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[PMID]:28459497
[Au] Autor:Smith JM; Van Aman MN; Schneiderhahn ME; Edelman R; Ercole PM
[Ti] Título:Assessment of Delirium in Intensive Care Unit Patients: Educational Strategies.
[So] Source:J Contin Educ Nurs;48(5):239-244, 2017 May 01.
[Is] ISSN:1938-2472
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently. METHOD: A pretest-posttest design was used to evaluate the success of a multimodal educational strategy (i.e., online learning module coupled with standardized patient simulation experience) on critical care nurses' knowledge and confidence to assess and manage delirium using the CAM-ICU. RESULTS: Participants (N = 34) showed a significant increase (p < .001) in confidence in their ability to assess and manage delirium following the multimodal education. No statistical change in knowledge of delirium existed following the education. CONCLUSION: A multimodal educational strategy, which included simulation, significantly added confidence in critical care nurses' performance using the CAM-ICU. J Contin Nurs Educ. 2017;48(5):239-244.
[Mh] Termos MeSH primário: Competência Clínica
Enfermagem de Cuidados Críticos/educação
Delírio/diagnóstico
Delírio/enfermagem
Educação Continuada em Enfermagem/organização & administração
Avaliação Educacional/métodos
Recursos Humanos de Enfermagem no Hospital/educação
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cuidados Críticos/métodos
Feminino
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Masculino
Meia-Idade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.3928/00220124-20170418-09


  2 / 1162 MEDLINE  
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[PMID]:29210768
[Au] Autor:Keys Y; Stichler JF
[Ad] Endereço:College of Nursing and Health Sciences, Texas A&M University-Corpus Christi, Corpus Christi (Dr Keys); and Research Consultant, Sharp Memorial Hospital, San Diego, California (Dr Stichler); and Professor Emerita, San Diego State University School of Nursing, San Diego, California (Dr Stichler).
[Ti] Título:Safety and Security Concerns of Nurses Working in the Intensive Care Unit: A Qualitative Study.
[So] Source:Crit Care Nurs Q;41(1):68-75, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intensive care units (ICUs) exist to serve as a safe place for critically ill patients to receive care from skilled practitioners. In this qualitative study, ICU nurses shared their perspectives on elements that promote safety and security on their units. After obtaining institutional review board approval, participants participated in telephone interviews with a nurse researcher who has experience as a bedside ICU nurse. Five categories and 14 themes were identified and then confirmed using member checking. Results indicate that participants prefer to provide care in ICUs with no more than 12 to 14 beds and provide the following: visibility of patients and coworkers; more than 1 way to exit; and can be locked in case of emergency or threat. Nearly all respondents mentioned adequate staffing as the most important attribute of a safe, secure care environment for patients and families. More research is needed to identify design features that make the most impact on providing a safe, secure ICU environment.
[Mh] Termos MeSH primário: Enfermagem de Cuidados Críticos/normas
Recursos Humanos de Enfermagem no Hospital/psicologia
Segurança do Paciente/normas
Medidas de Segurança/organização & administração
[Mh] Termos MeSH secundário: Feminino
Arquitetura Hospitalar/métodos
Seres Humanos
Unidades de Terapia Intensiva
Entrevistas como Assunto
Masculino
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000187


