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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.
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.
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

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 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.
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 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.
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.
Msn Nicole Davidson , Bsn Bethany Roberts, Bsn Christina Potts, Bsn Arlene Rieger, Bsn Alejandra Herrera, PhD Marian Altman
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 75-78; doi:10.4037/ccn2020911

Dnp Lauren Morata , Adn Mark Bowers
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 38-46; doi:10.4037/ccn2020240

Abstract:
Peripheral intravenous catheter placement is a skill that is used daily in the hospital. However, many nurses face the challenge of cannulating increasingly complex and difficult-to-access vasculature. Although emergency department clinicians have been using ultrasound to facilitate this procedure for the last 18 years, ultrasound-guided peripheral intravenous catheter placement has not been as rapidly adopted in the critical and acute care nursing realms. Given the benefits of this procedure, including increased patient satisfaction and reduced use of central catheters, its use should be encouraged among all acute care clinicians. The aim of this article is to provide the bedside nurse with a basic understanding of the techniques involved in placing ultrasound-guided peripheral intravenous catheters in patients with difficult venous access.
Sara Knippa, Jennifer Popies
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 67-71; doi:10.4037/ccn2020624

PhD Jane M. Flanagan, PhD Catherine Read, Phd Judith Shindul-Rothschild
Published: 1 October 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020171

Abstract:
Background Sepsis is a critical illness that requires early detection and intervention to prevent disability and/or death. Objective To analyze the association between various hospital-related factors and rates of sepsis after surgery in Massachusetts hospitals. Methods The sample consisted of 53 hospitals with intensive or critical care units and 25 hospitals with step-down units. Hospital characteristics, staffing levels, and health care–acquired conditions were examined using publicly available data. Analysis of variance and linear regression were performed to explore the relationship between nurse and physician staffing levels and sepsis rates. Results Sepsis rates were significantly lower when nurses cared for fewer patients (P < .001) and when intensivist hours were greater (P = .03). Linear regression for nurse staffing revealed that higher rates of catheter-associated urinary tract infection (P = .001) and higher numbers of step-down patients cared for by nurses (P = .001) were associated with a significantly higher rate of sepsis (P < .001). Linear regression for physician staffing revealed that higher rates of catheter-associated urinary tract infection (P < .001) and wound dehiscence after surgery (P < .001), greater hospitalist hours (P = .001), and greater physician hours (P = .05) were associated with a significantly higher sepsis rate, while greater intensivist hours were associated with a lower sepsis rate (P = .002). Conclusion In this study, greater nurse staffing and intensivist hours were associated with significantly lower rates of sepsis, whereas greater physician staffing and hospitalist hours were associated with significantly higher rates. Further research is needed to understand the roles of the various types of providers and the reasons for their differing effects on sepsis rates.
PharmD Kyle Brown , PharmD Calvin Tucker
Published: 1 October 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020419

Abstract:
Topic Ketamine is beneficial in clinical settings ranging from procedural sedation to the treatment of chronic pain. This article describes the clinical benefits of ketamine for treatment of acute pain and for sedation of patients undergoing mechanical ventilation. Clinical Relevance Ketamine causes analgesic and amnestic effects by noncompetitive inhibition of the N-methyl-D-aspartate receptor and activation of the opioid μ and κ receptors. Unlike other sedatives, ketamine provides analgesia and amnesia without causing hypotension or respiratory depression. Several studies have elucidated the clinical benefits of ketamine. The use of ketamine has extended beyond critical care areas such as the operating room and intensive care units. Nurses must be familiar with optimal clinical scenarios, monitoring parameters, and contraindications of ketamine. Purpose To highlight the clinical utility and pharmacological properties of ketamine through a literature review. Current studies of ketamine in acute pain and sedation management are summarized. Content Covered This narrative review describes pharmacological properties, dosing strategies, adminis­tration considerations, and adverse effects of ketamine.
Msn Julie Rogan , PharmD Megan Zielke, Msn Kelly Drumright, PhD Leanne M. Boehm
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 47-56; doi:10.4037/ccn2020111

