American journal of critical care : an official publication, American Association of Critical-Care Nurses
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The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. ⋯ This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.
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Moral distress is well-documented among civilian critical care nurses and adversely affects patient outcomes, care delivery, and retention of health care providers. Despite its recognized significance, few studies have addressed moral distress in military critical care nurses. ⋯ These results will help guide specific, targeted interventions to reduce the negative effects of moral distress on our military health care providers, especially in terms of readiness for the next global pandemic and retention of these invaluable personnel.
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Intensive care unit (ICU) delirium is associated with a proinflammatory state and poor outcomes. An epigenetic mechanism may modify inflammation. ⋯ Temporal variability in inflammatory gene methylation occurs after ICU admission. Delirium, female sex, and older age were more common with higher IL6ST methylation that decreased over time. Larger studies are needed to further elucidate these relationships.
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Elevated perioperative heart rate potentially causes perioperative myocardial injury because of imbalance in oxygen supply and demand. However, large multicenter studies evaluating early postoperative heart rate and major adverse cardiac and cerebrovascular events (MACCEs) are lacking. ⋯ More research is needed to assess the usefulness of heart rate measurement in patients after CABG.