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PhD Cindy L. Munro, Md Aluko A. Hope
American Journal of Critical Care, Volume 30, pp 4-6; doi:10.4037/ajcc2021734

Hayato Taniguchi, Tokuji Ikeda, MD Ichiro Takeuchi, Md Shingo Ichiba
American Journal of Critical Care, Volume 30, pp 55-63; doi:10.4037/ajcc2021351

The publisher has not yet granted permission to display this abstract.
Ms Linda Berger Spivack, Mpa/id Marla Spivack
American Journal of Critical Care, Volume 30, pp 80-82; doi:10.4037/ajcc2020537

PhD Grant A. Pignatiello
American Journal of Critical Care, Volume 30, pp 36-37; doi:10.4037/ajcc2021923

Md Florian B. Mayr , Judith L. Plowman, Sandra Blakowski, Msw Kimberly Sell-Shemansky, Crnp Joleene M. Young, Md Sachin Yende
American Journal of Critical Care, Volume 30; doi:10.4037/ajcc2021117

The publisher has not yet granted permission to display this abstract.
PhD Salah S. Al-Zaiti, Abdullah Ahmad, PhD Teri M. Kozik, PhD Michele M. Pelter, PhD Mary G. Carey
American Journal of Critical Care, Volume 30, pp 83-84; doi:10.4037/ajcc2021472

PhD Marjorie Funk , Kristopher P. Fennie, PhD Krista A. Knudson, PhD Halley Ruppel
American Journal of Critical Care, Volume 30, pp 38-44; doi:10.4037/ajcc2021122

The publisher has not yet granted permission to display this abstract.
Cindy Cain
American Journal of Critical Care, Volume 30, pp 10-10; doi:10.4037/ajcc2021103

Msn Filippo Binda , Msn Federica Marelli, Msn Alessandro Galazzi, Riccardo Pascuzzo, Msn Ileana Adamini, Msn Dario Laquintana
Published: 21 December 2020
Critical Care Nurse; doi:10.4037/ccn2020222

The publisher has not yet granted permission to display this abstract.
Dnp Lori Dugan Brien , PhD Marilyn H. Oermann, Dnp Margory Molloy, Dnp Catherine Tierney
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 364-370; doi:10.4037/aacnacc2020582

The publisher has not yet granted permission to display this abstract.
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 383-393; doi:10.4037/aacnacc2020535

The publisher has not yet granted permission to display this abstract.
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 431-434; doi:10.4037/aacnacc2020202

Erin D. Wieruszewski, PharmD Caitlin S. Brown, PharmD Jonathan G. Leung, Patrick M. Wieruszewski
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 349-356; doi:10.4037/aacnacc2020907

Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 419-424; doi:10.4037/aacnacc2020263

PhD Patricia Gonce Morton , Ms John Nerges
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 371-379; doi:10.4037/aacnacc2020716

The publisher has not yet granted permission to display this abstract.
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 381-382; doi:10.4037/aacnacc2020291

PharmD Colleen Teevan , Emily Perriello
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 394-400; doi:10.4037/aacnacc2020570

The publisher has not yet granted permission to display this abstract.
Roberta Kaplow , Dnp Pam Cosper, Dnp Ray Snider, Dnp Martha Boudreau, Md John D. Kim, Bsn Elizabeth Riescher, Melinda Higgins
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 401-409; doi:10.4037/aacnacc2020297

The publisher has not yet granted permission to display this abstract.
Mbe Kayla Tabari , PhD Melissa Kurtz Uveges, PhD Aimee Milliken
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 425-430; doi:10.4037/aacnacc2020953

DNP Ashleigh G. Vanblarcom , Ms Cristina A. Wojack, PhD Jesus Casida
Published: 15 December 2020
AACN Advanced Critical Care, Volume 31, pp 410-415; doi:10.4037/aacnacc2020324

Msn Mary Kay Bader , Dnp Annabelle Braun, Msn Cherie Fox, Lauren Dwinell, Dnp Jennifer Cord, Msn Marne Andersen, Bsn Bryan Noakes, Daniel Ponticiello
Published: 1 December 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020799

The publisher has not yet granted permission to display this abstract.
PhD Natalie S. McAndrew, Pa-C Laura Mark, PhD Mary Butler
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 42-51; doi:10.4037/ccn2020644

The publisher has not yet granted permission to display this abstract.
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 62-66; doi:10.4037/ccn2020873

