American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested. ⋯ The evaluation revealed positive and negative features of the MCA. Prevention and amelioration of moral distress require attention to cultural, structural, and leadership issues through education and communication.
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Therapeutic activity after stroke is a component of early recovery strategies. Interactive video games have been shown to be safe as an adjunct rehabilitation therapy in the medical intensive care setting, but patients with neurologic disease were often excluded from those protocols. ⋯ In this pilot study, prescriptive interactive video game therapy in early rehabilitation was feasible and safe in the neurosciences critical care setting. Video game therapy may be a valuable complement to existing rehabilitation for critically ill neurologic patients and warrants validation in a larger patient sample.
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Comparative Study
Point-of-Care Potassium Measurement vs Artificial Intelligence-Enabled Electrocardiography for Hyperkalemia Detection.
Hyperkalemia can be detected by point-of-care (POC) blood testing and by artificial intelligence- enabled electrocardiography (ECG). These 2 methods of detecting hyperkalemia have not been compared. ⋯ The ECG potassium measurement, with its high sensitivity and coverage rate, may be used initially and followed by POC potassium measurement for rapid detection of life-threatening hyperkalemia.
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For patients with head and neck cancer who have undergone microvascular free flap surgery, securing a tracheostomy collar onto the neck using the traditional method (ie, with tracheostomy ties) is contraindicated because the ties may compress the newly vascularized tissue. However, no clear guidance exists for the use of other methods in these patients. Current techniques often use safety pins, which can cause injury to staff members. ⋯ Several practical methods exist for securing a tracheostomy collar in patients with head and neck cancer who have undergone free flap surgery. These methods may be good alternatives to the use of safety pins.