111 results match your criteria: "Critical Care Clinical Nurse Specialist[Affiliation]"
Delirium in the Critically Ill Child.
Clin Nurse Spec
September 2017
Author Affiliations: Pediatric Critical Care Clinical Nurse Specialist, Randall Children's Hospital at Legacy Emanuel, Portland, Oregon (Dr Norman); and Associate Professor and Acute Care Nurse Practitioner (Dr Taha) and Assistant Clinical Professor and Clinical Nurse Specialist: Pain Management (Dr Turner), Oregon Health & Science University, Doernbecher Children's Hospital, Portland, Oregon.
Purpose/objective: The purposes of this article are to describe the scientific literature on assessment, prevention, and management of delirium in critically ill children and to articulate the implications for clinical nurse specialists, in translating the evidence into practice.
Description: A literature search was conducted in 4 databases-OvidMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Web of Science-using the terms "delirium," "child," and "critically ill" for the period of 2006 to 2016.
Outcome: The scientific literature included articles on diagnosis, prevalence, risk factors, adverse outcomes, screening tools, prevention, and management.
Oxygen Requirements for Acutely and Critically Ill Patients.
Crit Care Nurse
August 2017
Debra Siela is an associate professor, Ball State University School of Nursing, Muncie, Indiana.
Oxygen administration is often assumed to be required for all patients who are acutely or critically ill. However, in many situations, this assumption is not based on evidence. Injured body tissues and cells throughout the body respond both beneficially and adversely to delivery of supplemental oxygen.
View Article and Find Full Text PDFSafety and Acceptability of Patient-Administered Sedatives During Mechanical Ventilation.
Am J Crit Care
July 2017
Linda L. Chlan is associate dean for nursing research, Mayo Clinic, Rochester, Minnesota. Debra J. Skaar is an associate professor, College of Pharmacy, Kay Savik is a senior statistician, School of Nursing (retired), and Craig R. Weinert is an associate professor, School of Medicine, University of Minnesota, Minneapolis, Minnesota. Mary F. Tracy was a critical care clinical nurse specialist, University of Minnesota Medical Center, Minneapolis, Minnesota. Sarah M. Hayes is a pharmacy resident, North Memorial Medical Center, Minneapolis, Minnesota. Breanna D. Hetland is a postdoctoral fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
Background: Safety and acceptability of sedative self-administration by patients receiving mechanical ventilation is unknown.
Objectives: To determine if self-administration of dexmedetomidine by patients is safe and acceptable for self-management of anxiety during ventilatory support.
Methods: In a pilot trial in 3 intensive care units, 17 intubated patients were randomly assigned to dexmedetomidine and 20 to usual care.
Measuring Outcomes of an Intensive Care Unit Family Diary Program.
AACN Adv Crit Care
April 2018
Truong-Giang Huynh is ICU Assistant Nurse Manager, Jacobs Medical Center, University of California, San Diego Health, 9300 Campus Point Drive, La Jolla, CA 92037 Miranda Covalesky is Clinical Nurse II, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Samantha Sinclair is Clinical Nurse II, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Heather Gunter is Clinical Nurse III, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California. Tamara Norton is Clinical Nurse III, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California. Alice Chen is Clinical Nurse III, Jacobs Medical Center, University of California, San Diego Health, La Jolla, California. Cassia Yi is Critical Care Clinical Nurse Specialist, Sulpizio Cardiovascular Center, University of California, San Diego Health, La Jolla, California.
Patients discharged from intensive care units are at risk of short- and long-term physical, cognitive, and emotional symptoms known as post-intensive care syndrome. Family members of intensive care unit patients are at risk of similar symptoms known as post-intensive care syndrome-family. Both syndromes are common, and strategies to reduce risk factors should be employed.
View Article and Find Full Text PDFPassive Leg-Raising and Prediction of Fluid Responsiveness: Systematic Review.
