American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Physical restraints are frequently used for intensive care patients and are associated with substantial morbidity. The effects of common evidence-based critical care interventions on use of physical restraints remain unclear. ⋯ Several potentially modifiable risk factors are associated with next-day use of physical restraints.
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Stress and burnout are plaguing critical care nurses across the globe and leading to high levels of turnover. Resilience-building strategies such as mindfulness, self-care, and well-being can help shield nurses from the negative effects of workplace stress. As the first line of defense, nursing schools could provide students with strategies that build resilience; however, little is known about the availability of such resources in nursing education. ⋯ Training in practices to build resilience and prevent burnout is essentially absent from accredited nursing schools. This highlights an important opportunity to modify existing curricula to include preventative strategies-such as developing positive coping skills- that could mitigate symptoms of workplace stress in future generations of nurses.
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Pain, agitation, and delirium are associated with negative outcomes in critically ill patients. Reducing variation in pain, agitation, and delirium management among institutions could improve care. ⋯ Variation in assessment and management of pain, agitation, and delirium in British Columbia intensive care units highlights opportunities to improve care.
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Observational Study
Patient-Reported Outcomes Associated With Sedation and Agitation Intensity in the Critically Ill.
Patient-reported outcomes are essential to understand the relationship between patients' perception of sedation and clinicians' assessments of sedation. ⋯ Agitation index was significantly associated with several patient-reported outcomes and thus seems to be a promising descriptor of patients' experience.