American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Randomized Controlled Trial
Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization.
Critical care patients with delirium are at an increased risk of functional decline and mortality long term. ⋯ Increased delirium severity and days of delirium or coma are associated with higher mortality risk 2 years after discharge.
-
Multicenter Study Observational Study
Role Incongruence and Psychological Stress Symptoms in Substitute Decision Makers of Intensive Care Patients.
Most intensive care patients require substitute decision makers (SDMs) to make decisions. The SDMs may prefer an active, shared, or passive decision-making role. Role incongruence is when preferred and actual roles differ. ⋯ Adverse psychological symptoms are prevalent in SDMs of critically ill patients and are related to role incongruence.
-
Communication in the pediatric intensive care unit (PICU) between families and the health care team affects the family experience, caregiver psychological morbidity, and patient outcomes. ⋯ The PICU Supports intervention is feasible to implement and study and is viewed favorably by parents.
-
Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. ⋯ The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.
-
Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units. ⋯ No relationship seems to exist between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Further research is needed to evaluate the impact of educational attainment on nurse outcomes and determine how best to support nurses who are at risk for compassion fatigue.