American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Multicenter Study
Patients' perceptions and responses to procedural pain: results from Thunder Project II.
Little is known about the painfulness of procedures commonly performed in acute and critical care settings. ⋯ Procedural pain varies considerably and is procedure specific. Because procedures are performed so often, more individualized attention to preparation for and control of procedural pain is warranted.
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Multicenter Study
Sedating critically ill patients: factors affecting nurses' delivery of sedative therapy.
Critical care nurses often have wide discretion in managing the sedative therapy of patients receiving mechanical ventilation. Little is known about the factors and processes that influence sedative practice. ⋯ Social, personal, and professional factors influence sedative therapy. Future research should establish the relative importance of these factors and determine whether their impact is attenuated when sedation protocols are implemented.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Patency of radial arterial catheters.
Data on the influence of flush methods, blood-sampling methods, and site location on the patency of radial arterial catheters used for pressure monitoring are sparse. ⋯ Insertion sites closest to the bend of the wrist increase chances of maintaining patency. Catheters can be maintained with as-needed flushes, and either waste or nonwaste blood sampling can be used.
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Multicenter Study
Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses.
High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. ⋯ Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.
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Multicenter Study
Intensive care nurses' experiences with end-of-life care.
With much attention being focused on how patients die and whether or not they are provided appropriate care, the care of dying patients in intensive care units must be described and improved. ⋯ Disagreement among patients' family members or among caregivers, uncertainty about prognosis, and communication problems further complicate end-of-life care in intensive care units. Changes in the physical environment, education about end-of-life care, staff support, and better communication would improve care of dying patients and their families.