Critical Care Journal of Nursing

Scope of Advanced Practice for Nurses in the United Kingdom

Scope of Advanced Practice for Nurses in the United Kingdom

Tags: advanced practice apn clinical critical care ICU nursing leadership united kingdom

A 3,500 word article which critically discusses advanced practice for nurses within the United Kingdom. This was originally written for an MSc in Advanced Practice.

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Therapeutic Hypothermia Management

Therapeutic Hypothermia Management

Tags: cardiac cerebral ischemia critical care hemorrhage Hypothermia perioperative recommendations Subarachnoid Hemorrhage Therapeutic Hypothermia therapy traumatic brain injury treatment

The leading cause of death in North America is heart disease, resulting in 611,105 deaths in the last year. Cardiac arrest accounts for more than 300,000 heart disease related deaths. Patients that receive early quality chest compressions and defibrillation present with increased survival rate, however, the degree of brain dysfunction varies. The advancement in cardiopulmonary resuscitation after cardiac arrest and the use of therapeutic hypothermia have minimized brain injury and improved neurologic outcome. In 2002, two studies demonstrated the use of therapeutic hypothermia after cardiac arrest proving to lower mortality rate and have neuroprotective effect. This led the American Heart Association and the International Liaison Committee on Resuscitation to recommend the implementation of therapeutic hypothermia after the return of spontaneous circulation post-cardiac arrest. Mild hypothermia is also utilized in traumatic brain injury to control cerebral edema and to decrease intracranial pressure (ICP), cerebral ischemia, and subarachnoid hemorrhage (SAH). However, clinical effectiveness for subarachnoid hemorrhage is still questionable. This paper will focus on the recommendations for therapeutic hypothermia after cardiac arrest as well as a briefly discuss its use for clinical trials in traumatic brain injury, cerebral ischemia, and SAH.

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Embracing Change

Embracing Change

Tags: critical care Emergency nurse ICU ICU Nurse nursing experiences surgical unit transition

Exemplar of my nursing experience of my transition from ER nurse to an ICU nurse.

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American Association of Critical-Care Nurses Brings its National Nurse Leadership Skill-building Program to Texas

American Association of Critical-Care Nurses Brings its National Nurse Leadership Skill-building Program to Texas

Tags: aacn American Association of Critical-Care Nurses critical care innovation training program leadership skills nursing skill-building

The American Association of Critical-Care Nurses (AACN) expands its hospital-based nurse leadership and innovation training program to a fourth region with the addition of eight Austin-area hospitals. AACN Clinical Scene Investigator (CSI) Academy is designed to empower bedside nurses as clinician leaders and change agents whose initiatives measurably improve the quality of patient care with bottom-line impact to the hospital.

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Acute Renal Failure

Acute Renal Failure

Tags: acute renal failure Case Study critical care health care nurse patient concern patient outcomes

Acute renal failure (ARF) has become increasingly common in patients with critical illnesses. Up to two-thirds of intensive care unit (ICU) patients develop ARF with the leading cause being sepsis. Treatment of ARF has been associated with higher costs and the following adverse outcomes: increased length of stay, excess mortality of 30-71%, need for chronic dialysis in the patients who survive, and the requirement of discharge to short-term or long-term care facilities.

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Family Presence During CPR in the Emergency Department 

Family Presence During CPR in the Emergency Department 

Tags: Bedside Manner cpr critical care emergency emergency department Emergency nurse family Family Presence nurse

A descriptive survey conducted in 2000 (Myers, et al 2000) investigated attitudes and beliefs of patients’ families and ER staff members about FWR. The survey reported that 98% of patients’ families indicated that they had a right to be present and would do it and would participate in FWR again; 100% of family members said that FWR was helpful to them, and 95% said it was helpful for the patient. It also showed that 70% of professionals surveyed after their participation in FWR actually produced a higher level of “professional” behavior along with a more “professional” bedside dialog amongst the health care team. The survey also indicated that having the family in the resuscitation room prompted the staff to take the patient’s dignity, privacy, and need for pain management into greater consideration when compared to an un-witnessed resuscitation effort. (Myers, et al 2000)

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Thyroid Storm and the AACN Synergy Model

Thyroid Storm and the AACN Synergy Model

Tags: aacn Case Study crisis critical care hypermetabolic storm synergy thyroid

Thyroid storm, or thyrotoxic crisis is a rare, but critical hypermetabolic state requiring emergent treatment.

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