Abstract：
:To sustain optimal pain-relieving care for acutely and critically ill patients, organizations must have systems in place to support evidence-based interventions, facilitate expert practice in the area of pain management, and encourage ongoing communication among patients, families, and providers. The key to success may be to create an organizational culture that is supportive of all practitioners to use effectively the many therapeutic options available to manage pain. Although redesigning structures to support pain management care can be done with relative ease, altering the culture of the practice environment and the behavior of care providers may prove more challenging. Cultural changes occur slowly, but as the practice changes do take hold, so do the results. The steps to change an organizational culture around pain management include understanding the existing system and involving key formal and informal leaders. Most experts recommend not attacking the existing culture head-on but living the culture you are trying to create and understanding that the transformation is not going to take place overnight. The use of evidence-based collaborative practice and quality improvement models may be a key to improving the practice environment for pain management. Evidenced-based pain management practice combined with an organizational commitment to optimal pain management for all patients helps to create and sustain the environment to effect the change.
journal_name
Crit Care Nurs Clin North Amjournal_title
Critical care nursing clinics of North Americaauthors
Wild LRsubject
Has Abstractpub_date
2001-06-01 00:00:00pages
297-309issue
2eissn
0899-5885issn
1558-3481journal_volume
13pub_type
杂志文章,评审abstract：:Patients who acquire sepsis, ARDS, ARF, or MSOF subsequent to multiple trauma have a high mortality rate. The pathophysiology of these complications is complex and is thought to involve ischemia, the generation of mediators, alterations in regional perfusion, and cellular oxygen use. Because of the critical nature of ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:Solid organ transplantation has become a well-established standard of care for end-organ failure, and the nurse in the intensive care unit may be exposed to these patients at any stage in the care continuum of pretransplant or posttransplant care. Knowledge of risk factors, timing, and treatments for infections may he...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2016.09.002
更新日期：2017-03-01 00:00:00
abstract：:Heart failure is a progressive condition that continues to increase in both incidence and prevalence despite pharmacologic treatment. The high rate of morbidity and mortality associated with advanced heart failure has led to exploration of additional treatments, which include surgical interventions to improve outcomes...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2019.04.003
更新日期：2019-09-01 00:00:00
abstract：:Coronary artery bypass graft (CABG) reoperation carries an increased risk for mortality and other complications when compared with the risks and complications associated with the initial operative procedure. The purpose of this article is to describe the incidence of repeat CABG surgical procedures, risk factors, asso...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2007.07.008
更新日期：2007-12-01 00:00:00
abstract：:Sedation is a necessary component of care for the critically ill. Oversedation, however, is associated with immediate complications and long-term problems, termed post-intensive care unit syndrome. It also contributes to unnecessary costs of care. This article describes the physical, functional, psychiatric, and cogni...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2016.02.003
更新日期：2016-06-01 00:00:00
abstract：:Organ transplantation has become a viable treatment option for end-stage organ disease. With the advent of immunosuppressive medication and vastly improved preservation practices and surgical techniques, it is now possible to transplant an increasing number and variety of organs. In their role as direct care givers to...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-09-01 00:00:00
abstract：:Inflammation is a physiologic response to irritants, injury, and infection. Inflammatory dysregulation is believed to contribute to mortality and morbidity in illnesses common to critical care units, such as burns, trauma, sepsis, and cardiovascular disease. This article reviews the approaches used to investigate the ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2008.01.007
更新日期：2008-06-01 00:00:00
abstract：:Mass casualty incidents are events where the number of injured patients exceeds the resources of the health care institution to the degree that care may not be available or may be limited for a portion of the casualties. Mass casualty incidents are increasing in frequency throughout the United States. Managing mass ca...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2015.02.008
更新日期：2015-06-01 00:00:00
abstract：:Critical care nurses work in challenging environments that are often sterile, impersonal, noisy, and frightening to patients and their families. Nurses act as liaisons between medical professionals and patients and their families in multiple specialty intensive care units. Critical care nursing practice, guided by the...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2019.07.009
更新日期：2019-12-01 00:00:00
abstract：:Endocrine disorders can affect the cardiovascular system in many ways. Patients admitted to an intensive care unit with primary cardiovascular diagnoses may have underlying endocrine dysfunction that can cause or adversely influence cardiovascular problems. Early diagnosis and treatment of endocrine disease can often ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 00:00:00
abstract：:Ethically challenging situations are an increasing phenomenon in the nurse's environment, and literature on the subject is growing. Morally challenging experiences common in the critical care environment include end-of-life situations, barriers to providing the best care possible, and lack of organizational resources....
