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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Family satisfaction with intensive care is a measure of patient experience and patient-centered care. Among the factors that might influence family satisfaction are the timing of patient admittance to the intensive care unit (ICU), the ICU environment, and individual health care providers. ⋯ Family satisfaction with an ICU admission was not influenced by the timing of the admission. Overall satisfaction with the ICU was high. The qualitative analysis points to the importance of collecting qualitative data in addition to using standard survey tools to capture the richness of patient experience. Ongoing efforts to engage with families remain critical to the practice of family- and patient-centered care in the ICU.
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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.