Aust Crit Care
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Research findings over the last 20 years show that critical care nurses (CCNs) continue to underestimate and under medicate their patients' pain, despite an allegedly strong commitment to pain relief. This literature review investigates the determinants of CCNs' pain assessment and management behaviours. Fishbein and Ajzen's theory of reasoned action' and Ajzen's theory of planned behaviour have been used as models to facilitate understanding of this phenomenon. ⋯ Through an analysis of the behavioural determinants following the models described by Fishbein and Ajzen, strategies can be formulated to address CCN deficiencies, improve patient outcomes and satisfaction with nursing care and CCN fulfilment. Cervantes was quoted as saying "It's a long way from saying to doing". This report aims to improve on this idea.
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In 1996, The Wesley Hospital introduced a 2 day Advanced Life Support (ALS) course, targeted at all critical care registered nurses and medical officers. The purpose of this study was to explore the retention of theoretical knowledge and clinical skills of registered nurses who had successfully completed the 2 day ALS course 18 months previously and to establish effective retesting timeframes. The study utilised a repeated post-test measure design. ⋯ However, 18 months after successfully completing an ALS course, only 75 per cent (n = 30) of participants passed the practical skill assessment components, with the 25 per cent (n = 10) requiring a second attempt to pass. The implications from this study focus on the model of assessment utilised and the dichotomy between theoretical and practical skill assessment results. Additional study is required to determine the optimal timeframe for ALS retesting and educational strategies to help retain skills over time.
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Randomized Controlled Trial Clinical Trial
A nursing-implemented sedation protocol and the duration of mechanical ventilation.
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In the patient with blunt trauma, diagnosis of the cause of ongoing hypotension may be difficult. A number of causes may contribute to refractory hypotension, either alone or in combination. ⋯ The following case study highlights one of the diagnoses of exclusion for refractory hypotension in the blunt trauma victim. Ongoing considerations and implications for the nursing care of spinal injured patients are also discussed.