Articles: intensive-care-units.
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Delirium occurs in up to 80% of patients admitted to intensive care units. Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients. Here, we review the main risk factors, clinical manifestations and preventative and therapeutic approaches (pharmacological and non-pharmacological) for this illness.
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This implementation of a formalized safety program in a critical care unit highlights the importance of the "voice of the caregiver," as it relates to patient safety. This nurse-led program featured executive walkrounds and a multidisciplinary core team whose goal was to prioritize and resolve safety issues identified during the 6-month study period. ⋯ Staff identified 77 safety issues during executive walkrounds; 57% were resolved during the study period. Results indicate the clinical significance of nurse-led patient safety programs.
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Critical care nurse · Apr 2013
Case ReportsPharmacological considerations in human immunodeficiency virus-infected adults in the intensive care unit.
According to estimates, 1.2 million Americans are infected with human immuno deficiency virus (HIV). Because of antiretroviral therapy, persons who have HIV infection or have progressed to AIDS are living longer. ⋯ When persons who have HIV disease or AIDS are admitted to the intensive care unit, nurses must be prepared to provide care, especially management of complexities associated with antiretroviral therapy. Therefore, this article examines critical care nurses' role in initiating and administering antiretroviral therapy in the intensive care unit and reducing the risk of drug interactions associated with the therapy.
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Journal of critical care · Apr 2013
Interstitial cortisol obtained by microdialysis in mechanically ventilated septic patients: correlations with total and free serum cortisol.
The aim of this study was to measure subcutaneous tissue cortisol obtained by microdialysis (MD) in 35 mechanically ventilated septic patients. ⋯ Microdialysis CORT levels correlate moderately with circulating T-CORT and F-CORT. Of note, several patients presented with discrepant measurements between interstitial and circulating CORT concentrations. Thus, interstitial CORT measurements represent an additional tool to investigate the tissue CORT availability in critically ill patients.
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To describe current neonatal pain management and individual and organizational factors that can improve neonatal pain practice from the viewpoints of both head nurses and head neonatologists in Japan. ⋯ This study suggested that Japanese neonatal intensive care units need national guidelines for pain management, and these might improve collaboration between nurses and physicians in minimizing neonatal pain.