The publisher has not yet granted permission to display this abstract.
Linda M. Sulzbach-Hoke , Bsn Rachel T. Zekany
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 33-41; doi:10.4037/ccn2020289

The publisher has not yet granted permission to display this abstract.
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 84-84; doi:10.4037/ccn2020806

PhD Jacob Higgins , Bsn Sherri Casey, Dnp Erin Taylor, Bsn Riley Wilson, Dnp Paula Halcomb
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 52-61; doi:10.4037/ccn2020874

The publisher has not yet granted permission to display this abstract.
Dnp Allison M. L. Sloan , PhD Linda Dudjak
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 16-22; doi:10.4037/ccn2020653

The publisher has not yet granted permission to display this abstract.
Karen-Leigh Edward , Blaw Alessandra Galletti, Minh Huynh
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 23-32; doi:10.4037/ccn2020595

The publisher has not yet granted permission to display this abstract.
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 72-74; doi:10.4037/ccn2020372

Sara Knippa , Kristin Sollars, Marci Ebberts, Katherine M. Sabin
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 67-71; doi:10.4037/ccn2020422

PhD William E. Rosa, PhD Betty R. Ferrell, PhD Clareen Wiencek
Published: 1 December 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020946

Abstract:
Background The coronavirus disease 2019 pandemic has led to escalating infection rates and associated deaths worldwide. Amid this public health emergency, the urgent need for palliative care integration throughout critical care settings has never been more crucial. Objective To promote palliative care engagement in critical care; share palliative care resources to support critical care nurses in alleviating suffering during the coronavirus disease 2019 pandemic; and make recommendations to strengthen nursing capacity to deliver high-quality, person-centered critical care. Methods Palliative and critical care literature and practice guidelines were reviewed, synthesized, and translated into recommendations for critical care nursing practice. Results Nurses are ideally positioned to drive full integration of palliative care into the critical care delivery for all patients, including those with coronavirus disease 2019, given their relationship-based approach to care, as well as their leadership and advocacy roles. Recommendations include the promotion of healthy work environments and prioritizing nurse self-care in alignment with critical care nursing standards. Conclusions Nurses should focus on a strategic integration of palliative care, critical care, and ethically based care during times of normalcy and of crisis. Primary palliative care should be provided for each patient and family, and specialist services sought, as appropriate. Nurse educators are encouraged to use these recommendations and resources in their curricula and training. Palliative care is critical care. Critical care nurses are the frontline responders capable of translating this holistic, person-centered approach into pragmatic services and relationships throughout the critical care continuum.
Msn Linda Bell
Published: 1 December 2020
Critical Care Nurse, Volume 40, pp 82-83; doi:10.4037/ccn2020426

Ashley Barlow, Brooke Barlow, Nancy Tang, PharmD Bhavik M. Shah, PharmD Amber E. King
Published: 1 December 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020337

Abstract:
Topic This article reviews the management of intravenous fluids and the evaluation of volume status in critically ill adults. Clinical Relevance Intravenous fluid administration is one of the most common interventions in the intensive care unit. Critically ill patients have dynamic fluid requirements, making the management of fluid therapy challenging. New literature suggests that balanced salt solutions may be preferred in some patient populations. Purpose of Paper The bedside critical care nurse must understand the properties of various intravenous fluids and their corresponding impact on human physiology. The nurse’s clinical and laboratory assessments of each patient help define the goals of fluid therapy, which will in turn be used to determine the optimal patient-specific selection and dose of fluid for administration. Nurses serve a vital role in monitoring the safety and efficacy of intravenous fluid therapy. Although this intervention can be lifesaving, inappropriate use of fluids has the potential to yield detrimental effects. Content Covered This article discusses fluid physiology and the goals of intravenous fluid therapy, compares the types of intravenous fluids (isotonic crystalloids, including 0.9% sodium chloride and balanced salt solutions; hypotonic and hypertonic crystalloids; and colloids) and their adverse effects and impact on hemodynamics, and describes the critical care nurse’s essential role in selecting and monitoring intravenous fluid therapy.
Published: 23 November 2020
Critical Care Nurse; doi:10.4037/ccn2020830