Crit Care Nurse
April 2017
Joya D. Pickett completed her doctoral degree at the University of Washington, School of Nursing, and practices as a critical care clinical nurse specialist at Swedish Medical Center in Seattle, Washington.
Fluid boluses are often administered with the aim of improving tissue hypoperfusion in shock. However, only approximately 50% of patients respond to fluid administration with a clinically significant increase in stroke volume. Fluid overload can exacerbate pulmonary edema, precipitate respiratory failure, and prolong mechanical ventilation.
View Article and Find Full Text PDFCE: Original Research: Identifying Hospitalized Patients at Risk for Harm: A Comparison of Nurse Perceptions vs. Electronic Risk Assessment Tool Scores.
Am J Nurs
April 2017
Andrea Stafos is manager of the diabetes education program at Shawnee Mission Medical Center, Shawnee Mission, KS, where Susan Stark is the director of evidence-based practice, Kathryn Barbay and Susan Schedler are acute care clinical nurse specialists, Kristen Frost is a critical care clinical nurse specialist, and David Jackel is an ED clinical specialist. Lindsey Peters is a neurology clinical specialist at the University of Kansas Hospital, Kansas City. Elizabeth Riggs is the system director of regulatory readiness and Shalan Stroud is a critical care advanced practice nurse at Saint Luke's Health System in Kansas City, MO. The authors acknowledge Lyla Lindholm, DNP, CNS, for assisting with data analysis, and An-Lin Cheng, PhD, for guidance on statistical analysis. Contact author, Andrea Stafos: The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
Unlabelled: : Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods.
View Article and Find Full Text PDFHospital Value-Based Purchasing: Part 2, Implications.
AACN Adv Crit Care
October 2017
Kathleen M. Stacy is Critical Care Clinical Nurse Specialist and Clinical Associate Professor, Hahn School of Nursing and Health Science, University of San Diego, 5998 Alcala Park, San Diego, CA 92110-2492
Show Your Stuff and Watch Your Tone: Nurses' Caring Behaviors.
Am J Crit Care
March 2017
Ruth A. Weyant is a staff registered nurse in the cardiac intensive care unit, Medical Center of the Rockies, Loveland, Colorado. Lory Clukey is an associate professor, University of Northern Colorado, Greeley, Colorado. Melanie Roberts is a critical care clinical nurse specialist, Medical Center of the Rockies. Ann Henderson is an education nurse specialist, Medical Center of the Rockies.
Background: Although it is perceived as essential, documentation of caring behaviors executed by nurses is rarely done. To facilitate what is important to patients and their family members, we need to understand what behaviors are perceived as caring or not caring.
Objective: To explore perceptions of nurses' caring behaviors among intubated patients and their family members.
Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.
J Infus Nurs
July 2017
University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina (Dr Sherwood), CHI Health St. Francis, Grand Island, Nebraska (Ms Nickel). Gwen Sherwood, PhD, RN, FAAN, ANEF, professor and associate dean for practice and global initiatives at the University of North Carolina at Chapel Hill School of Nursing, was co-investigator for the Robert Wood Johnson funded Quality and Safety Education for Nurses (QSEN) project. She is a past keynote speaker for the Infusion Nurses Society. Barbara Nickel, APRN-CNS, NP-C, CCRN, CRNI®, is the critical care clinical nurse specialist for a community-based hospital in Grand Island, Nebraska. Her role includes incident investigation, including root cause analysis, and process improvement. She has used her CRNI® to enhance quality and safety in infusion-related care, and has been a member/chair of the Infusion Nurses Society's National Council on Education.
Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work.
View Article and Find Full Text PDFHospital Value-Based Purchasing: Part 1, Overview of the Program.
AACN Adv Crit Care
October 2016
Kathleen M. Stacy is Critical Care Clinical Nurse Specialist and Clinical Associate Professor, Hahn School of Nursing and Health Science, University of San Diego, 5998 Alcala Park, San Diego, CA 92110-2492
Non-Bachelor of Science in Nursing Registered Nurse to Bachelor of Science in Nursing Registered Nurse: A Change in Critical Thinking.