  3 / 1162 MEDLINE  
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[PMID]:29210765
[Au] Autor:Grota PG; Grant PS
[Ad] Endereço:Office of Faculty Affairs and Diversity, School of Nursing, University of Texas Health, San Antonio (Dr Grota); and Infection Prevention and Quality, Methodist Hospital for Surgery, Addison, Texas (Ms Grant).
[Ti] Título:Environmental Infection Prevention: Priorities of Patient Safety Collaboration.
[So] Source:Crit Care Nurs Q;41(1):38-46, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although progress has been made in decreasing health care-associated infections (HAI) in intensive care unit (ICU) patients, there has been an increase in HAI caused by drug-resistant pathogens, particularly those that contaminate the environment such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Pseudomonas spp, Acinetobacter spp, and Clostridium difficile. The ICU environment including sinks and medical equipment has been identified as being at risk for contamination and associated with cross-transmission of pathogens between the health care provider, the environment, and the patient. This article addresses the role of the ICU nurse as a team facilitator collaborating with environmental services, infection preventionists, and others to influence ICU design during preconstruction planning and unit environmental hygiene after construction to promote patient safety and prevent HAI associated with contaminated environments and equipment.
[Mh] Termos MeSH primário: Enfermagem de Cuidados Críticos/normas
Infecção Hospitalar/prevenção & controle
Arquitetura Hospitalar/métodos
Controle de Infecções/métodos
Segurança do Paciente/normas
[Mh] Termos MeSH secundário: Infecção Hospitalar/transmissão
Resistência a Múltiplos Medicamentos
Pessoal de Saúde
Seres Humanos
Unidades de Terapia Intensiva/normas
Staphylococcus aureus Resistente à Meticilina/isolamento & purificação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000184


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[PMID]:29210763
[Au] Autor:Islam F; Rashid M
[Ad] Endereço:School of Architecture and Design, The University of Kansas, Lawrence.
[Ti] Título:Evaluating Nurses' Perception of Patient Safety Design Features in Intensive Care Units.
[So] Source:Crit Care Nurs Q;41(1):10-28, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A methodological study was conducted to test the validity and reliability of the patient safety (PS) scale developed by Rashid (2007) for evaluating nurses' perception of adult intensive care unit (ICU) design features related to patient safety. Data for the study were collected using a Web-based survey instrument. A link to the survey instrument was posted on the Web site of American Association of Critical-Care Nurses (AACN) for ICU nurses in different US states to participate. A sample of 587 valid responses was divided into 2 halves for cross-validation. The first half of the sample was used for exploratory factor analysis and the second half for confirmatory factor analysis. This method was applied to identify any latent factor structure in the PS scale. Based on the factor analyses, 4 relevant PS subscales-Efficient Work Process, Patient Room, Accessibility and Visibility, and Maintain Sterility-were identified. These PS subscales were used to investigate whether ICU unit characteristics, nurse characteristics, and hospital type affected nurses' perception of ICU design features in relation to patient safety. The study shows that nurses' perception of ICU design features related to patient safety can be influenced by such factors as nurse characteristics and unit characteristics. When using the scales, therefore, the designers can be aware of the influence of these external factors on nurses' perception. It is hoped that the PS subscales evaluating nurses' perception of ICU physical environmental features related to patient safety would help designers and health care personnel make better ICU design choices.
[Mh] Termos MeSH primário: Arquitetura Hospitalar/normas
Unidades de Terapia Intensiva
Recursos Humanos de Enfermagem no Hospital/psicologia
Segurança do Paciente
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Enfermagem de Cuidados Críticos
Feminino
Seres Humanos
Masculino
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000182


  5 / 1162 MEDLINE  
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[PMID]:29210762
[Au] Autor:Hamilton DK; Swoboda SM; Lee JT; Anderson DC
[Ad] Endereço:Department of Architecture, Center for Health Systems and Design at Texas A&M University, College Station (Dr Hamilton); the Johns Hopkins University School of Medicine/Nursing in Baltimore, Maryland (Ms Swoboda); the College of Architecture at Texas A&M University, College Station (Ms Lee); and the Perkins+Will Human Experience Lab, Canada (Ms Anderson).
[Ti] Título:Decentralization: The Corridor Is the Problem, Not the Alcove.
[So] Source:Crit Care Nurs Q;41(1):3-9, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is controversy today about whether decentralized intensive care unit (ICU) designs featuring alcoves and multiple sites for charting are effective. There are issues relating to travel distance, visibility of patients, visibility of staff colleagues, and communications among caregivers, along with concerns about safety risk. When these designs became possible and popular, many ICU designs moved away from the high-visibility circular, semicircular, or box-like shapes and began to feature units with more linear shapes and footprints similar to acute bed units. Critical care nurses on the new, linear units have expressed concerns. This theory and opinion article relies upon field observations in unrelated research studies and consulting engagements, along with material from the relevant literature. It leads to a challenging hypothesis that criticism of decentralized charting alcoves may be misplaced, and that the associated problem may stem from corridor design and unit size in contemporary ICU design. The authors conclude that reliable data from research investigations are needed to confirm the anecdotal reports of nurses. If problems are present in current facilities, organizations may wish to consider video monitoring, expanded responsibilities in the current buddy system, and use of greater information sharing during daily team huddles. New designs need to involve nurses and carefully consider these issues.
[Mh] Termos MeSH primário: Enfermagem de Cuidados Críticos/métodos
Arquitetura Hospitalar/tendências
Política
[Mh] Termos MeSH secundário: Comunicação
Enfermagem de Cuidados Críticos/recursos humanos
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Segurança do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000181


