Nursing standard (Royal College of Nursing (Great Britain) : 1987)
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Caring for patients who are mechanically ventilated poses many challenges for critical care nurses. It is important to humidify the patient's airways artificially to prevent complications such as ventilator-associated pneumonia. There is no gold standard to determine which type of humidification is best for patients who are artificially ventilated. This article provides an overview of commonly used artificial humidification for mechanically ventilated patients and discusses nurses' responsibilities in caring for patients receiving artificial humidification.
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Patient-controlled analgesia (PCA) via an infusion pump enables patients experiencing pain as a result of surgery, trauma or acute exacerbation of chronic conditions, to administer their own analgesia. Opioids are commonly used in the pumps because of their effectiveness and availability. ⋯ The article emphasises the importance of educating patients in PCA use to maintain safety. It is suggested that nurses must provide the same level of care to patients using PCA as patients receiving analgesia by other means.
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Infection is a significant challenge in burn care, particularly for those patients who have major burn injuries. This article aims to review the literature and establish best practice in prevention and treatment of infection in patients with major burns. The article considers the causes and clinical features of wound infection, and examines systemic and local methods of prevention and treatment.
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Diabetes is a complex metabolic disorder that is more common in patients with cancer than in the general population. The ethical dilemmas facing many healthcare professionals in the management of diabetes during the terminal phase of life include the timing of withholding or withdrawing treatment. Communication can also be difficult between healthcare professionals, patients and their families at this time. ⋯ Local protocols on diabetes management at the end of life have been developed in some areas, but there are no national or standardised guidelines. This can result in fragmented care. This article explores the need for better communication and the development of national guidelines so that the quality of end of life care for patients with diabetes can be improved.