-
[show abstract]
[hide abstract]
ABSTRACT: Severe sepsis and septic shock affect more than 700,000 people annually and represent approximately $17 billion annually in health care costs. Mortality in patients with 3 or more failed organs is up to 70%. Early identification and prevention of severe sepsis and septic shock are key factors in impacting mortality rates. Health care providers must be knowledgeable in early identification and aggressive management. This case presentation outlines the components of care identified in the literature in the early and ongoing management of patients with severe sepsis and septic shock.
Critical care nursing quarterly 04/2012; 35(2):134-43.
-
[show abstract]
[hide abstract]
ABSTRACT: To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia.
Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30 degrees to 45 degrees , were observed in 99 intubated patients.
After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P < .001), and limiting the wearing of rings (P < .001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P= .38).
Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice.
American Journal of Critical Care 01/2007; 16(1):20-7. · 1.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Mesenteric ischemia is a well-documented complication associated with the repair of abdominal aortic aneurysm, especially when it is accomplished on an emergent basis. This case study outlines the roles of the nurse practitioner, working collaboratively with the intensivist, in the management of a complicated case. Medical and surgical care, along with rationale, will be presented and discussed as they relate to the patient subject in this case study.
Critical care nursing quarterly 34(2):159-64.
-
[show abstract]
[hide abstract]
ABSTRACT: Stroke is the third leading cause of death, ranking lower only to cardiac disease and cancer. Patients with stroke involving large vessels, including the middle cerebral artery, account for almost half of all patients with ischemic strokes and have an increased risk for poor outcomes and mortality at 6 months. Despite the availability and use of published guidelines for the early management of ischemic stroke, evidence to support treatment modalities for cerebral edema is still lacking. This case presentation will include the pathophysiology of an ischemic stroke and outline the established management guidelines. Literature related to the management of cerebral edema will also be discussed.
Critical care nursing quarterly 34(3):218-26.
-
[show abstract]
[hide abstract]
ABSTRACT: This case study explores the management of an unusually complicated case of acute respiratory distress syndrome (ARDS) extending over 52 days of hospitalization. Despite the utilization of conventional medical treatments and optimum respiratory support modalities, the patient's condition worsened and death was imminent without salvage therapy. After cardiovascular surgery consultation and spousal affirmation, extracorporeal membrane oxygenation (ECMO) therapy was initiated for 6 days. The patient recovered and was able to return to regular employment. The collaborative roles of the acute care nurse and intensivist will be discussed in association with clinical evaluation and management.
Critical care nursing quarterly 34(2):165-74.
