Impact of Transfusing Packed Red Blood Cells Through a Rapid Infuser on Potassium Levels.

Background: Hyperkalemia is associated with the rapid transfusion of packed red blood cells in trauma patients. Rapid infusers can infuse blood up to 500 ml/min.

Objective: This study aimed to determine whether infusing packed red blood cells through a rapid infuser impacts the potassium levels of the infused blood.

Effect of Anxiety on Individuals and Caregivers After Coronary Artery Bypass Grafting Surgery: A Review of the Literature.

Background: Coronary artery bypass graft surgery is the most frequently performed heart surgery on adults in the United States and often results in increased anxiety in patients and their caregivers as they attempt to cope with the process of open heart surgery.

Objective: This article is a comprehensive literature review examining the current information available to health care professionals about the relationship between preoperative anxiety and postoperative surgical outcomes in patients who underwent coronary artery bypass graft surgery.

Methods: Research articles from peer-reviewed sources from 2000 to present were retrieved from CINAHL Plus, EBSCOhost, and Internet search engine Google Scholar, as well as from the Centers for Disease Control and Prevention and the National Heart, Lung and Blood Institute databases.

Serum neuron-specific enolase predicting neurological outcomes post-cardiac arrest: a review of the literature.

Background: Coronary artery disease is a major problem in the United States, affecting 785 000 individuals, with the most serious event being a cardiopulmonary arrest. Families of post-cardiac arrest patients are left with difficult decisions to be made.

Objective: This article is a comprehensive literature review examining the current research available to health care professionals about the biomarker serum neuron-specific enolase (NSE) and its use in predicting neurological outcomes in comatose post-cardiac arrest patients.

Bleeding risk factors affecting warfarin therapy in the elderly with atrial fibrillation.

Purpose: Inadequate anticoagulation among elderly individuals with atrial fibrillation (AF) is a common problem. This synthesis of the literature review describes the pathophysiology of AF, explains the mechanism of action of warfarin (Coumadin), identifies factors that contribute to warfarin (Coumadin)-associated bleeding in the elderly population, and explores alternatives to warfarin (Coumadin) therapy. Implications for advanced practice nurse practice, education, and research will be discussed.

A pilot study on delirium in the intensive care unit: a creative inquiry project with undergraduate nursing students.

Introduction: Delirium continues to be a major issue in intensive care units (ICUs). Sedation and lack of rapid eye movement (REM) sleep could be important factors in the development of delirium. Improper sedation may interfere with a patient's sleep pattern, specifically time spent in REM sleep, and could be a contributor to the development of delirium.

Neuro/Trauma intensive care unit nurses' perception of the use of the full outline of unresponsiveness score versus the Glasgow Coma Scale when assessing the neurological status of intensive care unit patients.

Introduction: : This study compares the Full Outline of Unresponsiveness (FOUR) Score scale with the Glasgow Coma Scale (GCS) when evaluating a patient's level of responsiveness in the neuro/trauma intensive care unit of a large medical center. This new scoring tool evaluates 4 functional categories: eye response, motor response, brainstem reflexes, and respiratory pattern.

Aims And Methods: : A total of 57 patients 18 years or older were randomly selected as a convenience sample of those admitted to the neuro/trauma intensive care unit and were assessed using both the standard GCS and the FOUR Score scale.

A retrospective study evaluating response time and survival from a cardiopulmonary arrest: a creative inquiry project with undergraduate nursing students.

Cardiopulmonary arrest is a major health problem that claims lives daily in the United States. The adoption of a new standard of care or healthcare technology needs to be evaluated based on patient outcomes. This review focuses on this problem and possible solutions.

Energize staff to create a research agenda.

There is a need to explore and align priorities for building the foundation for nursing research in any institution. The Delphi technique was chosen as means of setting priorities for nursing research. This method enlisted feedback from all levels of nurses from various practice areas and various nursing roles.

Amiodarone use to prevent postoperative atrial fibrillation after cardiac surgery.

Atrial fibrillation is the most common complication occurring after coronary artery bypass graft surgery. The purpose of this article was to examine the incidence of, risk factors related to, and complications caused by postoperative atrial fibrillation. The pathophysiology and treatment of atrial fibrillation and postoperative atrial fibrillation will also be discussed.

Benchmarking to the international pressure ulcer prevalence survey.

Purpose: Authors and team members from the naval medical center at portsmouth (NMCP), virginia, obtained data on the prevalence and incidence of pressure ulcers (PUs) in our agency and compared them to national benchmark data as a basis for improving our wound care protocols.

Subjects And Setting: health care facilities throughout the nation volunteered to participate in the data collection process for a multiday PU prevalence survey performed in february 2009, including nmcp. Each facility collected prevalence data during a preselected 24-hour period out of the 72-hour time frame selected by the national study.

Improving communication and cost-effectiveness in the intensive care unit through palliative care: a review of literature.

Approximately 20% of deaths in the United States each year occur in the intensive care unit. This article reviews the literature on this important topic to critical-care nurses.

Functional status versus quality of life: where does the evidence lead us?

The interchangeable use of functional status with quality of life has lead to various interpretations when discussing outcomes related to functional status. The literature revealed gaps in the measurement and blurred conceptualization of functional status. Given the prognostic importance of functional status measures, the results highlight the importance of developing a reliable and efficient means of obtaining a measure of functional status resulting in the advancement of nursing science.

Evidence-based practice in a military intensive care unit family visitation.

Background: The dissatisfaction of family members with a restrictive visiting policy in a combined intensive care and step-down unit provides an opportunity for staff to develop better ways to meet the needs of patients and their families. A review of the evidence-based practice (EBP) literature as the measure of significance indicated that less restrictive visitation policies enhance patient and family satisfaction and offer many physiologic and psychological benefits to the patient.

Objective: The purpose of this study was to determine whether a less restrictive visitation policy could be implemented in the adult critical care department of a naval medical center.

Skill set requirements for nurses deployed with an expeditionary medical unit based on lessons learned.

Based in Kuwait 3 years apart, the authors recount how nurses and corps staff, along with their physician counterparts, came together to form well-run medical facilities under adverse circumstances. Their respective hospitals became competent organizations because of specific formulas for success, along with preparation, identification of required skill sets, and making improvements based on experience. This article describes the training of medical, nursing, and corps staff, the facilities and resources required for managing casualties, and some of the more commonly encountered combat injuries and conditions.

Cardiopulmonary resuscitation: how far have we come?

In the 43 years since it was first described, cardiopulmonary resuscitation (CPR) has grown from an obscure medical theory to a basic first aid skill taught to adults and is now the near-universal technique used in CPR instruction. This article provides insight into the history of CPR. We explore the phenomenon of sudden cardiac arrest, the historical roots of CPR, current practice data and recommendations, and the society's role in the development of this life-saving technique.

Transient finite element analysis of electric double layer using Nernst-Planck-Poisson equations with a modified Stern layer.

A finite element implementation of the transient nonlinear Nernst-Planck-Poisson (NPP) and Nernst-Planck-Poisson-modified Stern (NPPMS) models is presented. The NPPMS model uses multipoint constraints to account for finite ion size, resulting in realistic ion concentrations even at high surface potential. The Poisson-Boltzmann equation is used to provide a limited check of the transient models for low surface potential and dilute bulk solutions.

The use of propofol in the mechanically ventilated medical/surgical intensive care patient: is it the right choice?

This article provides a review of the use of propofol in the mechanically ventilated patient. The indications for the administration of propofol are presented as well as the contraindications, adverse effects, and nursing care.