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[PMID]:28505056
[Au] Autor:Gilmartin HM; Langner P; Gokhale M; Osatuke K; Hasselbeck R; Maddox TM; Battaglia C
[Ad] Endereço:Denver/Seattle Center of Innovation for Veteran-Centered and Value Driven Care, VA Eastern Colorado Health Care System, Denver, Colorado (Drs Gilmartin, Maddox, and Battaglia and Mss Langner and Gokhale); and National Center for Organization Development (Dr Osatuke) and Inpatient Evaluation Center, Office of Informatics and Analytics (Ms Hasselbeck), Veterans Health Administration Cincinnati, Ohio.
[Ti] Título:Relationship Between Psychological Safety and Reporting Nonadherence to a Safety Checklist.
[So] Source:J Nurs Care Qual;33(1):53-60, 2018 Jan/Mar.
[Is] ISSN:1550-5065
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patient safety checklists are ubiquitous in health care. Nurses bear significant responsibility for ensuring checklist adherence. To report nonadherence to a checklist and stop an unsafe procedure, a workplace climate of psychological safety is needed. Thus, an analysis of organizational data was conducted to examine the relationship between psychological safety and reports of nonadherence to the central line bundle checklist. Results showed varied perceptions of psychological safety but no relationship with nonadherence. Considerations for this finding and assessing psychological safety are provided.
[Mh] Termos MeSH primário: Lista de Checagem/utilização
Erros Médicos/estatística & dados numéricos
Papel do Profissional de Enfermagem
Segurança do Paciente/normas
[Mh] Termos MeSH secundário: Enfermagem de Cuidados Críticos
Coleta de Dados
Seres Humanos
Erros Médicos/psicologia
Cultura Organizacional
Estados Unidos
United States Department of Veterans Affairs
Local de Trabalho/organização & administração
Local de Trabalho/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE
[do] DOI:10.1097/NCQ.0000000000000265


