Bøger i The Clinics: Nursing serien

The Guest Editors have assembled expert authors to contribute current reviews devoted to critical care in pediatrics. The articles are devoted to Simulation and Impact on Code Sepsis; Cardiac Rapid Response Team/Modified Cardiac PEWS Development; Impact on Cardiopulmonary Arrest Events on Inpatient Cardiac Unit; Promoting Safety in Post-Tracheostomy Placement Patients in the Pediatric Intensive Care Unit Through Protocol; Innovation in Hospital-Acquired Pressure Ulcers Prevention in Neonatal Post-Cardiac Surgery Patients; Utilizing an Interactive Patient Care System in an Acute Care Pediatric Hospital Setting to Improve Patient Outcomes; Advances in Pediatric Pulmonary Artery Hypertension; and Creating a Safety Program in a Pediatric Intensive Care Unit or Assessing Pain in the Pediatric Intensive Care Patients to name a few. Readers will come away with information that is actionable in the pediatric ICU.

A cardiac dysrhythmia is a disturbance in the cardiac rhythm which can be normal (e.g., sinus arrhythmia) or instantly lethal (e.g., sustained ventricular tachycardia).  This issue of Critical Care Nursing Clinics of North America will provide state of the art diagnostic and treatment information for cardiac dysrhythmias as well as addressing how to achieve the most accurate diagnostic approach to interpreting an electrocardiogram, which is omnipresent in critical care and of critical importance in diagnosing arrhythmias. Articles in this issue are devoted to: The Normal Cardiac Conduction System; The Normal Electrocardiogram: Resting 12-lead and Continuous Cardiac Rhythm Strips; Premature Beats; Paroxysmal Supraventricular Tachycardia, Including the Special Type Called Wolff-Parkinson-White; Atrial Fibrillation, The Most Common Type of Supraventricular Arrhythmia; Ventricular Tachycardia and Its Disorganized Counterpart, Ventricular Fibrillation; Brady-Dysrhythmias, When Heart Rate Slows Myocardial Ischemia & Infarction and their Relationship to Dysrhythmias; Pharmacologically Induced Dysrhythmias; and Implantable Cardiac Devices and their Role in Dysrhythmias Management.

Dr. Goldsworthy has created a state-of-the-art issue that emphasizes the nurse''s role in mechanical ventilation. Pertinent clinical topics include the following: basics of mechanical ventilation for nurses; current modes for mechanical ventilation; best practices for managing pain, sedation, and delirium in the mechanically ventilated patient; mobilization of and optimal oxygenation for the mechanicaly ventilated patient; managing complications; and effective weaning strategies.  Authors also address mechanical ventilation in both children and neonates. The current content in this issue will leave nurses with the clinical information they need to effectively manage mechanically ventilated patients.

According to the Center for Research and Epidemiology of Disasters, the frequency and severity of disasters has increased over 300% in the last decade. Healthcare systems and individual healthcare practitioners, including nurses, are now fulfilling multiple roles in disaster preparedness in the whole of community: planning, preparedness, risk identification, mitigation, response and recovery. Nurses are considered first responders for biological events or when the disaster occurs where they are working. Nurses act as first receivers when accepting patients/victims for care whose injuries result from non-biological events occurring outside the nurse''s workplace. The vast majority of practicing nurses received no disaster preparedness education in their basic nursing education program. Nurses graduating in the 21st century are exposed to some of the concepts of disaster nursing but have little experience unless there is a disaster or emergency where they work or go to school. Readers will be updated on this topic because articles in this edition demonstrate a vast array of implications for nurses in disaster preparedness around the world: chemical, biological, radiological/nuclear, explosives (CBRNE); natural disasters; new models of training and educating nurses for disasters, military nurse response, mental health issues as well as non-government organizations.