Abstract:
Background Acute respiratory distress syndrome carries a 40% mortality rate. Prone positioning remains underused owing to clinicians’ low degree of confidence, concern about the risk of adverse outcomes, and lack of staff competency training. Local Problem and Purpose A prone positioning protocol and educational program were needed in an intensive care unit to achieve compliance with best practices for treating acute respiratory distress syndrome patients. Methods An initial survey was conducted to measure staff confidence and competency in prone positioning. A literature review was performed, and a plan-do-study-act approach was used to develop a protocol through in situ simulation involving mock patients. A training video and a simulation scenario using a high-fidelity manikin were developed to facilitate staff education. Staff were surveyed again after training. Interventions During the simulation scenario, interdisciplinary clinicians learned to apply the protocol and resupinate the patient during a simulated emergency. The training video was later used for “just in time” education minutes before actual prone positioning events. Results A total of 25 critical care nurses, 11 respiratory therapists, and 10 physicians completed the initial survey and simulation training. The survey showed that staff lacked confidence and competency in prone positioning. Staff demonstrated competence during the simulation sessions, and posttraining surveys indicated increased confidence. After the educational program, prone positioning was successfully used for 6 critically ill acute respiratory distress syndrome patients. Conclusions In situ simulation and interdisciplinary collaboration increase standardization of high-risk, underused procedures, improving staff confidence and competence as well as patient safety.
PhD Jenny Alderden , PhD Linda J. Cowan, Bsn Jonathan B. Dimas, Mstat Danli Chen, Yue Zhang, PhD Mollie Cummins, PhD Tracey L. Yap
American Journal of Critical Care, Volume 29; doi:10.4037/ajcc2020810

Abstract:
Background Hospital-acquired pressure injuries disproportionately affect critical care patients. Although risk factors such as moisture, illness severity, and inadequate perfusion have been recognized, nursing skin assessment data remain unexamined in relation to the risk for hospital-acquired pressure injuries. Objective To identify factors associated with hospital-acquired pressure injuries among surgical critical care patients. The specific aim was to analyze data obtained from routine nursing skin assessments alongside other potential risk factors identified in the literature. Methods This retrospective cohort study included 5101 surgical critical care patients at a level I trauma center and academic medical center. Multivariate logistic regression using the least absolute shrinkage and selection operator method identified important predictors with parsimonious representation. Use of specialty pressure redistribution beds was included in the model as a known predictive factor because specialty beds are a common preventive intervention. Results Independent risk factors identified by logistic regression were skin irritation (rash or diffuse, nonlocalized redness) (odds ratio, 1.788; 95% CI, 1.404-2.274; P < .001), minimum Braden Scale score (odds ratio, 0.858; 95% CI, 0.818-0.899; P < .001), and duration of intensive care unit stay before the hospital-acquired pressure injury developed (odds ratio, 1.003; 95% CI, 1.003-1.004; P < .001). Conclusions The strongest predictor was irritated skin, a potentially modifiable risk factor. Irritated skin should be treated and closely monitored, and the cause should be eliminated to allow the skin to heal.
Alyson Takaoka, Meredith Vanstone, Thanh H. Neville, Sophia Goksoyr, Marilyn Swinton, France J. Clarke, Orla M. Smith, Allana Leblanc, Denise Foster, Yuhan Kao, et al.
American Journal of Critical Care, Volume 29, pp 422-428; doi:10.4037/ajcc2020733

The publisher has not yet granted permission to display this abstract.
ScM Lisa Aronson Friedman, Pt Daniel L. Young, Archana Nelliot, Elizabeth Colantuoni, Pedro A. Mendez-Tellez, Fcpa Dale M. Needham, Victor D. Dinglas
American Journal of Critical Care, Volume 29, pp 429-438; doi:10.4037/ajcc2020966