  7 / 1162 MEDLINE  
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[PMID]:29244465
[Au] Autor:Delaney L
[Ti] Título:PEER REVIEWED BASED ASSESSMENT IN POST GRADUATE EDUCATION.
[So] Source:Aust Nurs Midwifery J;24(3):37, 2016 09.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Students have a propensity to focus their learning aligned to the assessment items established within the units of study, rather than acknowledging the broader need to learn and apply the content taught. This approach to education stifles students' learning and their ability to apply knowledge, and as a result, essential content can be poorly retained.
[Mh] Termos MeSH primário: Enfermagem de Cuidados Críticos/educação
Educação de Pós-Graduação em Enfermagem
Revisão por Pares
[Mh] Termos MeSH secundário: Austrália
Currículo
Avaliação Educacional
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:28743548
[Au] Autor:Johnson K; Petti J; Olson A; Custer T
[Ad] Endereço:Honor Health Thompson Peak Medical Center, 7400 E. Thompson Peak Parkway, Scottsdale, AZ, 85255, United States. Electronic address: Kari.Johnson@honorhealth.com.
[Ti] Título:Identifying barriers to early mobilisation among mechanically ventilated patients in a trauma intensive care unit.
[So] Source:Intensive Crit Care Nurs;42:51-54, 2017 Oct.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Mechanically ventilated patients can be at risk for functional decline (Cameron et al., 2015). Early mobilisation of mechanically ventilated patients can improve outcomes after critical illness to prevent this decline. Although registered nurses understand the importance of early mobilisation there are nurses who are unwilling to mobilise patients. AIM: The aim of this study is to examine whether nurses' attitudes and beliefs are barriers for early mobilisation and evaluate whether an education intervention can improve early mobilisation. METHOD: Pre-test, post-test intervention with registered nurses and charge nurses in a 22 bed trauma intensive care setting. PROCEDURE: Pre-test, post-test survey assessed perceived barriers in knowledge, attitudes, and behaviours followed by targeted education. RESULTS: Dependent Sample T-test revealed a statistically significant increase in post-test responses for the subscales knowledge, attitudes, and behaviours with early mobilisation. This over-all increase in post-test results support that understanding barriers can improve patient outcomes. CONCLUSION: Use of structured surveys to identify barriers for early mobilisation among nursing can assist in providing targeted education that address nurse's perception. The education intervention appeared to have a positive impact on attitudes but it is unknown if the difference was sustained over time or affected participants practice or patient outcomes.
[Mh] Termos MeSH primário: Deambulação Precoce/enfermagem
Enfermeiras e Enfermeiros/psicologia
Percepção
Respiração Artificial/enfermagem
[Mh] Termos MeSH secundário: Adulto
Arizona
Atitude do Pessoal de Saúde
Enfermagem de Cuidados Críticos/recursos humanos
Enfermagem de Cuidados Críticos/normas
Feminino
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Unidades de Terapia Intensiva/tendências
Masculino
Meia-Idade
Enfermeiras e Enfermeiros/normas
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE


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[PMID]:28457690
[Au] Autor:Cook M; Idzior L; Bena JF; Albert NM
[Ad] Endereço:Cleveland Clinic Health System, Office of Nursing Education and Professional Development, 9500 Euclid Avenue, Mail Code HSB-111, Cleveland, OH 44195, United States. Electronic address: cookm3@ccf.org.
[Ti] Título:Nurse and patient factors that influence nursing time in chest tube management early after open heart surgery: A descriptive, correlational study.
[So] Source:Intensive Crit Care Nurs;42:116-121, 2017 Oct.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. DESIGN: Prospective, descriptive. METHODS: Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. RESULTS: Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005). CONCLUSIONS: Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/enfermagem
Tubos Torácicos
Cuidados de Enfermagem/métodos
Fatores de Tempo
[Mh] Termos MeSH secundário: Idoso
Enfermagem de Cuidados Críticos/métodos
Feminino
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Masculino
Meia-Idade
Ohio
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457689
[Au] Autor:Brissie MA; Zomorodi M; Soares-Sardinha S; Jordan JD
[Ad] Endereço:Acute Care Nurse Practitioner, UNC Health Care, Neuroscience Intensive Care Unit, Department of Neurology, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC 27599-7025, United States. Electronic address: Megan.Brissie@unchealth.unc.edu.
[Ti] Título:Development of a neuro early mobilisation protocol for use in a neuroscience intensive care unit.
[So] Source:Intensive Crit Care Nurs;42:30-35, 2017 Oct.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. RESEARCH METHODOLOGY: Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. SETTING: This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. MAIN OUTCOME MEASURES: Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. RESULTS: Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. CONCLUSION: Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit.
[Mh] Termos MeSH primário: Deambulação Precoce/métodos
Guias como Assunto/normas
Enfermeiras e Enfermeiros/psicologia
Desenvolvimento de Programas/métodos
[Mh] Termos MeSH secundário: Lista de Checagem/instrumentação
Enfermagem de Cuidados Críticos/tendências
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Doenças do Sistema Nervoso/enfermagem
Sudeste dos Estados Unidos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE



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