...The American Association of Critical Care Nurses is an organization created to promote quality and safety in a critical care setting along with promoting the latest evidence-based practice in critical care. The association offers many articles for health care providers to utilize to ensure safe and quality care to patients. For example, the AACN provides articles that involve encouraging bedside report, implementing mock codes into effect to prepare the staff in the event of a real emergency, safe transport of an ICU patient while being transported to tests, and early mobility. Drahnak and Custer (2015) discussed in length the importance of critical care nurses knowing the benefits of prone positioning in combating Acute Respiratory Distress...
Words: 255 - Pages: 2
...Critical care delivery system is a branch of medicine that delivers special medical care to patients who are physiologically unstable and to patients who require constant titration of therapy according to the development of the disease process. As a nursing student on an intensive care unit, we contract the opportunity to learn about the complex health issues of critically ill patients, practice selected technical skills, and develop communication skills. With preparation, we are able to engage ourselves into the ICU environment, acquire new knowledge and skills, and participate alongside the nurse caring for critically ill patients. This allows us to gain knowledge about the kind of patients we will be seeing in our future careers. As...
Words: 1350 - Pages: 6
...developing acute skills for nurses in critical care wards. In this section of the literature review, we will discuss policies in the nursing profession, case studies and various approaches to work based acute skills learning programmes. For our purposes we conducted a literature search using popular medical databases and terms such as ‘acute skills’ ‘learning programmes’ and ‘critical care learning’. Our review highlights on the several important approaches to work based learning ranging from reflective practice to experiential learning and work based formal practical training to enhance professional skills. A learning programme for acute ward nurses responsible for caring of critically ill patients has been the central focus of nursing practice development. According to Coad et al (2002), a work-based learning approach has been found to empower ward staff with the necessary skills of nursing and the authors studied the efficacy of a five-day competency based high dependency skills course in enhancing professionalism and quality of care in nursing. The aims of comprehensive critical care are developing leadership potential and enhancing networking opportunities for nurses within critical care and acute ward areas. Critical care is the most challenging aspect of nursing care and acute skills in nursing are enhanced not just by work-based learning programs but also from first hand nursing and emergency experiences. Titchen (2003) describes emergency care in which one professional learns...
Words: 3933 - Pages: 16
...is the most common nosocomial infection in Critical Care units. VAP is linked with high mortality rates, increased hospital stays, longer mechanical ventilation and increased costs to hospitals and patients (Rosa, Hernandez, Carillo, Fernandez, & Valles, 2012). Patients who have an endotracheal tube (ETT) with mechanical ventilation are more likely to develop VAP. These patients have a poor cough reflex due to a decreased level of consciousness and diminished movement of the respiratory tract mucocila, leading to the inability to clear secretions. These contaminated secretions will then sit on top of the ETT cuff and eventually leak down and invade the lungs. Also aiding as a reservoir for microbes is a biofilm that can form on the ETT and enter the lungs causing infection (Mietto, Pinciroli, Patel, & Berra, 2013). Nurses are responsible for applying pharmacological and non-pharmacological measures to help prevent VAP which poses a very difficult challenge. Nurses must research and incorporate the use of evidence-based practice into their daily care of patients on mechanical ventilation (Sedwick, Lance-Smith, & Nardi, 2012). This paper will look closely at the evidence-based research and protocols implemented which best prevent ventilator-associated pneumonia. To help prevent further complications and improve outcomes in patients on mechanical ventilation, a standard of care was created by the Institute for Health Care Improvement (IHI) in 2004 called the Ventilator...
Words: 2122 - Pages: 9
...imperative we have a healthy awareness of these potential challenges. Improvements in health care technology have provided patients with an array of treatment options as well as assumed or possible increased chance of survival. As a result, nurses are met with a rise in ethical decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to the Patient’s Ethics Committee. Referring the family to the committee allows the family to make the final decision of what would be the most favorable outcome for the patient. The critical thinking exercise, however has more of an individual ethical dilemma. This includes the...
Words: 1859 - Pages: 8
...well as longer inpatient length of stays. The objective of this study is to measure the incidence and determine the predictors of re-admissions to the Adult Intensive Care Unit. Methods: Medline (1946-present) was searched using combinations of the following search terms ‘Intensive Care Units’ OR ’Critical Care’ AND ‘Patient re-admissions’. The searches were limited to abstracts in English language between 1990 and 2014. This search was then narrowed to ‘core clinical journals’ to increase the quality of the articles but this limitation cut the number of articles down to 2/3rd and even though these articles were saved under a separate folder, eventually all 91 articles were included in the final search. The term ‘Intensive Care Units’ were narrowed to include only ‘burn’, ‘coronary’ and ‘respiratory’ care units. The CINAHL and Cochrane Database search failed to reveal any relevant results. Results: My search generated 33 articles and their review shed light on a few recurrent themes identified as being the reason for early re-admissions. Premature discharge, time gaps between reaching the wards and being seen, lack of attention by ward nurses, lack of experience of medical staff in the wards were some of the themes identified. Conclusions: For a patient, coming back to the ICU is always a cause of concern for physicians, patients as well as their families. After reviewing a significant number of studies, we can see how certain factors have linear and non-linear relationships...
