Orthopedic Pain Management: Tools for Practicing Critical Care Nurses.

Nurses practicing in critical care units manage all forms of traumatic, acute, and chronic pain. Chronic pain must be managed in critical care scenarios to facilitate patient comfort and eventual recovery and healing. Patients with orthopedic injuries and conditions have distinct care needs that require specialized knowledge on the provider's part.

Strategies for Health Professionals in Managing Patients and Families in Critical Care Units.

The primary objective of this article is to share effective strategies for integrating patients and their families into the critical care setting. Additionally, it aims to address lack of pain management knowledge, burnout syndrome, and stress management tactics tailored for practicing critical care registered nurses.

Developing Resilience: Strategies to Adapt Within an Interprofessional Team.

Resilience can be defined as sustaining well-being in the face of adversity by harnessing internal and/or external resources. Many of the strategies that promote highly effective teams, such as regulating emotions, self-reflection, and inclusion, may also contribute to team resilience. Nurse leaders can facilitate social connections, optimism, self-care, mindfulness practices, and meaningful recognition as strategies to promote nurse resilience.

Management Strategies in the Intensive Care Unit to Improve Psychosocial Outcomes.

Critical care nurses work in challenging environments that are often sterile, impersonal, noisy, and frightening to patients and their families. Nurses act as liaisons between medical professionals and patients and their families in multiple specialty intensive care units. Critical care nursing practice, guided by the American Nurses Association Code of Ethics, respects patients' religious, spiritual, and cultural beliefs, contributing to holistic care delivery.

Addressing Tobacco Dependence Through a Nurse-driven Tobacco Intervention Protocol.

Tobacco use contributes to the largest proportion of preventable disease, disability, and death. Use of tobacco products is at epidemic proportions in the United States. Estimates retrieved between 2012 and 2013 by the US Centers for Disease Control and Prevention reported that 1 in 5 adults used tobacco products.

Orthopedic Injuries: Protocols to Prevent and Manage Patient Falls.

Health care organizations must adopt a culture of safety and implement effective fall prevention protocols. The teach-back method is a useful strategy for health providers to determine patient understanding of information taught to maintain a safe environment and prevent falls. Purposeful rounding is a proactive approach to ensure that patient assessments are accurate and research supports that patients use the call light less when nurses participate in hourly rounding.

Allergy skin testing: what nurses need to know.

Skin testing is a common procedure in any clinical setting. Critical care nurses will encounter skin testing in the inpatient and outpatient settings primarily to test for patient allergies to environmental factors, or allergies to certain medications. As there is a great deal of controversy about standard practices surrounding the different tests, information about various allergy tests and testing protocols is vital.

Angiography: From a patient's perspective.

In critical care, nurses are expected to react quickly to urgent and emergent situations. It is imperative that nurses have the ability to recognize signs and symptoms in patients that require diagnostic intervention. This article begins with a brief description of angiography and its role in the critical care environment.

Thoughtful nursing practice: reflections on nurse delegation decision-making.

This article discusses delegation challenges and legal and regulatory oversight associated with delegation in the clinical practice setting. The authors address moral and legal attributes of the roles and responsibilities of health care providers regarding delegating health care interventions. The article also explores guiding principles and rules of delegation within professional standards, national practice guidelines, and state nurse practice acts.

Avian influenza: are we ready?

We cannot be certain when the next influenza pandemic will emerge, or even whether it will be caused by avian influenza (H5N1) or some unrelated virus. However, we can be certain that an influenza pandemic will occur. The United States is leading the scientific effort to contain the pandemic through vaccine studies and antiviral studies.

Antimicrobials: classifications and uses in critical care.

Patients in the critical care setting are at high risk for infection because their normal host defenses are compromised. Critical care patients frequently have complicated, multisystem, mixed infections that can be life threatening. Optimal patient outcomes are the result of (1) early identification of signs and symptoms of infection; (2) nursing knowledge about common antimicrobials and their side effects and adverse reactions; (3) obtaining cultures before starting empiric therapy with antimicrobials; (4) consulting as needed with the infection control team; (5) practicing basic measures of infection control, such as hand washing; and (6) using special isolation precautions when the patient's condition warrants special care.

Bacterial infections: management by acute and critical care nurses.

Acute and critical care nurses must maintain a current knowledge base for advancing science and providing direct care for patients. When an infectious process is involved, it is the practicing nurse who must be knowledgeable in treatment and prevention modalities. The integument is the body's first line of defense for invading bacteria.

Spinal cord injury nursing and evidenced-based practice.

The importance of the dissemination of current data-based research findings cannot be said enough! Nurse researchers have an obligation to report their findings and potentially improve nursing practice and patient care outcomes. Conclusions drawn from the "evidence," whether good, bad, or indifferent, benefit nursing practice. Nurses need to know "what works," "what doesn't work," and the pluses and minuses of every finding.

Osteoporosis: incidence, prevention, and treatment of the silent killer.

Osteoporosis is a nationwide health care concern affecting millions of Americans. Health care dollars to prevent and treat osteoporosis are needed. Osteoporosis-related injuries and resulting disabilities, and consequent admissions to hospitals, nursing homes, and long-term care facilities is costing billions of dollars for care and treatment.

Who will educate the next generation of nurses? A looming faculty shortage.

Nursing is a profession that has many career choices. This article highlighted some of the major issues that will affect practicing hospital nurses and nurse educators. The nursing shortage is no longer "impending"-it is here and there are no signs that there will be a reprieve for staffing at the bedside.

Breaking through the glass ceiling: women in executive leadership positions--Part I.

Women have had their share of difficulties climbing the corporate ladder in their chosen professional roles. Excellent role models exist for nurses to look up to as role models for leadership and executive level positions. Nurses and women must strive to achieve their goals of attaining executive/management level positions in their respective organizations.

Delegation decision-making by registered nurses who provide direct care for patients with spinal cord impairment.

Delegation and coordination of patient care are critical skills for registered nurses (RN). Most educational programs and clinical experiences in nursing school have not prepared nurses to function in a delegation decision-making capacity. Nurses caring for individuals with spinal cord impairment (SCI) are especially challenged to provide partial or total assistance to meet the requisite care needs of this patient population.

End of life issues: renewed meaning for care of the dying in America.

The subject of death is a topic that many Americans, including their health care providers, have avoided talking about for many decades. End-of-life care is capturing the attention of many in our country and rightfully so. Dying is one aspect of life that we will all face.

Nurses as change agents in times of critical shortages.

SCI nurses care for people with demands for care, which may frequently exceed the supply for licensed caregivers. We need to not only provide safe and adequate care, but also provide quality in caregiving to patients and their families. During times of unprecedented shortages, nurses must be willing to change their "ways of doing" things.