American Journal of Critical Care

Journal Information
ISSN / EISSN : 1062-3264 / 1937-710X
Current Publisher: AACN Publishing (10.4037)
Total articles ≅ 1,215
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Latest articles in this journal

, Mn Mary Zellinger
American Journal of Critical Care, Volume 30, pp 122-127; doi:10.4037/ajcc2021205

The publisher has not yet granted permission to display this abstract.
, PhD Karen L. Johnson, R. Curtis Bay, Michael Todd
American Journal of Critical Care, Volume 30, pp 113-120; doi:10.4037/ajcc2021775

Abstract:
Background As the role of a health care system’s influence on nurse burnout becomes better understood, an under-standing of the impact of a nurses’ work environment on burnout and well-being is also imperative. Objective To identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover. Methods A total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results. Results Among nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction. Conclusions Efforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.
PhD Mary Lou Sole, Shibu Yooseph, PhD Steven Talbert, PhD Bassam Abomoelak, Chirajyoti Deb, Bsn Kimberly Paige Rathbun, PhD Daleen Penoyer, Bsn Aurea Middleton, Mbbs Devendra Mehta
American Journal of Critical Care, Volume 30, pp 128-132; doi:10.4037/ajcc2021194

The publisher has not yet granted permission to display this abstract.
, Mph Courtney Porter, Rn Anne Sheehan, Bsn Stephanie Whitamore, Bsn Deborah White, Bsn Penny Winter Nuttall, Bsn Tyler Blanchard, Bsn Norah Davis, Bsn Jennifer Steadman, PhD Patricia Hickey
American Journal of Critical Care, Volume 30, pp 95-102; doi:10.4037/ajcc2021534

The publisher has not yet granted permission to display this abstract.
American Journal of Critical Care, Volume 30, pp 156-160; doi:10.4037/ajcc2021569

Brandee Pak
American Journal of Critical Care, Volume 30, pp 121-121; doi:10.4037/ajcc2021647

American Journal of Critical Care, Volume 30, pp 144-144; doi:10.4037/ajcc2021507

PhD Konstantinos Grigoriadis, Pt Ioannis Efstathiou, PhD Zacharias Dimitriadis, Georgia Konstantopoulou, Pt Anna Grigoriadou, Md Georgios Vasileiadis, Md Maria Micha, Md Iraklis Tsagaris, Md Apostolos Armaganidis
American Journal of Critical Care, Volume 30; doi:10.4037/ajcc2021248

Abstract:
Background The association between peripheral striated muscle strength and respiratory muscle strength has been confirmed in a number of disorders. However, this association is unknown in intensive care unit patients with tracheostomies. Objective To examine correlations between handgrip force, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) in intensive care unit patients with tracheostomies. Methods Twenty patients (7 women, 13 men) with tracheostomies, in the intensive care unit longer than 11 days, in stable condition, with functional limbs, and with Glasgow Coma Scale scores of 15 were recruited. Both MIP and MEP were measured with a membrane manometer; handgrip force was measured with a hydraulic hand dynamometer. Results Handgrip force was significantly correlated with MIP (r = 0.45, P = .04) and MEP (r = 0.78, P = .001). Handgrip force was significantly predicted by MIP and MEP when the effect of sex was controlled for (P < .05). However, when MIP and MEP were included as predictors in a regression model, MEP was the only significant predictor (R = 0.80, R2 = 0.63, adjusted R2 = 0.57). Conclusions Strength of the hand flexors and strength of the expiratory muscles (abdominal) were significantly correlated in intensive care unit patients. Handgrip strength appears to be an easy, fast way to evaluate expiratory muscle strength by using a simple handhold command without special equipment. A strong handhold may also correspond to strong expiratory muscles. ClinicalTrials.gov: NCT03457376
, Andrea (Annie) Johnson, Joanne McPeake, Hali Felt, Carla M. Sevin, Mark E. Mikkelsen, Theodore J. Iwashyna, Caroline Lassen-Greene, Kimberley J. Haines, Sachin Agarwal, et al.
American Journal of Critical Care, Volume 30, pp 150-154; doi:10.4037/ajcc2021675

, Theodore J. Iwashyna, LeAnne M. Boehm, Elizabeth Hibbert, Rita N. Bakhru, Anthony J. Bastin, Brad W. Butcher, Tammy L. Eaton, Wendy Harris, Aluko A. Hope, et al.
American Journal of Critical Care, Volume 30, pp 145-149; doi:10.4037/ajcc2021702

Abstract:
Background After critical illness, patients are often left with impairments in physical, social, emotional, and cognitive functioning. Peer support interventions have been implemented internationally to ameliorate these issues. Objective To explore what patients believed to be the key mechanisms of effectiveness of peer support programs implemented during critical care recovery. Methods In a secondary analysis of an international qualitative data set, 66 telephone interviews with patients were undertaken across 14 sites in Australia, the United Kingdom, and the United States to understand the effect of peer support during recovery from critical illness. Prevalent themes were documented with framework analysis. Results Most patients who had been involved in peer support programs reported benefit. Patients described 3 primary mechanisms: (1) sharing experiences, (2) care debriefing, and (3) altruism. Conclusion Peer support is a relatively simple intervention that could be implemented to support patients during recovery from critical illness. However, more research is required into how these programs can be implemented in a safe and sustainable way in clinical practice.
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