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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Use of the 3 Wishes Project to Help Individualize End-of-Life Care in a Medical Intensive Care Unit.
Multiple organizations recommend that individualized end-of-life (EOL) care should be standard practice. However, a standardized approach does not exist because EOL care should be individually tailored. The 3 Wishes Project is an EOL intervention that provides direction for individualized care with 3 goals: dignify death, celebrate the patient's life, and support family members and the intensive care unit clinicians caring for the patient. Patients and families are given the opportunity to choose 3 wishes during the dying process. ⋯ The survey data support the 3 Wishes Project as a method that allowed the medical team to individualize EOL care and as a valuable tool for incorporation at the bedside.
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Intrapulmonary placements of feeding tubes inserted with use of an electromagnetic placement device (EMPD) continue to occur. ⋯ User error was a significant factor, which highlights the need for empirical data to clarify the amount of training needed to safely credential EMPD operators. Clearer information is needed about anatomical variations that may contraindicate use of an EMPD, as well as medical devices that may interfere with an EMPD. Use of follow-up radiographs, interpreted by qualified personnel, is supported to increase the probability of identifying intrapulmonary tube placements.
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Improving retention of nurses working in critical care is an urgent priority. Ideas on how to do this abound, but actual data are inconclusive. One common theory is that simply increasing nurse resiliency will minimize turnover. ⋯ The study findings are consistent with current literature indicating that prevention of compassion fatigue and burnout cannot be achieved by the efforts of individuals alone but requires collaboration between professionals and their institutions, with special attention to 3 elements: (1) a healthy work environment, (2) organizational support, and (3) nurse resiliency.