The publisher has not yet granted permission to display this abstract.
Peter Nydahl , PhD Ingrid Egerod, Megan M. Hosey, Md Dale M. Needham, Christina Jones, Md O. Joseph (Joe) Bienvenu
Published: 1 October 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020958

Abstract:
Topic Many patients in intensive care units have frightening experiences and memories and subsequent post–intensive care syndrome, with psychiatric morbidity including depression, anxiety, and posttraumatic stress disorder. Intensive care unit diaries, written by staff members and families, support patients’ understanding of what occurred and may alleviate their psychological suffering. Clinical Relevance An increasing number of critical care nurses in the United States and elsewhere are implementing intensive care unit diaries, but implementation remains challenging. Purpose To address emerging questions and support implementation in the United States, we held the Third International Intensive Care Unit Diary Conference as a 1-day preconference during the Seventh Annual Johns Hopkins Critical Care Rehabilitation Conference on November 1, 2018, in Baltimore, Maryland. This article summarizes the conference. Content Covered Conference presentations included intensive care unit–related experiences of patients and families, psychosocial aspects of post–intensive care syndrome, the evolution of diaries, implementation strategies for intensive care unit diaries, special topics (eg, legal issues, electronic vs handwritten diaries, pediatric diaries, and time of handover), and psychosocial recovery.
Msn Brandee Pak
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 80-81; doi:10.4037/ccn2020966

Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 84-84; doi:10.4037/ccn2020615

Md Taylor A. Kobussen, Md Gregory Hansen, Bsn Rebecca J. Brockman, Tanya R. Holt
Published: 1 October 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020710

Abstract:
Background Children with complex chronic conditions present unique challenges to the pediatric intensive care unit, including prolonged length of stay, complex medical regimens, and complicated family dynamics. Objectives To examine perspectives of pediatric intensive care unit health care providers regarding pediatric patients with complex chronic conditions, and to explore potential opportunities to improve these patients’ care. Methods A prospective mixed-methods sequential explanatory study was conducted in a tertiary medical-surgical pediatric intensive care unit using surveys performed with REDCap (Research Electronic Data Capture) followed by semistructured interviews. Results The survey response rate was 70.6% (77 of 109). Perspectives of health care providers did not vary with duration of work experience. Ten semistructured interviews were conducted. Eight overarching themes emerged from the interviews: (1) the desire for increased formal education specific to pediatric complex chronic care patients; (2) designation of a primary intensivist; (3) modifying delivery of care to include a discrete location for care provision; (4) establishing daily, short-term, and long-term goals; (5) monitoring and documenting care milestones; (6) strengthening patient and family communications with the health care team; (7) optimizing discharge coordination and planning; and (8) integrating families into care responsibilities. Conclusions Pediatric intensive care unit health care providers’ perspectives of pediatric patients with complex chronic conditions indicated opportunities to refine the care provided by establishing daily goals, coordinating discharge planning, and creating occasions for close communication between patients, families, and providers.
Msn Rachel E. Smith , Dnp Megan M. Shifrin
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 15-24; doi:10.4037/ccn2020746

The publisher has not yet granted permission to display this abstract.
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 57-66; doi:10.4037/ccn2020439

The publisher has not yet granted permission to display this abstract.
Bsn Hannah Nakashima, PhD Cara Gallegos
Published: 1 October 2020
Critical Care Nurse, Volume 40, pp 26-37; doi:10.4037/ccn2020293

