Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069361
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Publisher ↗
Critical care areas saw an unprecedented number of patients throughout the coronavirus disease 2019 (COVID-19) pandemic. Unfortunately, many of these patients continue to experience lingering symptoms long after their di...Critical care areas saw an unprecedented number of patients throughout the coronavirus disease 2019 (COVID-19) pandemic. Unfortunately, many of these patients continue to experience lingering symptoms long after their discharge from the intensive care unit, related to post-intensive care syndrome and/or post-acute sequelae of COVID-19. Nurses should be aware of these often invisible illnesses and attentive to the fact that this patient population requires ongoing support via multidisciplinary, coordinated care.
Potter KM, Pun BT, Maya K
… +5 more, Young B, Williams S, Schiffman M, Hosie A, Boehm LM
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069360
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Full text
During the coronavirus disease 2019 pandemic, crisis changes in clinical care increased rates of delirium in the intensive care unit (ICU). Deep sedation, unfamiliar environments with visitor restrictions, and such facto...During the coronavirus disease 2019 pandemic, crisis changes in clinical care increased rates of delirium in the intensive care unit (ICU). Deep sedation, unfamiliar environments with visitor restrictions, and such factors due to high workload and health system strain contributed to the occurrence of delirium doubling in the ICU. As the pandemic wanes, health care systems and ICU leadership must emphasize post-pandemic recovery, integrating lessons learned about delirium management, evidence-based care, and family involvement. Strategies to empower clinicians, creatively deliver care, and integrate families pave the way forward for a more holistic approach to patient care in the post-pandemic era.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069359
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Publisher ↗
Health equity exists when everyone has an equal opportunity to achieve their highest level of health. Effective communication is essential to ensure a therapeutic relationship. Patients with limited English proficiency (...Health equity exists when everyone has an equal opportunity to achieve their highest level of health. Effective communication is essential to ensure a therapeutic relationship. Patients with limited English proficiency (LEP) experience communication barriers, leading to poorer outcomes. Federal regulation requires hospitals to provide medically trained interpreters; however, this does not always occur. We identified 3 broad areas of research: communication barriers, outcomes, and costs. Findings highlight the challenges patients with LEP face in the health-care system, and the need for targeted interventions to enhance language access, improve cultural competence among health-care professionals, and ensure equitable outcomes for all.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069358
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Publisher ↗
Nursing documentation is essential to communicate patient care delivery. This review explores available evidence on the contribution of nursing documentation toward quality care delivery during the COVID-19 pandemic. Nin...Nursing documentation is essential to communicate patient care delivery. This review explores available evidence on the contribution of nursing documentation toward quality care delivery during the COVID-19 pandemic. Nine articles were evaluated for at least one of the 6 factors of quality (eg, safe, timely, equitable, patient-centered, effective, and efficient). Analysis suggests that right-sizing documentation for optimal care quality requires continued efforts to reinforce the value and need of nursing documentation as a primary data source. Continued practice and research efforts are needed to reframe nursing documentation's essential role in benefiting a patient's current and future health care needs.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069357
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Publisher ↗
Clinical nurse educators (CNEs) are expert clinical nurses tasked with supporting the orientation and professional development of nurses on clinical units, yet CNEs themselves often do not receive a formal orientation to...Clinical nurse educators (CNEs) are expert clinical nurses tasked with supporting the orientation and professional development of nurses on clinical units, yet CNEs themselves often do not receive a formal orientation to support their role transition. CNEs at a large academic medical center participate in a quality improvement program aimed at developing communication skills for difficult conversations, feedback, and debriefing. Findings highlight some of the interpersonal communication challenges CNEs encounter, which endorse the need for a formal CNE orientation and mentoring program.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069356
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Publisher ↗
This article explores current evidence and practical strategies for nurse leaders to advance a healthy work environment. American Association of Critical Care Nurses's Standards for Establishing and Sustaining Healthy Wo...This article explores current evidence and practical strategies for nurse leaders to advance a healthy work environment. American Association of Critical Care Nurses's Standards for Establishing and Sustaining Healthy Work Environments should guide efforts to reconnect clinical teams with meaningful and satisfying work. Authors propose adding the domain of Wellbeing to guide leaders in holistically addressing the health of all care team members and the work environment.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069355
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Publisher ↗