Dimens Crit Care Nurs
March 2018
Constance E. McIntosh, EdD, MBA, RN, is an assistant professor in the School of Nursing at Ball State University School. Dr McIntosh teaches information technology courses and management/leadership in the master's program. Dr McIntosh's lines of research are school nursing, autism, and transition into practice. Cynthia M. Thomas, EdD, MS, BSN, ASN, RNc, CDONA, is an associate professor in the School of Nursing at Ball State University in Muncie Indiana. Dr Thomas teaches management/leadership in the traditional prelicensure, RN-BSN, and graduate programs. Dr Thomas's research focuses on the transition to practice, nurse leadership, autism and school nursing. Debra Siela, PhD, RN, CCNS, ACNS-BC, CCRN-K, CNE, RRT, is an associate professor in the School of Nursing at Ball State University in Muncie, Indiana. She has experience as a critical care clinical nurse specialist. She is a coinvestigator of fall risks and family presence during resuscitation research. Dr Siela teaches across the prelicensure, graduate, and DNP programs.
With recommendations from national nursing associations and accrediting bodies to transition to an all baccalaureate prepared nurse workforce by 2020, it is important to understand the expertise that a baccalaureate degreed nurse brings to patient care. The purpose of this article is to establish the differences of a non-bachelor of science in nursing (BSN) registered nurse and a 4-year prepared nurse, as well as to identify the education and clinical trends in critical care that require a BSN-prepared nurse. The history of associate degree and diploma degree nurses is admirable and served a purpose serving up to and post World War II.
View Article and Find Full Text PDFA Pilot Randomized Controlled Trial of the Feasibility of a Multicomponent Delirium Prevention Intervention Versus Usual Care in Acute Stroke.
J Cardiovasc Nurs
February 2018
Karen L. Rice, DNS, APRN, ACNS-BC, ANP Nurse Scientist & Director, The Center for Nursing Research, Ochsner Medical Center, New Orleans, Louisiana. Marsha J. Bennett, DNS, APRN, ACRN Professor, Louisiana State University Health Sciences Center, School of Nursing, New Orleans. Linley Berger, MCD, CCC-SLP Speech Language Pathologist, Ochsner Medical Center, New Orleans, Louisiana. Bethany Jennings, MN, APRN, FNP-C Stroke Program Director, Ochsner Medical Center, New Orleans, Louisiana. Lynn Eckhardt, MSN, APRN, GNP-BC Nurse Practitioner, Neurology Clinic, Ochsner Medical Center, New Orleans, Louisiana. Nicole Fabré-LaCoste, PharmD, BCPS, CGP Clinical Pharmacist Residency Program Director, Ochsner Medical Center, New Orleans, Louisiana. David Houghton, MD, MPH Chief, Division of Memory and Movement Disorders, Ochsner Medical Center, New Orleans, Louisiana. Gabriel Vidal, MD Vascular and Interventional Neurologist, Ochsner Medical Center, New Orleans, Louisiana. Toby Gropen, MD Chief, Division of Vascular Neurology, Ochsner Medical Center, New Orleans, Louisiana. Erica Diggs, MD Hospitalist, Division of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana. Erin Barry, MSN, RN, CNRN Neuro-Critical Care Clinical Nurse Specialist, Ochsner Medical Center, New Orleans, Louisiana. Jennilee St. John, MSN, APRN, AGCNS-BC, CCRN Neuro-Critical Care Clinical Nurse Specialist, Ochsner Medical Center, New Orleans, Louisiana. Sheena Mathew, PharmD Clinical Pharmacist, Ochsner Medical Center, New Orleans, Louisiana. Allison Egger, MPH Biostatistician, Ochsner Medical Center, New Orleans, Louisiana. Stephanie Ryan, DNP, FNP-C Stroke Team Nurse Practitioner, Ochsner Medical Center, New Orleans, Louisiana. Raymond Egger, BSN, RN, CNRN Stroke Central Coordinator, Ochsner Medical Center, New Orleans, Louisiana. David Galarneau, MD Vice Chairman, Department of Psychiatry, Ochsner Medical Center, New Orleans, Louisiana. Kenneth Gaines, MD Director, Ochsner's Neuroscience Institute, Ochsner Medical Center, New Orleans, Louisiana. E. Wesley Ely, MD, MPH Professor of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, and the Veteran's Affairs Geriatric Research Education Clinical Center (GRECC) of the VA Tennessee Valley Healthcare System, Nashville.