Words: 9145 - Pages: 37
...EDUCATION Critical thinking and analysis: a model for written assignments Sharon L Edwards W hat is critical analysis? In the author’s personal experience this question has been answered by the following statement: ‘It is being critical of the literature.’ However, this does not answer the question. A literature search also failed to provide any information on critical analysis. The justification for developing a model for critical analysis, however, was not solely the lack of available literature. Other reasons included: to provide a definition of the terms; and to help both educationalists and students interpret the concepts involved. Nurse educationalists and nursing students lack a clear understanding of the critical processes and this could severely diminish the profession’s ability to articulate issues that are imperative to the advancement of nursing practice in the future. This article recommends a model of critical analysis that can be used by students and educationalists. It suggests that critical thinking and analysis are interrelated and complementary, but not synonymous. It gives examples of the model’s components in order to clarify their meaning. The model will hopefully give students a premise on which to base their assignments, and nurse educationalists will be able to incorporate it into their teaching practice. It will also provide an element of reality to critical analysis which will prevent it from becoming so abstract and idealistic as to render...
Words: 6508 - Pages: 27
.....…...8 Data collection ……………………………………..………….……………………………8 Statistics and data analysis …………………………………………………………….…...9 Expected results …………………………………………………………………………………..9 References cited………………………………………………………………………………….10 Appendix A………………………………………………………………………………………13 Appendix B………………………………………………………………………………………14 Appendix C………………………………………………………………………………………15 Appendix D………………………………………………………………………………………16 Ventilator associated pneumonia and chlorhexidine use in the traumatic brain injured patient Ventilator associated pneumonia (VAP), is defined as, a nosocomial pneumonia that develops more than 48 hours following endotrachial intubation and mechanical ventilation, and is a common and serious intensive care unit (ICU) complication. VAP causes noteworthy morbidity, mortality, amplified hospital costs, and increased utilization of healthcare resources, prolonged time for ventilator support, as well as lengthened ICU and hospital stay (Caruso, 2009). Antibiotics (ATBs) have traditionally been used to treat VAP, but the occurrence of resistance...
Words: 2745 - Pages: 11
...Six Caps Case Study University of Phoenix Undergraduate Nursing Studies Introduction In the words of Albert Einstein, “the world we have created is a product of our thinking; it cannot be changed without changing our thinking.” Today more and more nurses have to change their thinking process to ensure clients receive quality care. Therefore, clinical judgments cannot be based on speculation but on outcome, directed thinking. As the client health status changes, the nurse must be able recognize, assess, and evaluate all the presenting information to make an outcome decision that is best for the client and client’s family. To make appropriate decisions require nurses to put on their thinking caps. Edward de Bono’s six thinking caps integrates knowledge, comprehension, application, analysis, and evaluation allowing the nurse to make quality, outcome based decision. The purpose of this paper will focus on a case study using six thinking caps to critically analyze and make clinical decisions in promoting client safety and quality care. White Cap Thinking Looking at the case study with the White, Ms. Marianne first presented with a severe headache. The nurse uses her knowledge base about hemorrhagic stroke to decide what additional information is needed. Since information cannot be obtained from the patient, the nurse ask the patient’s family questions about the patient’s health problems, family health problems, medical history, medication regimen...
Words: 1255 - Pages: 6
...practice and ADN practice? This is a question that every nursing student should ask and research as both BSN and ADN nurses can sit for the same NCLEX-RN exam. There are multiple answer to this question, however the short answer is that nurse with a BSN degree has more opportunities to work in a variety of health care settings that offer an extensive array of opportunities for professional growth. (Moore, 2009) BSN student learn skills at a higher level that are required for exceptional practice. (Huston 7) The difference between the ADN nurse and the BSN nurse is not limited to the opportunities allotted but spans out to the education. The BSN nurse completes a curriculum that has a different focus than that of the ADN curriculum. The BSN curriculum emphasizes evidence based practice, leadership, critical thinking, and public/community health. (Moore, 2009) As part of this curriculum you receive crucial training in key areas like communication, leadership, and critical thinking- enhanced knowledge that will become ever more valuable in the complex and changing future of health care delivery. (Simons, 2012) BSN nurses can be and are not limited to bedside nurses, educators, case managers, discharge planners, administrators, and work in public health, home health, and community clinics. If you are thinking of joining any branch of the military, you will need to have your BSN. The BSN degree is not only a minimum for the military but also a minimum for most medical institutions, as it...
