American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Readiness of critical care physicians and nurses to handle requests for organ donation.
Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. ⋯ Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.
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Review Case Reports
Propofol for the long-term sedation of a critically ill patient.
To report a case in which propofol was used successfully in an intubated patient on a prolonged basis and to review the literature that discusses long-term infusions (> 7 days) of propofol. ⋯ The limited data available suggest that long-term infusion of propofol is a practical alternative to use of standard agents for sedation of intubated patients. Adverse effects such as cardiovascular depression, respiratory depression, and hypertriglyceridemia may limit the routine use of propofol.
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Comparative Study Clinical Trial Controlled Clinical Trial
Effectiveness of a structured communication program for family members of patients in an ICU.
In ICUs, an essential component of caring for patients' families is providing information about the patient's status. Nevertheless, interruptions by family members requesting information create an additional burden for nursing staff. ⋯ The intervention reduced the number of incoming calls from family members, without compromising family members' satisfaction with care or how well their information needs were met.
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Comparative Study
Influence of port site on central venous pressure measurements from triple-lumen catheters in critically ill adults.
Measurements of central venous pressure are generally obtained through one of the three ports of centrally placed triple-lumen catheters. However, no scientifically based literature is available that guides clinical practice and indicates which of the lumens is most appropriate for obtaining these measurements. ⋯ Because measurements of central venous pressure may not always be comparable for all three ports of a triple-lumen catheter, care should be taken to distinguish when changes in pressure readings are a result of a change in port site rather than in the patient's condition.
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Approximately half of the families asked to consider donation of a relative's organs decline to give consent. Understanding the difference between stated public support of organ donation and actual behavior is key to decreasing the shortage of donor organs. ⋯ Organ donation rates could be increased by enhancing the quality of hospital care and ensuring that the request for donation is handled in a way that meets the families' informational and emotional needs.