Abstract:
Background Families experience high levels of stress during a loved one’s critical illness. Objective To provide an overview of current evidence on the use of journal writing as a coping mechanism for family members during a loved one’s critical illness in a neonatal, pediatric, or adult intensive care unit. Methods Five databases (MEDLINE, PsycINFO, CINAHL, APA PsycArticles, and Health Source: Nursing/Academic Edition) were searched to identify studies examining the benefits of journal writing for family members of critically ill patients. Eight eligible studies reported data from 426 relatives of critically ill patients. Results Regarding quality assessment, the quantitative studies met 73.1% of relevant quality criteria, whereas qualitative studies met 81.3%. Mixed-methods studies met 82.4% of quantitative and 55% of qualitative criteria. Various key themes were identified: communication and understanding, connection to the patient, emotional expression, creating something meaningful, and the importance of pictures and staff entries. Overall, writing in a diary seems to be beneficial for reducing psychological distress and posttraumatic stress disorder, but none of the studies found that it significantly decreased anxiety or depression. Conclusions The findings of this review suggest that having family members of critically ill patients write in a diary is a simple and cost-effective intervention that may improve their psychological outcomes. Critical care nurses are in a position to educate families about the potential benefits of writing in a diary. Future research would be valuable regarding the benefits of using a diary and an optimal approach for doing so in this population.
PhD Annette M. Bourgault , PhD Lovoria B. Williams
Published: 5 August 2020
Critical Care Nurse; doi:10.4037/ccn2020757

Dnp Jessica Grimm
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 12-13; doi:10.4037/ccn2020565

Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 10-11; doi:10.4037/ccn2020717

PhD Amy Jo Lisanti, Msn Stephanie Helman, Msn Andrea Sorbello, Bsn Jamie Fitzgerald, Annemarie D'amato, Ms Xuemei Zhang, J. William Gaynor, Bsn Annemarie D’Amato
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 16-24; doi:10.4037/ccn2020260

The publisher has not yet granted permission to display this abstract.
PhD Kathleen Monforto , Msn Madeline Perkel, Msn Donna Rust, Msn Raymond Wildes, Msn Karen King, PhD Ruth Lebet
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 54-64; doi:10.4037/ccn2020585

The publisher has not yet granted permission to display this abstract.
Bsn Shervin Esfahani , Msn Cassia Yi, PhD Catherina A. Madani, Dnp Judy E. Davidson, Kyle P. Edmonds, Bsn Susan Wynn
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 32-41; doi:10.4037/ccn2020576

Abstract:
Background Goals-of-care conversations are a central component of high-quality patient-centered care. However, clinicians may not engage in such conversations until patients are critically ill. Objective To assess the frequency and quality of goals-of-care conversation documentation among patients who died in an intensive care unit, and then to develop and implement mechanisms to improve the quantity and quality of such conversations. Methods A baseline retrospective medical records review of intensive care unit deaths that occurred within 1 year was conducted to assess the barriers to high-quality goals-of-care conversations. A nurse-led inter-professional task force was formed to address possible solutions. Interventions A new electronic health record tab, note type, and preformatted template known as a SmartPhrase for goals-of-care conversations were created. Nurses and physicians were educated and encouraged to perform and document goals-of-care conversations. Results Before implementation of the initiative, the electronic health record lacked a consistent place to document goals-of-care conversations, and such conversations were not occurring until patients required intensive care. Moreover, the content of documentation of the conversations was inconsistent. Three years after implementation of the initiative, the goals-of-care conversation documentation tab was used for 75% of hospital deaths, and 67% of goals-of-care conversation notes included use of the SmartPhrase template. Conclusions Electronic health record platforms can be used to improve the frequency, consistency of documentation, and quality of goals-of-care conversations. A standardized process coupled with effective work tools can foster a culture of advance care planning.
Bsn Sandy L. Arneson , Mba Sara J. Tucker, Msn Marie Mercier, Md Jaspal Singh
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 25-31; doi:10.4037/ccn2020126

Abstract:
Background The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. Objective To describe how the skilled tele–intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. Methods We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele–intensive care unit nurses to work from home. Results Tele–intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele–intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. Conclusion Tele–intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.
PhD Marilyn Schallom , Dpt Heidi Tymkew, Bs Kara Vyers, PhD Donna Prentice, Msn Carrie Sona, Dpt Traci Norris, Cassandra Arroyo
Published: 1 August 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020632