Abstract:
Background Participant retention is vital for longitudinal studies. Home visits may increase retention, but little is known about the subset of patients they benefit. Objective To evaluate patient-related variables associated with home visits. Methods In a 5-year, longitudinal, multisite, prospective study of 195 survivors of acute respiratory distress syndrome, in-person assessments were conducted at a research clinic. Home visits were offered to participants who could not attend the clinic. Associations between having a home visit, prior follow-up visit status, and baseline and in-hospital patient variables were evaluated with multivariable, random-intercept logistic regression models. The association between home visits and patients’ posthospital clinical status was evaluated with a subsequent regression model adjusted for these variables. Results Participants had a median age of 49 years and were 56% male and 58% White. The following had independent associations with home visits (adjusted odds ratio [95% CI]): age (per year: 1.03 [1.00-1.05]) and immediately preceding visit incomplete (2.46 [1.44-4.19]) or at home (8.24 [4.57-14.86]). After adjustment for prior-visit status and baseline and hospitalization variables, these posthospital patient outcome variables were associated with a subsequent home visit: instrumental activities of daily living (≥ 2 vs < 2 dependencies: 2.32 [1.29-4.17]), EQ-5D utility score (per 0.1-point decrease: 1.15 [1.02-1.30]), and 6-minute walk test (per 10-percentage-point decrease in percent-predicted distance: 1.50 [1.26-1.79]). Conclusions Home visits were important for retaining older and more physically impaired study participants, helping reduce selection bias caused by excluding them.
PhD Mary G. Carey, PhD Salah S. Al-Zaiti, PhD Teri M. Kozik, PhD Michele M. Pelter
American Journal of Critical Care, Volume 29, pp 493-494; doi:10.4037/ajcc2020827

Grant A. Pignatiello
American Journal of Critical Care, Volume 29, pp 448-449; doi:10.4037/ajcc2020415

PhD Annette M. Bourgault , PhD Jan Powers, Dnp Lillian Aguirre, Robert Hines
American Journal of Critical Care, Volume 29, pp 439-447; doi:10.4037/ajcc2020744

The publisher has not yet granted permission to display this abstract.
Rhonda Board
American Journal of Critical Care, Volume 29, pp 419-419; doi:10.4037/ajcc2020411

PhD Jean Connor , Mph Lauren Hartwell, PhD Jennifer Baird, Mph Benjamin Cerrato, Mph Araz Chiloyan, Mph Courtney Porter, PhD Patricia Hickey
American Journal of Critical Care, Volume 29, pp 468-478; doi:10.4037/ajcc2020884

The publisher has not yet granted permission to display this abstract.
PhD Marilyn Schallom , PhD Donna Prentice, Msn Carrie Sona, Bs Kara Vyers, Cassandra Arroyo, Brian Wessman, Md Enyo Ablordeppey
American Journal of Critical Care, Volume 29, pp 458-467; doi:10.4037/ajcc2020741

The publisher has not yet granted permission to display this abstract.
EdD Bobbie Ann Adair White, Do Heath D. White, Christie Bledsoe, Randy Hendricks, Md Alejandro C. Arroliga
American Journal of Critical Care, Volume 29; doi:10.4037/ajcc2020886

Abstract:
Background Conflicts in medical settings affect both team function and patient care, yet a standardized curriculum for conflict management in clinical teams does not exist. Objectives To evaluate the effects of an educational intervention for conflict management on knowledge and perceptions and to identify trends in preferred conflict management style among intensive care unit workers. Methods A conflict management education intervention was created for an intensive care team. The intervention was 1 hour long and incorporated the Thomas-Kilmann Conflict Mode Instrument as well as conflict management concepts, self-reflection, and active learning through discussion and reviewing clinical cases. Descriptive statistics were prepared on the participants’ preferred conflict management modes. A pretest/posttest was analyzed to evaluate knowledge and perceptions of conflict before and after the intervention, and 3 open-ended questions on the posttest were reviewed for categories. Results Forty-nine intensive care providers participated in the intervention. The largest portion of participants had an avoiding conflict management mode (32%), followed by compromising (30%), accommodating (25%), collaborating (9%), and competing (5%). Pretest/posttest data were collected for 31 participants and showed that knowledge (P < .001) and perception (P = .004) scores increased significantly after the conflict management intervention. Conclusions The conflict management educational intervention improved the participants’ knowledge and affected perceptions. Categorization of open-ended questions suggested that intensive care providers are interested in concrete information that will help with conflict resolution, and some participants understood that mindfulness and awareness would improve professional interactions or reduce conflict.
Md Aluko A. Hope, PhD Cindy L. Munro
American Journal of Critical Care, Volume 29, pp 415-417; doi:10.4037/ajcc2020334

Vinciya Pandian, Linda L. Morris, Martin B. Brodsky, James Lynch, Brian Walsh, Cynda Rushton, Jane Phillips, Alphonsa Rahman, Troy Derose, Leah Lambe, et al.
American Journal of Critical Care, Volume 29; doi:10.4037/ajcc2020561

The publisher has not yet granted permission to display this abstract.
American Journal of Critical Care, Volume 29, pp 489-492; doi:10.4037/ajcc2020694

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