American journal of critical care : an official publication, American Association of Critical-Care Nurses
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The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. ⋯ This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.
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Respiratory rate (RR) alarms alert clinicians to a change in a patient's condition. However, RR alarms are common occurrences. To date, no study has examined RR alarm types and associated patient characteristics, which could guide alarm management strategies. ⋯ High parameter limit RR alarms were most frequent. Factors associated with RR alarms included monitoring time, ICU type, male sex, and mechanical ventilation. Although these factors are not modifiable, these data could be used to guide management strategies.
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Communication with patients receiving mechanical ventilation in an intensive care unit can be challenging. Once a patient is tracheostomized, a speaking valve may enable restoration of verbal communication. To date, no data are available on the effect of speaking valves on communication success in intensive care units. ⋯ A speaking valve should be considered for patients with a tracheostomy as soon as possible to improve their communication success.
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Meta Analysis
Prevention of Endotracheal Tube-Related Pressure Injury: A Systematic Review and Meta-analysis.
Hospital-acquired pressure injuries, including those related to airway devices, are a significant source of morbidity in critically ill patients. ⋯ Airway device-related pressure injuries are common in critically ill patients, and patients with nasotracheal tubes are particularly susceptible to iatrogenic harm. Fastening devices and barrier dressings decrease the incidence of injury. Evidence regarding interventions is limited by lack of standardized assessments.
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Intensive care unit (ICU) delirium is associated with a proinflammatory state and poor outcomes. An epigenetic mechanism may modify inflammation. ⋯ Temporal variability in inflammatory gene methylation occurs after ICU admission. Delirium, female sex, and older age were more common with higher IL6ST methylation that decreased over time. Larger studies are needed to further elucidate these relationships.