Words: 715 - Pages: 3
...Decision-Making Case Study HCS/514 Ed Paluch Decision-Making Case Study It has been estimated that approximately 75% of the average managers time is spent on the decision-making process (Free Case Study on Decision Making, 2011). A critical component in managing an organization, its staff and resources is successful decision-making. The quality and efficiency of those decisions will determine how well the manager is doing. Managers have plenty of responsibility because they are the ones that have to make the right decision when solving issues. Today, decision-making regarding health services for consumers and patients are becoming guided by evidence of need, effectiveness, and ways to use resources optimally. This is becoming a growing model among health care organizations and its managers. However, there are barriers for managers in using evidence decision-making. Time is a big barrier, there are deadlines that managers usually have to work with that is very time consuming. For instance, plenty of time is required to research, accessing relevant data, reliance on outside consultants and subordinates in acquiring quality information, politics, and lack of resources. The use of an sufficient decision-making tool that assists managers in efficiently making strategic, evidence based decision-making as well as improving the performance of their organizations is the Informed Decisions Toolbox as outlined by Thomas Rundall. The Informed Decisions Toolbox is...
Words: 1125 - Pages: 5
...The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format. To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X. Mr X was an 80-year-old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure. His initial clinical observations were: Systolic Blood Pressure: 100mmHg MAP: 58mmHg Heart Rate: 120 beats per minute Lactate: 3.2mmol/l Temperature: 38.6* These clinical observations indicated that the patient was experiencing a systemic inflammatory response syndrome (SIRS) as the patient had a pyrexia above 38*C and a heart rate above 90 beats per minute. The results of the blood cultures and chest radiograph indicated pneumonia. The patient’s condition was now treated as sepsis. Sepsis is characterized by SIRS, which is complicated by a severe infection (Neveire, Parsons and Wilson 2008). The pathophysiology of systemic inflammatory response, experienced by Mr X is portrayed in Table 1: Table 1 Morton et al 2005 Mediator | Source...
Words: 3132 - Pages: 13
...Techniques At the Critical Care Unit, visiting hours are restricted in a guise to allow patients to rest and nurses to provide care in a setting that guarantees modesty and patient privacy. Over the years, though, perceptions have changed and practitioners believe that family presence plays is crucial for improved patient outcomes (Kable, Chenoweth, Pond, & Hullick, 2015). Research, however is necessary to assess whether this new perception is realistic or influenced by certain unrealistic factors. However, further research is always necessary before making such major changes in the healthcare sector. Possibly, nurses are expressing interests in the change without a consideration of the initial factors that were considered when the policy was adopted. Random sampling is necessary to avoid biasness, include all crucial participants, and for certainty of reliable findings (Sawbridge & Hewison, 2013), which is necessary for the evaluation of the validity of the new perceptions before instituting any change is necessary. Since the study ought to capture a diverse group of nurses, patients, and family members, then sampling is appropriate. Researchers will gather information from three samples; nurses, patients, and family members. With a properly structures research question, hypotheses, and questionnaires relevant to the three groups, it will be easy to gather enough data from the three groups. Usually, data collected from a sample during a study is interpreted as a representative...
Words: 652 - Pages: 3
...frequently are overwhelmed with the amount and complexity of the material that is covered during each class meeting. Consequently, they may resort to memorizing facts instead of comprehending, applying, and transferring knowledge to practice. In addition, students rely on teachers to provide lecture notes and may not be adequately prepared to participate in class discussions. Case studies, which are an effective way of connecting critical thinking, problem solving, and decision-making to practice (Baumberger-Henry, 2003; Campbell, 2004), enhance students’ participation in class discussions. Conceptual models of nursing provide a unique body of knowledge that can be used to guide construction of case studies and enhance application of didactic course content to nursing practice. Students tend to undervalue the contributions of a nursing conceptual model to guide practice. By integrating a nursing conceptual model into the organization of course content and construction of case studies, students are exposed to how conceptual models can guide nursing practice. The purpose of this column is to explore the use of case studies for a senior level medical-surgical nursing course constructed within the context of the Roy adaptation model. Roy Adaptation Model The Roy adaptation model is a conceptual model of nursing that provides a solid foundation for nursing practice (Roy & Andrews, 1999). The philosophical and scientific assumptions of Roy’s model assert that the person is a holistic Nursing...
Words: 1904 - Pages: 8
...Experience of Moral Distress in Critical Care Nurses Jessy Thomas Grand Canyon University: NRS-433V May 24, 2015 Gender and the experience of moral distress in critical care nurses Patricia Banner, an American nurse theorist defined the ethical compartment as “the embodied skilled know-how of relating to others” in ways that are respectful and support their concerns (Corley MC, Nurses Ethics 2002). Moral distress is fairly new topic of discussion in the print and media. The term begins when Jameton recognized the negative feelings when one person realize the morally correct course to be taken but can’t practice due to the restriction imposed by the place they work. Moral distress can happen in variety of setting and roles. Many researchers studied this topic among various health care workers among nurse educators, students, critical care and medical-surgical nurses and administrators. The moral distress among nurses may vary depending upon many factors such as gender, ethnic back ground or the context in which they practice. A meta-analysis of 19 studies on moral sensitivity and moral judgment found that females are higher in the case of moral sensitivity scores. (Christopher B, Gender and moral distress) Problem Statement The problem of this study aimed to address was: “Critical care settings are highly technical, dynamic patient care environments”. Often nurses need to make sudden judgments and decisions of complex nature that can take care of patients needs while keeping...
Words: 1159 - Pages: 5