The nursing profession has witnessed its share of challenging and trying times including toxic or unhealthy work environments, unsustainable workloads, an aging workforce, inadequate staffing, nurse burnout, staff retent...The nursing profession has witnessed its share of challenging and trying times including toxic or unhealthy work environments, unsustainable workloads, an aging workforce, inadequate staffing, nurse burnout, staff retention, inadequately trained staff, an increase in workplace violence, and several pandemics. Both individually and collectively, these thorny issues have placed a heavy burden on nurses. Unfortunately, many capable and competent nurses have left the profession altogether, which further compounds an already problematic situation. This article highlights several important strategies for recruiting, retaining, and supporting a high functioning nursing workforce in challenging and trying times.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069354
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Publisher ↗
Newly licensed registered nurses (NLRNs) were significantly impacted by the COVID-19 pandemic. NLRNs experienced interruptions or significant alterations across, academia, clinical rotations, precepted experiences, and t...Newly licensed registered nurses (NLRNs) were significantly impacted by the COVID-19 pandemic. NLRNs experienced interruptions or significant alterations across, academia, clinical rotations, precepted experiences, and transition to practice programs. All NLRNs were impacted, especially those in critical care who cared for the most acutely ill patients. This article represents a program evaluation of NLRNs in the critical care area during the COVID-19 pandemic and a comprehensive review of the literature related to COVID-19s impact on NLRNs.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069353
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Publisher ↗
When exploring the realm of Patient Safety in the context of a COVID-19 global pandemic, the traditional methods of assessment may not be sufficient. This was a crisis that could not be isolated to intensive care units o...When exploring the realm of Patient Safety in the context of a COVID-19 global pandemic, the traditional methods of assessment may not be sufficient. This was a crisis that could not be isolated to intensive care units or the hospital environment. In addition to patient safety, one must consider the safety of health care providers and others. Understanding human behavior when faced with a novel disease such as COVID-19 may help prepare for the future when society may once again face a public health crisis together.
Crit Care Nurs Clin North Am
· 2024 Sep · PMID 39069352
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Publisher ↗
Coronavirus disease 2019 (COVID-19) was first identified in December 2019 and quickly became a global pandemic. The understanding of the pathophysiology, treatment, and management of the disease has evolved since the beg...Coronavirus disease 2019 (COVID-19) was first identified in December 2019 and quickly became a global pandemic. The understanding of the pathophysiology, treatment, and management of the disease has evolved since the beginning of the pandemic in 2020. COVID-19 can be complicated by immune system dysfunction, lung injury with hypoxemia, acute kidney injury, and coagulopathy. The treatment and management of COVID-19 is based on the severity of illness, ranging from asymptomatic to severe and often life-threatening disease. The 3 main recommended medication classes include antivirals, immunomodulators, and anticoagulants. Other supportive therapies include ensuring adequate oxygenation, mechanical ventilation, and prone positioning.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705695
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Publisher ↗
Parents who are experiencing neonatal death need support in promoting and maintaining their parental role. This includes parenting their infant during end-of-life. Bedside nurses should partner with parents to help them...Parents who are experiencing neonatal death need support in promoting and maintaining their parental role. This includes parenting their infant during end-of-life. Bedside nurses should partner with parents to help them maintain the parent-infant relationship by establishing effective communication, building trust, and promoting the parental role. By doing so, parents will utilize these experiences to process their grief through meaning-making.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705694
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The death of a child is a devastating event that can lead to chronic sorrow and great stress among parents and caregivers. Legacy-building and memory-making experiences for anticipatory grief and bereavement have become...The death of a child is a devastating event that can lead to chronic sorrow and great stress among parents and caregivers. Legacy-building and memory-making experiences for anticipatory grief and bereavement have become increasingly popular in pediatric hospitals, including the use of heartbeat recordings. This intervention created by Brian Schreck at Cincinnati Children's Hospital Medical Center involves audio recording the patient's heartbeat or other respiratory sounds with a digital stethoscope to construct and preserve the patient's legacy, as well as to act as a therapeutic tool.
Ramirez JD, Sarik DA, Matsuda Y
… +1 more, Ortiz J
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705693
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Publisher ↗
Mothers with an infant hospitalized in the neonatal intensive care unit (NICU) are at an increased risk of mental health concerns, including depression and anxiety. Successful mental health support during the critical ti...Mothers with an infant hospitalized in the neonatal intensive care unit (NICU) are at an increased risk of mental health concerns, including depression and anxiety. Successful mental health support during the critical time of transition from hospital to home requires careful consideration of the mothers' mental health beginning during the NICU stay. Major themes from a scoping review to identify best practices to support maternal mental health include (1) comprehensive evaluation of needs and continuity of care, (2) key role of in-person support, and (3) the potential to use technology-based support to increase mental health support.