Abstract:
Background Increasing mobility in the intensive care unit is an important part of the ABCDEF bundle. Objective To examine the impact of an interdisciplinary mobility protocol in 7 specialty intensive care units that previously implemented other bundle components. Methods A staggered quality improvement project using the American Association of Critical-Care Nurses mobility protocol was conducted. In phase 1, data were collected on patients with intensive care unit stays of 24 hours or more for 2 months before and 2 months after protocol implementation. In phase 2, data were collected on a random sample of 20% of patients with an intensive care unit stay of 3 days or more for 2 months before and 12 months after protocol implementation. Results The study population consisted of 1266 patients before and 1420 patients after implementation in phase 1 and 258 patients before and 1681 patients after implementation in phase 2. In phase 1, the mean (SD) mobility level increased in all intensive care units, from 1.45 (1.03) before to 1.64 (1.03) after implementation (P < .001). Mean (SD) ICU Mobility Scale scores increased on initial evaluation from 4.4 (2.8) to 5.0 (2.8) (P = .01) and at intensive care unit discharge from 6.4 (2.5) to 6.8 (2.3) (P = .04). Complications occurred in 0.2% of patients mobilized. In phase 2, 84% of patients had out-of-bed activity after implementation. The time to achieve mobility levels 2 to 4 decreased (P = .05). Intensive care unit length of stay decreased significantly in both phases. Conclusions Implementing the American Association of Critical-Care early mobility protocol in intensive care units with ABCDEF components in place can increase mobility levels, decrease length of stay, and decrease delirium with minimal complications.
Sara Knippa , Karen Simon
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 74-78; doi:10.4037/ccn2020335

Msn Linda Bell
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 89-90; doi:10.4037/ccn2020483

PhD Ayda Kebapçı, PhD Gül Dikeç , PhD Serpil Topçu
Published: 1 August 2020
Critical Care Nurse, Volume 40; doi:10.4037/ccn2020200

Abstract:
Background Intensive care units frequently use the Glasgow Coma Scale to objectively assess patients’ levels of consciousness. Interobserver reliability of Glasgow Coma Scale scores is critical in determining the degree of impairment. Objective To evaluate interobserver reliability of intensive care unit patients’ Glasgow Coma Scale scores. Methods This prospective observational study evaluated Glasgow Coma Scale scoring agreement among 21 intensive care unit nurses and 2 independent researchers who assessed 202 patients with neurosurgical or neurological diseases. Each assessment was completed independently and within 1 minute. Participants had no knowledge of the others’ assessments. Results Agreement between Glasgow Coma Scale component and sum scores recorded by the 2 researchers ranged from 89.5% to 95.9% (P = .001). Significant agreement among nurses and the 2 researchers was found for eye response (73.8%), motor response (75.0%), verbal response (68.1%), and sum scores (62.4%) (all P = .001). Significant agreement among nurses and the 2 researchers (55.2%) was also found for sum scores of patients with sum scores of 10 or less (P = .03). Conclusions Although the study showed near-perfect agreement between the 2 researchers’ Glasgow Coma Scale scores, agreement among nurses and the 2 researchers was moderate (not near perfect) for subcomponent and sum scores. Accurate Glasgow Coma Scale evaluation requires that intensive care unit nurses have adequate knowledge and skills. Educational strategies such as simulations or orientation practice with a preceptor nurse can help develop such skills.
Dnp Michelle M. Fernald, Nicholas A. Smyrnios , PhD Joan Vitello
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 66-72; doi:10.4037/ccn2020251

The publisher has not yet granted permission to display this abstract.
Denise M. Kresevic , Dnp Donna Miller, Msn Carole W. Fuseck, Msn Mia Wade, Bs Laura Whitney, Pt Mary Conley, Ms Joanne Rimac, Frank Jacono, Heather L O'Leary-Wilson, Christopher J. Burant, et al.
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 42-52; doi:10.4037/ccn2020137

The publisher has not yet granted permission to display this abstract.
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 92-92; doi:10.4037/ccn2020491

Bsn Stephanie Welling, Dnp Margaret Gettis , Bsn Sharon Jordan, Msn Cindy Henderson
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 85-88; doi:10.4037/ccn2020750

Msn Kayla Little , Msn Deborah Klein
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 79-82; doi:10.4037/ccn2020402

Bsn Charlene Nieten
Published: 1 August 2020
Critical Care Nurse, Volume 40, pp 12-12; doi:10.4037/ccn2020274

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