Suchergebnisse

Biorepository research in children raises numerous ethical questions that are heightened in the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents of PICU patients to elucidate perspectives on biorepository research. A/YAs had a positive attitude toward biobanking. In young adults, comprehension was higher for knowledge of a choice to withdraw and participate in the research and lower for purpose, procedures, risks, and benefits of participation. All but one A/YA wanted to have a say in whether their samples would be used. Parent views on child assent were mixed; 55% of parents favored child involvement in decisions. Efforts should be made to improve comprehension by A/YAs and involvement of A/YAs in decisions.

Background Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients are often overlooked in health systems. Essential Emergency and Critical Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. EECC includes the effective care of low cost and low complexity for the identification and treatment of critically ill patients across all medical specialties. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19. Methods In a Delphi process, consensus (>90% agreement) was sought from a diverse panel of global clinical experts. The panel iteratively rated proposed treatments and actions based on previous guidelines and the WHO/ICRC's Basic Emergency Care. The output from the Delphi was adapted iteratively with specialist reviewers into a coherent and feasible package of clinical processes plus a list of hospital readiness requirements. Results The 269 experts in the Delphi panel had clinical experience in different acute medical specialties from 59 countries and from all resource settings. The agreed EECC package contains 40 clinical processes and 67 requirements, plus additions specific for COVID-19. Conclusion The study has specified the content of care that should be provided to all critically ill patients. Implementing EECC could be an effective strategy for policy makers to reduce preventable deaths worldwide.

A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z. Mahmoud, Abdelmoneim SuliemanA7 High-frequency ultrasound in determining the causes of acute shoulder joint painMustafa Z. MahmoudA8 Teaching WINFOCUS Ultrasound Life Support Basic Level 1 for Providers in resource-limited countriesAbbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H. Lester Kirchner, Gregor ProsenA9 Changes of arterial stiffness and endothelial function during uncomplicated pregnancyAjda Anzic, Paul LeesonA10 Cardiovascular haemodynamic properties before, during and after pregnancyAjda Anzic, Paul LeesonA11 An old man with generalized weaknessMaryam Bahreini, Fatemeh RasooliA12 Ultrasonography for non-specific presentations of abdominal painMaryam Bahreini, Houman HosseinnejadA13 Introduction of a new imaging guideline for suspected renal colic in the emergency department: effect on CT Urogram utilisationGabriel Blecher, Robert Meek, Diana Egerton-WarburtonA14 Transabdominal ultrasound screening for pancreatic cancer in Croatian military veterans: a retrospective analysis from the first Croatian ...

This research tested the generalizability of the mediating role of stress resistance resources to stressors in the physical environment. One hun-dred hospital critical care unit nurses were surveyed. Results indicated that less sensitivity to noise and greater personality hardiness may act as noise-induced stress resistance resources. When the three dimensions of hardiness (commit-ment, control, and challenge) were analyzed separately via a stepwise multiple regression, commitment was the only variable to uphold this relationship. The latter result is discussed in terms of potentially effective coping strategies in nurses and compatibility within the person-environment relationship.

Objectives: Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy. Review method: We performed a scoping review including papers published in 1992–2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin). Design and data sources: Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search. Results: The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking. Conclusions: This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any ...

The European Clinical Trials Directive requires an informed consent from the patient or a proxy in drug trials. Although informed consent is a valuable tool to protect patients' rights in clinical trials, this requirement largely impedes research in critical care settings, and if pursued in this context, it does not provide the patient with adequate protection. Instead of insisting on informed consent, we suggest that the focus should be shifted towards two other ethically relevant elements in human experimentation: risk assessment and selection of research subjects. When reviewing protocols in which a waiver of consent is deemed necessary, the Ethical Review Board should ensure that non-therapeutic risks are minimal, that the research is specifically designed to benefit critically ill patients, and that it cannot be conducted under circumstances where an informed consent can be obtained. If the European Directive is changed accordingly, this permits clinical trials in critical care settings, while adequate protection from risky non-therapeutic procedures is ensured and exploitation of the patient as an easily accessible research subject is prevented.

Front Cover -- Infection in the Intensive Care Unit -- Copyright -- Contributors -- CONSULTING EDITOR -- EDITORS -- AUTHORS -- Contents -- Preface -- An Interprofessional Team Approach to Decreasing Surgical Site Infection After Coronary Artery Bypass Graft Surgery -- Management of Sepsis in Patients with Pulmonary Arterial Hypertension in the Intensive Care Unit -- Infection in the Critically Ill Older Adult -- The Role of Liver Function in the Setting of Cirrhosis with Chronic Infection and Critical Illness -- Hospital-Acquired Infections: Current Trends and Prevention -- Opportunistic Fungal Infections in Critical Care Units -- Wound Infections in Critical Care -- Infections in the Intensive Care Unit: Posttransplant Infections -- Antibiotic Trends Amid Multidrug-Resistant Gram-Negative Infections in Intensive Care Units -- Interpreting Laboratory Tests in Infection: Making Sense of Biomarkers in Sepsis and Systemic Inflammatory Response Syndrom ... -- CRITICAL CARE NURSING CLINICS OF NORTH AMERICA -- FORTHCOMING ISSUES -- June 2017 -- September 2017 -- December 2017 -- RECENT ISSUES -- December 2016 -- September 2016 -- June 2016 -- Preface -- An Interprofessional Team Approach to Decreasing Surgical Site Infection After Coronary Artery Bypass Graft Surgery -- Key points -- INCIDENCE OF SURGICAL SITE INFECTION AND IMPACT ON OUTCOMES -- DEFINITION OF SURGICAL SITE INFECTION -- RISK FACTORS FOR SURGICAL SITE INFECTION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT -- EVIDENCE-BASED SURGICAL SITE INFECTION PREVENTION STRATEGIES -- Hair Removal -- Preoperative Skin Decolonization -- Hand Hygiene -- Tissue Optimization and Skin Preparation in the Operating Room -- Antibiotic Prophylaxis -- Preoperative Nasal Decolonization with Mupirocin -- Glycemic Control -- Surgical Technique -- Incision Care and Postoperative Bathing.

Abstract


Objective

The aim of this scoping review (Registration https://doi.org/10.17605/OSF.IO/28NKU) is to understand the extrinsic and intrinsic factors that motivate critical care nurses to stay in their job.

Introduction

Previous reviews failed to consider both critical care nurses who stay in their job as well as other critical care nurses who have already left the job or switched from critical care to another medical discipline. Moreover, the literature mainly discusses extrinsic factors that lead to job attrition and turnover, but misses out to exemplify intrinsic factors and to put both in relation to one another.

Inclusion criteria

The inclusion criteria will be described by applying the PCC-framework (Population, Context, Concept). The population is limited to fully qualified critical care nurses who currently work or have been working in the field of critical and emergency care. The context is defined within critical care (intensive care units and emergency care in hospitals). Other contexts (e. g., common surgical wards, palliative care) are excluded. The concept is the personal motivation concerning professional engagement.

Methods

Eleven databases and grey literature from 2015–2023 will be searched. We will apply a two-stage screening process by at least two independent reviewers. First, titles and abstracts will be scanned. In a further step, relevant articles will receive a full-text review. Finally, the research team (approx. 5–6 persons) will discuss the extracted data independently.

Ethics and Dissemination

Ethical approval is not required for scoping reviews. Dissemination will include submission to peer-reviewed journals and presentations in conferences and workshops in the area of critical care.