Nurses are challenged to understand the scientific bases of psychiatric disorders and treatment implications that modify behavior and improve functional status and quality of life for clients and their significant others. This challenge extends to integration of scientific knowledge into the biological, functional, and psychosocial distress experienced by persons with mental disorders. The primary strength of this issue is its broad focus and synthesis of scientific knowledge into psychiatric mental health practice. The initial section centers on technological advances and the art of psychiatric mental health nursing and legal considerations when caring for persons with mental disorders. The following section provides discussions of various psychiatric disorders, including anxiety and mood disorders, acute psychosis, attention deficit disorders, substance-related disorders, eating disorders, and borderline personality disorder. The remaining section focuses on special populations and treatment concerning children and adolescents and families in crisis, geriatric emergencies, adverse drug reactions, and suicide. Each article integrates innovative treatment modalities, including pharmacotherapy and psychotherapeutic interventions such as psychoeducation, family involvement, and psychosocial rehabilitation. This issue will provide timely updates in these areas and be a go-to source for mental health and psychiatric nurses.

Sedation is a necessary component of care for critically ill and injured individuals. Sedatives assist in coping with mechanical ventilation and other invasive devices, and help patients tolerate procedures and noxious stimuli in the intensive care unit. Sedatives are also useful in the control of agitation and delirium. In addition to fundamental humane reasons, calming patients with sedatives provides physiologic benefits, such as reducing oxygen consumption expended during restlessness, and prevents dislodgement of life-preserving tubes and catheters. When administering sedatives to manage critically ill patients, clinicians must be cognizant of the many complex issues surrounding their use. This issue, edited by Consulting Editor, Dr. Jan Foster, provides current updates in this area, including new guidelines and a focus on delirium.

Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC).  Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses.  Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family''s physical, psychosocial and spiritual concerns, and aligning treatments with each patient''s goals, values, and preferences.  PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.

This issue will address health care issues and clinical implications of rural and other medically underserved priority populations. The Agency for Health Care Research and Quality identified priority populations to include rural residents, racial and ethnic minorities, low income groups, women, children, older adults, and other individuals who may require chronic care.  The editors identified a need for articles focusing on priority populations to help further understand health implications of health disparities among specific populations. A main focus is on identifying useful clinically focused strategies to address racial, ethnic, and socioeconomic differences that are relevant and influence overall healthcare, access, and quality of life. The articles will provide clinicians and other consumers of Nursing Clinics of North America with a diverse and unique perspective on an array of clinically relevant and population focused topics.  Some example topics included are:  Tailoring interactive multimedia to improve diabetes self- management; Addressing mental and physical health among older adults; Using mobile devices to access evidence- based information in a rural setting; Identifying family history and development of risk factors for diabetes among underserved preschool children; Addressing smoking cessation, Cancer screening issues, Cardiovascular health, and Obesity.

Focuses on Magnet Hospitals. This title includes topics such as nursing workforce data on magnet versus non-magnet hospitals, magnet culture and satisfaction, best practices in ensuring engagement among nurses, nursing retention, partnerships between academics and practice, and nursing retention strategies.

Critical care clinicians must be knowledgeable about the anatomic, physiologic, and biochemical processes that are critical to the restoration of a functioning microvascular affecting organ perfusion. These basic physiologic processes critical to tissue perfusion and cellular oxygenation are presented in this issue on Monitoring Tissue Perfusion and Oxygenation. A working knowledge of oxygen delivery and oxygen consumption at the microvascular level will provide critical information needed for clinicians to continuously question the adequacy of tissue perfusion given our current lack of microvascular bedside monitoring.

Focuses on Diabetes. This title includes article topics such as Management of Diabetes in the Clinical Setting, Hyperglycemia management after solid organ transplantation, Insulin therapy in the hospitalized patient, Limb salvage for Vetrans with diabetes, and Management of steroid induced hyperglycemia in the ICU.

