The American journal of nursing
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Five million Americans require admission to ICUs annually owing to life-threatening illnesses. Recent medical advances have resulted in higher survival rates for critically ill patients, who often have significant cognitive, physical, and psychological sequelae, known as postintensive care syndrome (PICS). This growing population threatens to overwhelm the current U. ⋯ Developed around the principles of implementation and complexity science, the CCRC opened in 2011 as a clinical center with a secondary research focus. Care is provided through a pre-CCRC patient and caregiver needs assessment, an initial diagnostic workup visit, and a follow-up visit that includes a family conference. With its sole focus on the prevention and treatment of PICS, the CCRC represents an innovative prototype aimed at modifying post-critical illness morbidities and improving the ICU survivor's quality of life.
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Review Comparative Study
Physician vs. nonphysician anesthetists for surgical patients.
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The goal of rapid response team (RRT) activation in acute care facilities is to decrease mortality from preventable complications, but such efforts have been only moderately successful. Although recent research has shown decreased mortality when RRTs are activated more often, many hospitals have low activation rates. This has been linked to various hospital, team, and nursing factors. Yet there is a dearth of research examining how hospital systems shape nurses' behavior with regard to RRT activation. Making systemic constraints visible and modifying them may be the key to improving RRT activation rates and saving more lives. ⋯ Although it's generally thought that RRTs are activated without hesitation, this study found the opposite was true. All of the aforementioned constraints increase the cognitive processing load on the nurse. The value of the RRT could be increased by modifying these constraints-in particular, by lifting the need to justify calls, improving protocols, and broadening the range of culturally acceptable triggers-and by involving the RRT earlier in patient cases through discussion, consultation, and collaboration.