American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Multicenter Study Observational Study
Surrogates' and Researchers' Assessments of Prehospital Frailty in Critically Ill Older Adults.
Prehospital frailty has been associated with adverse hospital outcomes in critically ill adults. Although frailty assessment in intensive care units depends on patients' surrogates, frailty assessments by surrogates and researchers have not been compared. ⋯ Surrogates identified fewer patients as frail than did researchers. Factors involved in surrogates' assessments of patients' prehospital frailty status should be studied to see if the Clinical Frailty Scale can be modified to facilitate more accurate surrogate assessments.
-
Multicenter Study
Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients.
Thirst is a common, intense symptom reported by hospitalized patients. No studies indicate frequency of use of ice water and lip moisturizer with menthol to ameliorate thirst and dry mouth. In an audit of 30 intensive care unit patients at a 580-bed community teaching hospital, 66% reported dry mouth with higher thirst distress and intensity scores than in published studies. ⋯ Scheduled use of ice water oral swabs and lip moisturizer with menthol may lessen thirst intensity and dry mouth in critical care patients.
-
Multicenter Study
Electrocardiographic Correlates of Acute Allograft Rejection Among Heart Transplant Recipients.
Acute allograft rejection appears to be associated with increases in QT/QTc intervals. ⋯ Moderate to severe acute allograft rejection was associated with electrocardiographic changes after transplant surgery. Studies are needed to assess the value of computerized electrocardiogram measurement algorithms for detecting acute allograft rejection.
-
Multicenter Study
Validation of a Postextubation Dysphagia Screening Tool for Patients After Prolonged Endotracheal Intubation.
Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available. ⋯ The reliability and validity of a postextubation dysphagia screening tool that can help nurses determine an extubated patient's ability to swallow after prolonged endotracheal intubation were established.
-
Multicenter Study
Organizational Domains and Variation in Attitudes of Intensive Care Providers Toward the ABCDE Bundle.
The ABCDE interprofessional bundle (Awakening and Breathing Coordination, Delirium monitoring and management, and Early mobility) reduces delirium and weakness in critically ill patients. ⋯ Focusing interventions on policy and protocol factors, unit milieu, and task autonomy, which have the strongest associations with providers' attitudes, may facilitate ABCDE bundle uptake.