Nurses are faced with unprecedented challenges and opportunities. Healthcare delivery models are transforming that require adaptive and flexible nurses.  The primary role of the frontline nurse is providing patient care. To be successful in this role it requires numerous competencies supported by evidence-based data. Frontline bedside nurses are fundamental to the success of value-based care delivery models. These transformational models rely on robust nursing contributions for success. Most frontline nurses don't understand value-based care models and their role in promoting positive outcomes for reimbursement. This issue is a tool kit to empower our frontline nurses for challenges they are facing with transformations occurring at their bedside practice site. The articles will be a best practice handbook for frontline nurses by providing resources to develop clinical skills to provide safe, quality, and accountable patient care needed for new healthcare delivery models.

Dealing with the topic of Surgical Instruments, this title includes articles on: History of Surgical Instruments; Nursing Role in Creating New Instruments; Best Practices Related to Instrument Counts; Innovations in Instrument Care; Evidence Base for Hands-Free Techniques; and, Evidence Base for Sharps Design to Prevent Injury.

Focuses on Central Nervous System Infections. In this title, article topics include bacterial meningitis, viral meningitis, viral encephalitis, cerebral abscess, spinal abscess, and ventriculitis.

This issue contains a series of articles focused on various initiatives aimed at improving the quality of patient care delivery and promoting safe passage across the continuum of care. Exemplary, evidence-based nursing practice is the cornerstone of quality care, and this issue highlights many ways in which nurses have led changes to optimize patient outcomes. In addition, quality care enhances cost-effectiveness by reducing avoidable complications and diminishing avoidable hospital readmissions, a concept more important than ever due to value-based purchasing and the Affordable Care Act. Articles are specifically devoted to prevention of delirium in critical care patients, palliative care in the intensive care unit, prevention of pressure ulcers, fall prevention in high-risk patients, prevention readmissions, preventing sepsis mortality, and nursing interventions in the elderly critical care patient, to name a few.

Focuses on Aging and Critical Care. This book includes article topics such as epidemiology of acute and critical illness in the older adult, impact of aging physiology in critical care, ethnogeriatrics perspectives in critical care, and focused assessment and patient safety for the older adult in critical care.

Includes articles on the following topics: Non-invasive ventilation; Modes of mechanical ventilation; Mechanical ventilation effect on heart/lung interactions; Effect of ventilation on the lungs; VAP; Liberation/weaning & Sedation/pain control; Self/unplanned extubation; Communication; recovery and rehab post ICU; and, home ventilation.

The articles appearing in this geriatrics-focused issue are consistent with the collaborative and translational concepts held by a life course perspective. Each supports interprofessional collaboration and some are either authored or coauthored by interdisciplinary colleagues. Three goals are reflected in these articles: keeping community-dwelling older adults safe, sensible, and secure with solutions that will enable them to stay healthy, wise, and aware. Topics include maintaining physical functions, benefits and consequences of weight-bearing exercise on foot health; cancer prevention; managing nocturiäs effect on sleep quality and safety; protection from financial exploitation; and providing safe and affordable living environments. Several articles address physical or cognitive challenges that include monitoring medication adherence, threat of anxiety and stigma in dementia, and approaches to managing self-care in the home for persons with dementia. These evidence-based articles address emerging and best practices to support targeted interventions for persons in community-dwelling home settings. They provide a frame-work of person-centered approaches that foster good health in older age, a central tenet of aging in place and the global response to population aging.

Features subject topics such as: OR Attire's Potential for Infection Transmission; Strategies for Preventing Sharps Injuries; Managing Patients with MDROs - Implementing Isolation Procedures in the Perioperative Setting; and, Anesthesia Care Providers - Identifying/Mitigating Potential for Infection Transmission.

Complies a range of articles on the subject of Sepsis. This title covers such topics as: The History of Sepsis, Molecular Biology of Sepsis, Sepsis Induced Tissue Hypoperfusion, Hemodynamic Monitoring in Sepsis, Performance Improvement in Sepsis, and more.