American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Multicenter Study
Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study.
Patients' anxiety on intensive care unit (ICU) admission is associated with subsequent deterioration. ⋯ Absence of fear of dying is associated with new organ failure within the first 7 days after ICU admission. Fear of dying may protect against subsequent deterioration by mobilizing patients' homeostatic resources. ClinicalTrials.gov Identifier: NCT02355626.
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Parents of newborns with congenital heart disease (CHD) are at risk for anxiety, depression, and post-traumatic stress. Few studies have examined whether modifiable factors that influence parents' mental health after discharge are present during postoperative care in the pediatric cardiac intensive care unit (PCICU). ⋯ Parental role alteration perceived by parents during the PCICU stay is a modifiable stressor contributing to adverse mental health symptoms 3 months after discharge. Interventions targeting parental role alteration in the PCICU are critically needed.
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The COVID-19 pandemic has been distressing to health care professionals, causing significant burnout. Burnout has resulted in notable rates of mental health symptoms and job turnover. Hospitals have incorporated programming to meet the needs of health care professionals. ⋯ In addition to educational seminars, programs that address lasting distress should be offered to health care professionals. Targeting job-related burnout at organizational and systemic levels may ameliorate distress. This article discusses methods of integrating organizational programs into clinics.
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Managing sepsis and fluid resuscitation in patients with chronic kidney disease or end-stage renal disease is challenging for health care providers. Nurses are essential for early identification and treatment of these patients. Nurse education on assessing perfusion and implementing 3-hour bundled care can improve mortality rates in patients with sepsis. ⋯ The standard initial fluid resuscitation bolus of 30 mL/kg may be safe for patients with chronic kidney disease or end-stage renal disease and sepsis. Fluid responsiveness could be a valuable resuscitation criterion, promoting better decision-making by multidisciplinary teams. Further research is required.
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Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer). ⋯ Therapeutic virtual music was well received and provided tangible benefits to patients. Additional research would provide information on patients' outcomes and differences between live and virtual live music.