Background: Delirium after acute stroke is a serious complication. Numerous studies support a benefit of multicomponent interventions in minimizing delirium-related complications in at-risk patients, but this has not been reported in acute stroke patients. The purpose of this study was to explore the feasibility of conducting a randomized (delirium care) versus usual standardized stroke care (usual care) in reducing delirium in acute stroke.
View Article and Find Full Text PDFAngioedema: Clinical Presentations and Pharmacological Management.
Dimens Crit Care Nurs
February 2018
Angela Smith Collins-Yoder PhD, RN, CCNS, ACNS BC, is a clinical professor at the University of Alabama Capstone College of Nursing and is a critical care clinical nurse specialist.
Angioedema (AE) is a unique clinical presentation of an unchecked release of bradykinin. The origin of this clinical presentation can be either genetic or acquired. The outcome within the patient is subcutaneous swelling of the lower layers of the epidermis.
View Article and Find Full Text PDFDeveloping a Diary Program to Minimize Patient and Family Post-Intensive Care Syndrome.
AACN Adv Crit Care
March 2017
Meaghan Locke is a Consultant, Critical Care Nursing Section, Madigan Army Medical Center. Sarah Eccleston is Critical Care Clinical Nurse Specialist, Center for Nursing Science & Clinical Inquiry, Madigan Army Medical Center. Claire N. Ryan is Intensive Care Unit (ICU) Staff Nurse, Critical Care Nursing Section, Madigan Army Medical Center. Tiffany J. Byrnes is ICU Staff Nurse, Critical Care Nursing Section, Madigan Army Medical Center. Cristin Mount is Chief, Department of Medicine, Madigan Army Medical Center. Mary S. McCarthy is Senior Nurse Scientist, Center for Nursing Science & Clinical Inquiry, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431
A series of evidence-based interventions beginning with an intensive care unit diary and a patient/family educational pamphlet were implemented to address the long-term consequences of critical illness after discharge from the intensive care unit, bundled as post-intensive care syndrome and post-intensive care syndrome-family. An extensive literature review and nursing observations of the phenomenon highlighted the potential for this project to have a favorable impact on patients, their families, and the health care team. The goal of this article is to explain the education of all stakeholders; the introduction of the diary, video, and educational pamphlet; and the evaluation of the acceptance of these interventions.
View Article and Find Full Text PDFUnderstanding the Role and Legal Requirements of the Institutional Review Board.
Clin Nurse Spec
October 2016
Author Affiliations: Nurse Scientist, Southern California Patient Care Services, Kaiser Permanente, Oakland, California (Dr Kawar); Director, Department of Public Health, Perth, Western Australia (Dr Pugh); and Critical Care Clinical Nurse Specialist (Dr Scruth), Quality and Regulatory, Kaiser Permanente, Oakland, California.
Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit.
Am J Crit Care
March 2016
Katie Swafford is a critical care clinical nurse specialist and Rachel Culpepper and Christina Dunn are staff nurses and shift coordinators in the critical care unit at Eskenazi Health, Indianapolis, Indiana.
