Development of paediatric critical care in northwestern Nigeria: Initial implementation with a needs assessment model.

Introduction: There is high paediatric morbidity and mortality in northwestern Nigeria, attributable in part to vaccine-preventable illnesses and lack of comprehensive training of medical and nursing staff in the healthcare delivery of paediatric critical care. Pediatric Universal Life-Saving Effort Inc. (PULSE), a New York-based nonprofit organisation with a mission to develop paediatric critical care in resource-limited settings, collaborated with Aminu Kano University Teaching Hospital to decrease the gaps in knowledge and skills of medical and nursing personnel.

REadmission PREvention in SepSis: Development and Validation of a Prediction Model.

Hospital 30-day readmissions remain a major quality and cost indicator. Traditional readmission risk scores, such as LACE (length of stay, acuity of admission, Charlson comorbidity index, and emergency department visits), may be suboptimal in special patient populations, such as those with sepsis. As sepsis survivorship improves, there is a need to determine which variables might be associated with a decrease in 30-day readmission.

Navigating the Doctor of Nursing Practice project within an academic practice partnership.

The Doctor of Nursing Practice (DNP) curriculum was initially developed in 2004. The DNP degree is a practice doctorate, which educates nurses to the highest level of clinical nursing practice. DNP students must complete a scholarly project in accordance with the American Association of Colleges of Nursing (AACN) guidelines.

Neuro R score: Predicting high-risk neurologic readmissions within 30 days.

Objective: To evaluate clinical and demographic factors of patients with neurologic disorders to determine which patient characteristics are significant for predicting 30-day hospital readmissions to develop a readmission risk predictor specific to patients with neurologic disorders.

Methods: We performed a retrospective single-center chart review for all patients admitted to the Department of Neurology or neurologic intensive care unit from January 1, 2013, to December 31, 2017. Clinical and demographic factors were analyzed to determine the association with readmission.

Implementing primary palliative care best practices in critical care with the Care and Communication Bundle.

Background: Clinician-family communication is a central component of medical decision-making in the intensive care unit (ICU) and the quality of this communication has a direct impact on decisions made regarding care for patients who are critically ill.

Aim: The purpose of the project was to emphasise the need for quality improvement in the medical ICU at the University of Florida Health Hospital in regard to communication between the patients, families and providers.

Method: Interventions included development of a more systemic approach to primary palliative care by using the nationally recognised and published Care and Communication Bundle tool.

Minimally Invasive Surgical Options with Valvular Heart Disease.

The incidence and prevalence of structural heart disease has risen due to the longevity of the population, placing an economic burden on society. Over the past 20 years, treatment options for structural heart disease has significantly evolved. Advances in technology and interventional techniques have now shifted therapeutic options to include minimally invasive approaches to correct valvular heart disease.

Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me?

Over the past decade, leading health care organizations have recommended doubling the number of doctorally prepared nurses to meet the future demands of health care. In 2018, the National Organization of Nurse Practitioner Faculties committed to move all nurse practitioner degree programs to the Doctor of Nursing Practice degree by 2025. As more and more doctorally prepared nurses enter the workforce, other nurses are considering returning to school for a terminal degree.

Early mobilisation in intensive care during renal replacement therapy: A quality improvement project.

Objective: To improve mobility for patients undergoing renal replacement therapy within intensive care.

Design: A quality improvement study utilising a step-wise mobility protocol within a before-and-after audit design.

Setting: Twenty-four bed Trauma/Surgical intensive care unit within a level one trauma and academic centre.

A model of successful DNP and PhD collaboration.

Background And Purpose: Within nursing education, the existence of two graduate-level programs has created some challenges. Role confusion between the practice-focused Doctor of Nursing Practice (DNP) and the research-focused Doctor of Philosophy (PhD) is compounded by competition for similar positions. Collaboration between DNP and PhD nurses, however, benefits the health care system and patients.

Academic nursing scholarship redefined.

The American Association of Colleges of Nursing (AACN) last defined academic nursing scholarship in 1999. The AACN recognized faculty scholarship must align with the increasingly complex and dynamic health care environment to prepare nurses for an ever-changing future. The new, broader definition recognizes multiple ways of knowing and values all scholarly contributions, which affect nursing science and the health care system.

Improving Cardiac Surgery Outcomes by Using an Interdisciplinary Clinical Pathway.

A cardiothoracic intensive care unit (CTICU) team evaluated preoperative and postoperative processes to improve outcomes for cardiac surgery patients. The primary aim of this project was to streamline and improve care in the CTICU by implementing a new clinical pathway for patients undergoing coronary artery bypass graft or valve replacement procedures. We analyzed processes, communication, ventilator days, respiratory complications, patient mobility, presence of invasive catheters and lines, CTICU length of stay, and hospital-adjusted length of stay before and after we implemented the clinical pathway.

CE: A Review of the Revised Sepsis Care Bundles.

: Sepsis is an extreme response to infection that can cause tissue damage, organ failure, and death if not treated promptly and appropriately. Each year in the United States, sepsis affects more than 1.5 million people and kills roughly 250,000.

Sleep Deprivation in Neurointensive Care Unit Patients From Serial Neurological Checks: How Much Is Too Much?

Objective: Hourly neurological examinations are frequently performed in the neurointensive care unit (NICU) to quickly detect neurological deterioration. These examinations require the patient to be awakened hourly for days disrupting the sleep cycle and potentially causing neurological deterioration through sleep deprivation and the development of delirium. This pilot study's aim was to describe the prevalence of neurologic deterioration and delirium in patients receiving hourly neuro checks.

CE: Assessing and Managing Pain, Agitation, and Delirium in Hospitalized Older Adults.

: In the acute care setting, pain, agitation, and delirium (PAD) often occur as interrelated parts of a syndrome rather than as separate entities. Because the three facets of PAD may be similar in presentation, it is often difficult for clinicians to recognize the syndrome and to assess and treat it. The challenge is particularly great in older patients, who are more likely than their younger counterparts to have such comorbid conditions as dementia, which may impair the ability to report pain, or age-related physiologic changes that may affect the metabolism and clearance of certain medications.

Predicting Which Patients Will Benefit From Palliative Care: Use of Bundles, Triggers, and Protocols.

Intensive care units provide a wide range of care to patients with serious or life-threatening conditions. This care provides excellent state-of-the-art interventions, often concentrated on meeting national health priorities and performance measures. Overall patient care and the resultant outcomes in the intensive care unit are superb.

Making the Case for Palliative Care in Critical Care.

The United States has a changing populace with an increasing number of vulnerable, diverse, and older adults. Of people aged 65 and older, nearly two-thirds suffer from serious comorbidities. Costs associated with chronic illness increase with age and number of conditions.