American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Multicenter Study
Measurement of Quality of Nursing Practice in Congenital Cardiac Care.
The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States. ⋯ External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks.
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Evidence-based guidelines have resulted in decreases in bloodstream infections associated with central catheters (CLABSIs) in hospital intensive care units. However, relatively little is known about CLABSI incidence and prevention in long-term acute care hospitals (LTACHs). ⋯ The bundle resulted in a significant and sustained reduction in CLABSI rates in 30 LTACHs for 14 months. These results encourage the development and implementation of similar bundles as effective strategies for infection reduction in LTACHs.
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Multicenter Study Observational Study
Use of Physical Restraints in Dutch Intensive Care Units: A Prospective Multicenter Study.
Increasing evidence indicates that harmful effects are associated with the use of physical restraint. ⋯ Physical restraint is frequently used in Dutch intensive care units. The differences in frequency between units suggest that opportunities exist to limit the use of physical restraint.
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Multicenter Study
Standardizing Communication From Acute Care Providers to Primary Care Providers on Critically Ill Adults.
To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. ⋯ The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds.
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Multicenter Study
Intensive Care Nurses' Knowledge About Use of Neuromuscular Blocking Agents in Patients With Respiratory Failure.
The recent increase in use of neuromuscular blocking agents (NMBAs) in patients with acute respiratory distress syndrome is set against a backdrop of concerns about harm associated with use of these high-risk drugs. Bedside nurses play a pivotal role in the safe and effective use of these agents. ⋯ Critical care nurses are knowledgeable about the importance of concurrent analgesia and sedation during use of NMBAs. Routes of elimination, duration of action, and adverse effects were less commonly known and represent areas for focused education and quality improvement surrounding use of NMBAs in the intensive care unit.