Background: Hospital-acquired pressure ulcers (HAPUs) are a costly and largely preventable complication occurring in a variety of acute care settings. Because they are considered preventable, stage III and IV HAPUs are not reimbursed by Medicare.
Objectives: To assess the effectiveness of a formal, year-long HAPU prevention program in an adult intensive care unit, with a goal of achieving at least a 50% reduction in 2013, compared with 2011.
Simulation in the Acute Care Setting.
AACN Adv Crit Care
February 2016
Mary Fran Tracy is the Editor of AACN Advanced Critical Care and Critical Care Clinical Nurse Specialist, University of Minnesota Medical Center, 500 Harvard St SE, Minneapolis, MN 55455
The Strengths and Challenges of Implementing EBP in Healthcare Systems.
Worldviews Evid Based Nurs
February 2016
Critical Care Clinical Nurse Specialist, Holy Cross Hospital, Silver Spring, MD.
Background: Multihospital healthcare system leaders and individual nurses are challenged to integrate standardized evidence-based practices that support continuous performance improvement in their systems.
Aim: This study was undertaken to evaluate the strength of and the opportunities for implementing evidence-based nursing practice across a diverse 9-hospital system located in the mid-Atlantic region.
Methods: A cross-sectional survey of 6,800 registered nurses (RNs), with a 24% response rate, was conducted to learn about their attitudes, beliefs, and perceptions toward organizational readiness and implementation of EBP.
OMAN: The Emergence of the Clinical Nurse Specialist.
Clin Nurse Spec
November 2016
Author Affiliation: Registered Nurse, Sultan Qaboos University, Muscat, Oman (Ms Almukhaini); Associate Professor, Department of Physiological Nursing, UCSF School of Nursing, San Francisco, California (Dr Donesky); and Critical Care Clinical Nurse Specialist (Dr Scruth), Quality and Regulatory, Kaiser Permanente, Oakland, California.
Original Research: Implementation of an Early Mobility Program in an ICU.
Am J Nurs
December 2015
Danielle Fraser is a critical care clinical nurse specialist at WellStar Kennestone Hospital in Marietta, GA, where Wendy Forman is the ICU early mobility team leader. LeeAnna Spiva is the interim executive director of the Center for Nursing Excellence, WellStar Health System, also in Marietta. Caroline Hallen is a staff nurse at Children's Healthcare of Atlanta. Contact author: Danielle Fraser, The authors have disclosed no potential conflicts of interest, financial or otherwise.
Objective: Research is needed to determine the feasibility of implementing a dedicated ICU mobility team in community hospital settings. The purpose of this study was to assess, in one such hospital, four nurse-sensitive quality-of-care outcomes (falls, ventilator-associated events, pressure ulcers, and catheter-associated urinary tract infections [CAUTIs]), as well as hospital costs, sedation and delirium measures, and functional outcomes by comparing ICU patients who received physical therapy from a dedicated mobility team with ICU patients who received routine care.
Methods: We conducted a retrospective longitudinal study at a community acute care hospital; patients were randomly assigned to intervention or routine care groups.
Peripheral muscle strength and correlates of muscle weakness in patients receiving mechanical ventilation.
Am J Crit Care
November 2015
Linda L. Chlan was the Dean's Distinguished Professor of Symptom Management Research, College of Nursing, Ohio State University, Columbus, Ohio at the time of this research. Mary Fran Tracy is a critical care clinical nurse specialist, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota. Jill Guttormson is an assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin. Kay Savik is a senior statistician, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
Background: Intensive care unit-acquired weakness is a frequent complication of critical illness because of patients' immobility and prolonged use of mechanical ventilation.
Objectives: To describe daily measurements of peripheral muscle strength in patients receiving mechanical ventilation and explore relationships among factors that influence intensive care unit-acquired weakness.
Methods: Peripheral muscle strength of 120 critically ill patients receiving mechanical ventilation was measured daily by using a standardized handgrip dynamometry protocol.
