American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Factors such as the thought of losing the patient, the uncertainty of the course of the disease, and the inability to obtain sufficient information about the patient are frightening and alarming for relatives of patients in the intensive care unit. ⋯ In addition to the uncertainty and fear associated with the COVID-19 pandemic, it is very distressing to have a relative who is a patient in the intensive care unit. In this context, it is especially important to improve the level of coping with stress of the relatives of patients in the intensive care unit and to increase their quality of life.
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Work-related stressors are present in almost every profession, but many believe nurses caring for critically ill patients experience additional and unique stresses. Results of previous studies have demonstrated the potential benefits of various interventions to reduce stress among intensive care nurses. However, the practicality of nurses taking time out from a busy unit to meet their own needs remains in question. ⋯ The variables that lead to stress and burnout among medical intensive care unit nurses also prevent nurses from using a "relaxation room." A more effective approach may be organizational change that supports reduction of workload through increased staffing, prearranged breaks during shifts, and increased recovery time between shifts by limiting work to no more than 40 hours per week.
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Up to 80% of pediatric intensive care unit (PICU) patients experience new morbidities upon discharge. Patients and families rely on clear communication to prepare for post-PICU morbidities. ⋯ Most parents and physicians reported having prognostic conversations, primarily about post-PICU physical morbidities. More than half of parents wanted more information about potential post-PICU morbidities. More research is needed to understand how and when medical professionals should have prognostic conversations with parents.
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Nurse-led rounding checklists are a common strategy for facilitating evidence-based practice in the intensive care unit (ICU). To streamline checklist workflow, some ICUs have the nurse or another individual listen to the conversation and customize the checklist for each patient. Such customizations assume that individuals can reliably assess whether checklist items have been addressed. ⋯ Using a paper-based assessment tool, a single trained critical care nurse can reliably assess the discussion of elements of the ABCDEF bundle during multidisciplinary rounds.