American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Instillation of normal saline before suctioning is a common nursing intervention although little research supports the practice. ⋯ The results of the survey helped determine target areas for educational programs for nurses and respiratory therapists. A protocol is being developed for use by all who do suctioning.
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Long-term use of an intra-aortic balloon pump is often necessary for patients with severe left ventricular dysfunction who are awaiting cardiac transplantation. Complications caused by prolonged bed rest and immobility can occur when the traditional femoral approach is used for insertion of the balloon catheter. ⋯ This approach is now being used to prevent the complications of immobility in patients awaiting cardiac transplantation. In this article, the special considerations, potential complications, and nursing interventions unique to the iliac artery approach are delineated.
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Dyspnea, a devastating sign, is rarely monitored by clinicians. One reason may be the lack of a valid measurement scale that is easy to use in a clinical setting. ⋯ Present and usual dyspnea are different constructs. The numeric rating scale is a valid measure of present dyspnea.
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Care of patients after stent placement has evolved with the goal of reducing thrombosis and bleeding. Initially, all patients received full antithrombotic therapy; now most receive antiplatelet therapy only. Despite this evolution, no description of the differences in complications and nursing care with these two treatments has been published. ⋯ Patients receiving anticoagulant therapy had more complications and required a higher intensity of nursing care than did patients who received antiplatelet therapy alone.
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Given the current demands of the healthcare environment, a clear sense of the unique contributions of nursing to patients' outcomes is critical. This paper articulates a model that describes nursing practice on the basis of the needs and characteristics of patients. The model was developed by the American Association of Critical-Care Nurses Certification Corporation to link certified practice to patients' outcomes. ⋯ By creating safe passage for patients, nurses make a significant contribution to the quality of patients' care, containment of costs, and patients' outcomes. Although the Synergy Model will be used as a blueprint for the certification of acute and critical care nurses, it is conceptually relevant to the entire profession. Dissemination of this model may help situate nursing within the current healthcare environment and facilitate intradisciplinary dialogue.