American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Surrogates of incapacitated patients in the intensive care unit (ICU) face decisions related to life-sustaining treatments. Decisional conflict is understudied. ⋯ These findings provide insight into bereaved ICU surrogates' experiences. The low overall survey scores may reflect retrospective measurement. Surrogates who pursued treatment were underrepresented. Novel approaches to support bereaved surrogates are warranted.
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Randomized Controlled Trial Multicenter Study
Serum Albumin Level at Intensive Care Unit Admission and Delirium Duration and Severity in Critically Ill Adults.
Hypoalbuminemia has been associated with an increased risk of in-hospital delirium. However, the relationship between serum albumin levels and the duration and severity of delirium is not well defined. ⋯ In patients with delirium, higher albumin levels were associated with shorter hospital stays but not with delirium duration or severity.
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Observational Study
Picturing Empathy in the Intensive Care Unit: Patient Photographs at an Urban Community Teaching Hospital.
Intensive care unit (ICU) clinicians are at risk for burnout, which can be driven by depersonalization. Photographs of patients in their baseline state of health before ICU admission may enhance the connection between clinicians and patients. The use of patient photographs has not been evaluated in an urban community teaching hospital. ⋯ Patient photographs may enhance connections between clinicians and patients in the ICU, potentially reducing depersonalization and burnout.
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Various social determinants of health have been established as significant risk factors for COVID-19 transmission, prevalence, incidence, and mortality. Area deprivation index (ADI, a composite score made up of educational, housing, and poverty markers) is an accepted multidimensional social determinants of health measure. Little is known about how structural social determinants of health before hospitalization, including ADI, may affect mortality related to COVID-19 in critically ill patients. ⋯ In this study, clinical factors were more predictive of mortality than ADI and other social determinants of health. The influence of ADI may be most relevant before hospital admission. These findings could serve as a foundation for shaping targeted public health strategies and hospital interventions, enhancing care delivery, and potentially contributing to better outcomes in future pandemics.
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Although nurses are the primary clinicians in telemedicine intensive care units (tele-ICUs), their experiences remain underresearched. ⋯ Tele-ICU nurses play a transformative role in nursing practice. These findings have implications for nursing practice, education, health policy, enhancement of the current American Association of Critical-Care Nurses (AACN) Tele-ICU Nursing Practice Model, and future research on ICU telemedicine.