Care of the Patient With an Artificial Airway.

Background: Artificial airways are essential in various clinical settings to maintain a patient's airway and provide necessary support for ventilation and oxygenation. These devices are commonly temporary and come in several types, each serving specific purposes. Understanding the indications, types, and proper care of artificial airways is crucial for health care professionals to ensure patients receive optimal care and prevent complications.

Evaluation of Door-to-Balloon Times After Implementation of a ST-Segment Elevation Myocardial Infarction Network.

Background: ST-segment elevation myocardial infarction (STEMI) requires prompt therapy. It is recommended for door-to-balloon (DTB) times to be less than 90 minutes. In the United States, some locations have difficulty meeting this goal.

Evaluating the Influence of a Standardized Bedside Handoff Process in a Medical-Surgical Unit.

Background: Patient safety is a national and global concern. In the United States, medical errors result in more than 50,000 unnecessary patient deaths annually and contribute to billions of dollars in health care costs. The purpose of this project was to evaluate a standardized bedside handoff process and its influence in a medical-surgical unit.

Identification and Management of Acute Cardiac Tamponade.

Although incidence is rare, acute cardiac tamponade (CT) is a cardiovascular condition often resulting in a high mortality rate. In acute CT, rapid accumulation of fluid occurs in the pericardial sac and prevents the heart's chambers from adequately filling with blood, leading to reduced diastolic filling, diminished stroke volumes, and subsequent hemodynamic instability. Health care providers should be aware of at-risk patients and the earliest signs and symptoms because an acute CT is considered a medical emergency.

Identifying Barriers to Hospitalized Patients' Participation in a Free Smoking Cessation Support Program.

Hospitalized patients who smoke were surveyed to determine per- ceived barriers to participation in a smoking cessation support pro- gram. Identification of barriers allows.healthcare teams to develop support programs that maximize participation.

Care of the patient with pulmonary arterial hypertension.

Patients presenting with pulmonary arterial hypertension (PAH), the rarest of the groups of pulmonary hypertension diagnoses, are infrequently seen in the critical care arena. However, when patients with PAH present in the intensive care unit, it is generally related to an exhaustion of treatments. This article focuses on the current state of the literature addressing the group designation, pathophysiology, symptom expression, and treatment modalities of the patient with PAH.

Care of the patient with an acute pulmonary embolism.

There are evidence-based prevention strategies known to reduce the risk of pulmonary embolism formation. However, pulmonary emboli remain a leading cause of death in critically ill patients with a 3-month mortality of 10% to 15%. This article addresses patients' risk factors, pulmonary embolism prevention strategies, clinical manifestations, and treatment modalities the interdisciplinary team should understand.

Chest tubes in the critically ill patient.

This article is meant as a review for critical care nurses caring for patients with chest tubes. The types of chest tubes, equipment needed, types of chest drainage systems, chest tube placement and setup, nursing care, chest tube removal, and complications will be discussed.

Caring for the critically ill patient with tuberculosis.

Pulmonary tuberculosis is still a major health problem in the United States as well as around the world. The purpose of this article is to provide critical care nursing staff as well as other healthcare providers with a foundation to recognize and manage patients with pulmonary tuberculosis. Topics discussed include etiology, risk factors, pathophysiology, multidrug-resistant tuberculosis, extrapulmonary tuberculosis, signs and symptoms, diagnostic testing, and the role of the critical care nurse in the management of these patients.

Political climate and smoke-free laws in rural Kentucky communities.

The purpose was to determine factors associated with rural communities' political readiness to enact smoke-free laws. Data from baseline assessment of a longitudinal intervention study to promote smoke-free policy in rural Kentucky communities; key informants (n = 144) and elected officials (n = 83) from 29 counties participated in cross-sectional telephone interviews. Controlling for population size and county-level smoking rate, the following factors predicted elected officials' perception of the likelihood of a local smoke-free law passing in the next 12 months: (1) support from the local board of health; (2) support from local leaders; and (3) smoke-free hospitals.

Understanding the alphabet soup of mechanical ventilation.

Invasive mechanical ventilation has evolved from a fairly simplistic, basic machine with just a few knobs into an exceedingly complicated, microprocessor-based life support system. This article sorts out the "alphabet soup" concerning mechanical ventilation and focuses on invasive procedures.

Trends in caring for adult respiratory distress syndrome patients.

