American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Multicenter Study
Withholding or continuing enteral feedings during repositioning and the incidence of aspiration.
Withholding enteral feedings during repositioning is based on tradition, but available evidence does not support this practice. Although research indicates that withholding of enteral feedings during repositioning contributes to undernourishment, the relationship between continuing enteral feedings during repositioning and the incidence of aspiration has not been determined. ⋯ A research protocol to directly explore the relationship between the incidence of aspiration and withholding or continuing enteral feedings during repositioning is feasible.
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Ethical conflicts, often leading to poor teamwork and moral distress, are very challenging to patients, patients' families, and health care providers. A proactive approach to ethical conflicts may improve patient care outcomes. ⋯ A phenomenon of shared suffering emerged from the study and signifies the importance of relational strategies such as routine family conferences and ethics consultation.
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Nosocomial infections are frequent complications in patients with intracerebral hemorrhage. ⋯ Pneumonia was the most common infection among patients with intracerebral hemorrhage.
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The RightLevelpH indicator is a new device designed to measure the pH of gastric aspirate obtained via a nasogastric tube while minimizing exposure of the operator. ⋯ The RightLevelpH indicator provides accurate measurements of the pH of gastric aspirate in patients.
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Negotiating Transitions: Involvement of Critical Care Outreach Teams in End-of-Life Decision Making.
Little research has examined the involvement of critical care outreach teams in end-of-life decision making. ⋯ A considerable amount of time is being spent on these emergency referrals, and decisions to limit medical treatment are common. The appropriateness of escalation of levels of care is often not questioned until patients become critically or acutely unwell, and outreach teams subsequently intervene.