Phillips R, VanNatta D, Chu J
… +5 more, Best A, Ruiz P, Oswalt T, Wooldridge D, Fayard E
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705692
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Preterm babies who received 72 hours of breastfeeding practice before introducing a bottle had significantly higher rates of breastfeeding at the time of neonatal intensive care unit (NICU) discharge than did babies who...Preterm babies who received 72 hours of breastfeeding practice before introducing a bottle had significantly higher rates of breastfeeding at the time of neonatal intensive care unit (NICU) discharge than did babies who were introduced to bottle-feeding with or before breastfeeding during the first 72 hours of oral feeding or babies who were primarily bottle-fed. There were no statistical differences in corrected gestational age (CGA) at birth, first oral feeding, or full oral feeds, in days from first to full oral feeds, or in CGA or days of life at NICU discharge.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705691
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Publisher ↗
The number of infants diagnosed with neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) has increased. The expression of NAS/NOWS symptoms differs and typically begins within the first few d...The number of infants diagnosed with neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) has increased. The expression of NAS/NOWS symptoms differs and typically begins within the first few days of life, considered a critical period for feeding skill establishment, nourishment, and attachment. Non-pharmacologic interventions may be deployed to reduce or eliminate the need for replacement opioids while targeting outcomes like feeding dysfunction. Critical care providers can benefit from a structured examination of disordered feeding experiences to inform their selection of non-pharmacologic interventions. This structure can be provided using the Ecology of Human Performance model.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705690
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Publisher ↗
The increase in substance use during pregnancy results in a higher incidence of neonatal abstinence syndrome/neonatal opioid withdrawal syndrome (NAS/NOWS), straining health care and social systems and creating an econom...The increase in substance use during pregnancy results in a higher incidence of neonatal abstinence syndrome/neonatal opioid withdrawal syndrome (NAS/NOWS), straining health care and social systems and creating an economic burden. There is a paradigm shift in transitioning the care approach for NAS/NOWS from a medical model of care to a family-centered individualized non-pharmacological care approach with non-pharmacological interventions as the first line of treatment. Supporting families after birth with a nurturing environment and providing them with a toolbox of non-pharmacological interventions prepares them for the transition from hospital to home.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705689
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Publisher ↗
Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the general population, with estimates of 10% to 15% of pregn...Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the general population, with estimates of 10% to 15% of pregnant women experiencing substance abuse. Illicit substance use during pregnancy has increased substantially during the past decade in the United States. During the past decade, novel or atypical substances have emerged and become increasingly popular. Occurrences of toxicity and untoward fetal effects from designer drug use must be kept high on the watch list for all who practice in maternal-fetal, newborn, and emergency departments.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705688
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Publisher ↗
All newborns experience pain during routine care, which can have long-lasting negative effects. Despite the availability of effective methods to prevent and reduce pain, most infants will receive ineffective or no treatm...All newborns experience pain during routine care, which can have long-lasting negative effects. Despite the availability of effective methods to prevent and reduce pain, most infants will receive ineffective or no treatment. Optimal pain management includes the reduction of the number of procedures performed, routine pain assessment and the use of effective pain-reducing interventions, most notably breastfeeding, skin-to-skin contact and sweet-tasting solutions. Parents are an essential component of the comprehensive assessment and management of infant pain; however, a gap exists regarding the uptake of parent-led interventions and the engagement of families. Practice recommendations for infant pain care are discussed.
Crit Care Nurs Clin North Am
· 2024 Jun · PMID 38705687
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Publisher ↗
The goal of baby and family-centered care in the neonatal intensive care unit (NICU) is to recognize the baby's needs exhibited through the baby's individual behavior and communication and support parent education, engag...The goal of baby and family-centered care in the neonatal intensive care unit (NICU) is to recognize the baby's needs exhibited through the baby's individual behavior and communication and support parent education, engagement, and interaction with the baby to build a nurturing relationship. Health care providers and caregivers must guide rather than control the role of the parents from birth through NICU care, transition to home, and continuing care at home. Parents are health care team members, primary caregivers, and shared decision-makers in caring for their babies.