Acute respiratory distress syndrome is considered the most severe form of acute lung injury resulting in high morbidity and mortality. This syndrome is characterized by noncardiogenic pulmonary edema, diffuse pulmonary infiltrates, and hypoxemia refractory to oxygen delivery. Critical care nurses should be aware of newer treatment modalities available for patients with acute respiratory distress syndrome.

Legislators' beliefs on tobacco control policies in Nevada.

The purpose of this study was to identify Nevada legislators' views on comprehensive smoke-free (SF) policy development. The Nevada Clean Indoor Air Act (NCIAA) is a weak law that prohibits smoking in most indoor public places, excluding stand-alone bars and casino gaming areas. Nevada's state senators and assembly members were contacted to participate in the study.

Strength of tobacco control in rural communities.

Purpose: This study aimed to: (a) describe the Strength of Tobacco Control (SoTC) capacity, efforts and resources in rural communities, and (b) examine the relationships between SoTC scores and sociodemographic, political, and health-ranking variables.

Methods: Data were collected during the baseline preintervention phase of a community-based randomized, controlled trial. Rural counties were selected using stratified random sampling (n = 39).

A baseline evaluation of casino air quality after enactment of Nevada's Clean Indoor Air Act.

Objective: The U.S. Surgeon General reports that there is no safe level of exposure to secondhand smoke (SHS).

Simulating rapid response in undergraduate critical care education.

This article describes use of high-fidelity patient simulators to simulate patient emergencies in an undergraduate critical care course. Our rapid response scenarios integrate the nursing process, teamwork, communication, and delegation principles to assist students in recognizing and intervening with patients who are physiologically deteriorating and require urgent nursing care. The scenarios were developed to provide students an understanding of who is involved in rapid response situations, how participants behave, and the roles of the registered nurse and an opportunity to practice those roles.

Nursing research in community-based approaches to reduce exposure to secondhand smoke.

Secondhand smoke (SHS) is the third leading cause of preventable death in the United States and a major source of indoor air pollution, accounting for an estimated 53,000 deaths per year among nonsmokers. Secondhand smoke exposure varies by gender, race/ethnicity, and socioeconomic status. The most effective public health intervention to reduce SHS exposure is to implement and enforce smoke-free workplace policies that protect entire populations including all workers regardless of occupation, race/ethnicity, gender, age, and socioeconomic status.

Community readiness for local smoke-free policy change.

Purpose: The purpose of this study was to use the Community Readiness Model to examine local smoke-free policy development.

Design, Setting, And Subjects: A descriptive, cross-sectional design was used to assess 64 Kentucky communities. Dimensions of readiness included a community's knowledge of the problem and existing voluntary smoke-free policies; leadership for policy development; resources for policy development; climate surrounding policy development; existing voluntary policy efforts; and political climate for policy development.

The Community Readiness Model: evaluating local smoke-free policy development.

The purpose of this article is to review the literature on community readiness and assess the utility of the community readiness model (CRM) for understanding and affecting smoke-free policy development and implementation. The CRM evaluates a community's capacity for successfully developing and implementing prevention or treatment interventions. The purposes of evaluating a community's readiness are to: (a) identify the stage of readiness for policy change, and (b) determine stage-specific strategies to advance a community toward policy change.

Cultural differences with end-of-life care in the critical care unit.

Critical care nurses are providing healthcare for an increasingly multicultural population. This ever-increasing diversity in cultures and subcultures presents a challenge to nurses who want to provide culturally competent care. It is common for patients and families to face difficult decisions about end-of-life care in critical care units, and minority cultures do not always believe in the Westerner's core values of patient autonomy and self-determination.

A blueprint for developing an undergraduate critical care nursing course.

The purpose of this article is to provide a blueprint for nursing programs to create or modify baccalaureate critical care courses. The benefits of providing a critical care course include offering students an in-depth experience in a specialty area, reinforcing previously learned medical-surgical content, and improving students' critical thinking skills. In addition, hospitals are given the opportunity to interact with students while also recruiting them into a high-demand area.

Implementing a family presence protocol option.

Families' needs of patients being resuscitated in critical care areas are frequently not a high priority for the healthcare team. However, recent research suggests family member presence during life-saving efforts may help families cope with the devastating outcomes of unsuccessful resuscitation. This article provides the rationale and process for implementing a family presence option during resuscitation.