American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Multicenter Study
Factors Associated With Nurses' Knowledge of and Perceived Value in Evidence-Based Practices.
Little is known about how the education and specialty certification of intensive care unit nurses influence patients' outcomes. ⋯ Nursing specialty certification was associated with nurses' individual psychosocial beliefs and their perceptions of evidence-based practices in the intensive care unit, whereas education level was not. Supporting nurses in obtaining specialty certification could assist with the adoption of evidence-based practices as a means to improve quality of care in the intensive care unit.
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Multicenter Study
A Team-Based Early Action Protocol to Address Ethical Concerns in the Intensive Care Unit.
Ethical conflicts complicate clinical practice and often compromise communication and teamwork among patients, families, and clinicians. As ethical conflicts escalate, patient and family distress and dissatisfaction with care increase and trust in clinicians erodes, reducing care quality and patient safety. ⋯ When health care teams were encouraged to communicate routinely about goals of care, more patients received needed support and communication barriers were reduced.
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Multicenter Study Observational Study
Validation of the Withdrawal Assessment Tool-1 in Adult Intensive Care Patients.
The Withdrawal Assessment Tool-1 (WAT-1) has been validated for assessing iatrogenic withdrawal syndrome in critically ill children receiving mechanical ventilation, but little is known about this syndrome in critically ill adults. ⋯ Despite showing reliability, the WAT-1 is not a valid tool for assessing the presence of iatrogenic withdrawal syndrome in adults.
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Multicenter Study Observational Study
Pain in the Pediatric Intensive Care Unit: How and What Are We Doing?
Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units experience pain and the practices being used to lessen pain. ⋯ Critically ill children experience pain and multiple painful procedures daily. Assessment and intervention practices vary considerably. Research is needed to establish best practices for pain assessment in patients with limited communicative ability and to determine which pain management strategies improve patients' outcomes.
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Multicenter Study
Attitudes of Community Hospital Critical Care Nurses Toward Family-Witnessed Resuscitation.
Family-witnessed resuscitation is not consistently practiced in critical care despite the fact that it is recommended and research shows that it supports the emotional needs of families and patients and improves decision-making, care, and communication. Nurses support the idea of family-witnessed resuscitation but may not believe it should be standard practice. ⋯ Findings show that community hospital critical care nurses support family-witnessed resuscitation. Prior experiences and cultural beliefs should be considered when developing family-witnessed resuscitation policies. Further research is needed on the influence of these factors on nurses' attitudes toward family presence to inform practice.