Critical care nurse practitioners improve compliance with clinical practice guidelines in "semiclosed" surgical intensive care unit.

This prospective study examined whether the integration of acute care nurse practitioners (ACNP) in a "semiclosed" surgical intensive care unit (SICU) model increased compliance with clinical practice guidelines (CPG). Patients were admitted to critical care services with a (a) "semiclosed"/ACNP team or (b) "mandatory consultation"/non-ACNP team. CPG compliance was significantly higher (P < .

Transthoracic echocardiography for suspected pulmonary embolism in the intensive care unit: unjustly underused or rightfully ignored?

Transthoracic echocardiography (TTE) is an established part of modern medical practice, and its use in documenting cardiac disorders has long been recognized. Since the introduction of 2-dimensional TTE, the right-sided heart chambers have become amenable to fairly accurate analysis, enabling the evaluation of morphologic and functional abnormalities associated with many cardiopulmonary diseases, including pulmonary embolism (PE). The availability of small, portable echocardiographic units combined with an increasing number of intensive care specialists trained in echocardiography makes TTE an attractive modality for the diagnosis of PE in the intensive care unit (ICU).

Transthoracic echocardiography for pulmonary embolism in the ICU: finding the "right" findings.

Background: Use of transthoracic echocardiography (TTE) in documenting cardiac disorders is well accepted. This study reviews institutional experience with TTE in the clinical setting of pulmonary embolism (PE).

Study Design: Retrospective review of surgical ICU patients who underwent TTE within 72 hours of diagnosis of PE, from January 2005 to March 2007.

Improved nurse job satisfaction and job retention with the transition from a "mandatory consultation" model to a "semiclosed" surgical intensive care unit: a 1-year prospective evaluation.

Objective: The change from a "mandatory consultation" to a "semiclosed" surgical intensive care unit (SICU) model will impact nurses considerably. We hypothesize that nurse job satisfaction, job turnover rates, and hospital costs for temporary agency nurses will improve and these improvements will be more dramatic in SICU sections with greater involvement of a dedicated surgical critical care service (SCCS).

Design: Prospective longitudinal survey.