Promotion of progressive mobility activities with ventricular assist and extracorporeal membrane oxygenation devices in a cardiothoracic intensive care unit.
Dimens Crit Care Nurs
January 2017
Jennifer Chavez, MSN, RN, CCRN-CSC, is a level III staff nurse, Evidence Based Practice and Progressive Mobility Nurse Champion in Cardiothoracic Intensive Care Unit. Her clinical interests include translating evidence into practice related to cardiovascular surgery. Shannon Johnson Bortolotto, MS, RN, APN, CCNS, is a critical care clinical nurse specialist. Her clinical interests include incorporating best practices into updated bedside care. Ms Bortolotto's quality improvement initiatives include awakening trials, delirium, progressive mobility, and care of the septic patient. Research interests include gathering data on the patient experience while intubated. Martha Paulson, MSN, RN, CCRN, is a cardiothoracic intensive care unit nurse manager. Her clinical interests include promoting staff engagement and problem solving to improve patient outcomes. Nicole Huntley, BSN, RN, is a level III staff nurse in the surgical intensive care unit. Her clinical interests include nursing interventions to decrease patient falls while promoting safe mobility. Breandan Sullivan, MD, is an assistant professor at the Department of Anesthesiology and Critical Care Medicine and co -medical director of the cardiothoracic intensive care unit. Dr Sullivan's clinical interests include quality improvement, decreasing delirium, and improving multidisciplinary collaboration in cardiovascular surgery. Ashok Babu, MD, is an assistant professor at the Division of Cardiothoracic Surgery. Dr Babu's clinical interests include various clinical publications and research related to cardiovascular surgery.
Background: Progressive mobility (PM) is a clinical intervention that influences complications experienced throughout critical illness. Early PM is a relevant topic in critical care practice literature and was principle to introducing a PM care guideline in an acute cardiothoracic/cardiovascular intensive care unit.
Purpose: A noted challenge in the cardiothoracic/cardiovascular intensive care unit is caring for acute cardiac and pulmonary failure.
Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients.
Crit Care Nurse
October 2015
Odette Y. Comeau is an adult critical care clinical nurse specialist at University of Texas Medical Branch (UTMB) in Galveston, Texas.Josette Armendariz-Batiste is the director of patient care and assistant chief nursing officer for adult medical-surgical and critical care units at UTMB Galveston.Scott A. Woodby is a nurse clinician in the medical intensive care unit/cardiac care unit at UTMB Galveston.
Background: Adult critical care patients in an academic medical center experienced adverse events during intrafacility transport resulting from lack of preparation. An intervention was needed to help keep patients safe during intrafacility transport.
Objective: To develop a checklist for transport that is easy to use and effective in preparing patients for transport.
Intensive Care Nurses' Knowledge About Use of Neuromuscular Blocking Agents in Patients With Respiratory Failure.
Am J Crit Care
September 2015
Erin N. Frazee and Heather A. Personett are pharmacists in Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Seth R. Bauer is a medical intensive care unit clinical specialist in the Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio. Amy L. Dzierba is a critical care pharmacist in the Department of Pharmacy, New York Presbyterian Hospital, New York, New York. Joanna L. Stollings is a critical care pharmacist in the Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Lindsay P. Ryder is a pharmacist in the Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio. Jennifer L. Elmer is a critical care clinical nurse specialist in the Department of Nursing at the Mayo Clinic. Sean M. Caples and Craig E. Daniels are intensive care physicians in the Division of Pulmonary and Critical Care Medicine, Mayo Clinic.
Background: The recent increase in use of neuromuscular blocking agents (NMBAs) in patients with acute respiratory distress syndrome is set against a backdrop of concerns about harm associated with use of these high-risk drugs. Bedside nurses play a pivotal role in the safe and effective use of these agents.
Objective: To describe critical care nurses' knowledge of the therapeutic properties, adverse effects, and monitoring parameters associated with NMBAs.