider the effect of a readmission to an intensive care unit, distinct from hospital readmission, on acute respiratory distress syndrome survivors' physical status.
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Observational Study
CORTRAK Superuser Competency Assessment and Training Recommendations.
Blind insertion of feeding tubes remains unsafe. Electromagnetic placement devices such as the CORTRAK Enteral Access System allow operators to interpret placement of feeding tubes in real time. However, pneumothoraces have been reported and inadequate user expertise is a concern. ⋯ At least 3 observations should be performed to assess initial competency; the number should be individualized to the operator. Interpretation of the insertion tracing is complex and requires multiple performance opportunities to gain competency and confidence for this high-risk skill.
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Education opportunities for night shift nurses are limited compared with those for their day-shift counterparts. However, patients remain critically ill regardless of shift and require intensive nursing care at all hours. Overnight, this care is often provided with fewer resources. These challenges can lead to disengagement and high turnover on the night shift. ⋯ The introduction of an informal educational series improved nurses' access to education and nurses' feelings of support from administrators and overall job satisfaction.