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2020.05.002
更新日期：2020-09-01 00:00:00
abstract：:The purpose of this article is to present an option for a model of care that allows small rural hospitals to be able to provide specialty physicians for critical care patient needs in lieu of on-site critical care physician coverage. A real-time, 2-way audio and video remote presence robot is used to bring a specialis...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2014.08.006
更新日期：2014-12-01 00:00:00
abstract：:Hyperglycemia and diabetes place hospitalized patients at greater risk for serious complications such as infections, diabetic ketoacidosis, hyperosmolar hyperglycemic state, dehydration, electrolyte imbalances, greater antibiotic use, and lengthened hospitalization. Identification and proper treatment of hyperglycemia...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2012.11.001
更新日期：2013-03-01 00:00:00
abstract：:Many older patients in critical care settings have significant arterial disease, so the assessment of peripheral circulation may be important in their management. A great deal of information can be gained through the physical examination, which can be supplemented by the use of the Doppler velocity detector. This devi...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-09-01 00:00:00
abstract：:The nutritional needs of the bum-injured patient are exaggerated and change constantly with the patient's stage of convalescence. Nurses working closely with other members of the health care team, specifically the nutritional specialist, can positively affect the patient's survival by optimizing the nutritional assess...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2003.09.004
更新日期：2004-03-01 00:00:00
abstract：:The greatest threats to America's public health include accidental importation of deadly diseases by international travelers and the release of biologic weapons by our adversaries. The greatest failure is unpreparedness because international travel and dispersion of biologic agents by our enemies are inevitable. An ef...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0899-5885(02)00079-5
更新日期：2003-06-01 00:00:00
abstract：:Sepsis in the elderly occurs frequently and carries a high rate of mortality. With increasing numbers of elderly patients being cared for in critical care units, the critical care nurse must have a thorough understanding of the unique aspects of this patient population. Nurses must be prepared to deliver expert nursin...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-03-01 00:00:00
abstract：:Transplantation of skin has been recognized as a method to increase the survival of patients who have suffered a massive skin deficit. Until about 30 years ago, a patient who suffered a 60% BSA skin deficit usually died from the effects of overwhelming sepsis. Great strides have since been made in the techniques and t...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Knowledge of NO and its role in the human body currently is limited. Further scientific research involving this unique molecule will expand its clinical usefulness. It is an exciting era in research,involving numerous body processes and systems. The initial work on pulmonary vascular response in newborns who have PPHN...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2004.02.004
更新日期：2004-06-01 00:00:00
abstract：:Throughout the years, bum care treatment in the United States has made major strides in the ability to save the lives of those once rendered helpless as a result of an extensive bum injury. Bum care professionals are able to assist these individuals to live as normal a life as possible as they heal from one of the mos...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2003.10.003
更新日期：2004-03-01 00:00:00
abstract：:Arterial cannulation, while common in critical care, is a procedure with attendant risks of complications. Anecdotal data from the American Association of Critical Care Nurses' Thunder Project provided evidence that catheters, insertion sites, and monitoring systems continue to be sources of complications. The problem...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：:Transition from hospital to home is a vulnerable period for older adults with multiple chronic conditions. A pilot of the Transitional Care Model at a community hospital reduced readmission rates for patients with heart failure by 48%. This article shares the experience of a large metropolitan health care system in ex...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2014.08.009
更新日期：2014-12-01 00:00:00
abstract：:In most inpatient settings, the complexity of care required by individual patients coupled with the wide range of services provided within a single institution mean patients are routinely cared for in highly specialized units. Service lines, such as surgical services; intensive care; emergency services; and maternity,...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2010.03.008
更新日期：2010-06-01 00:00:00
abstract：:Septic shock is the leading cause of death in critical care units. New research in the management of septic shock is focused on the use of immune-based therapy such as antiendotoxin monoclonal antibodies. The object of this therapy is to neutralize endotoxin and prevent the progression of the pathophysiologic events o...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：:The crisis of near-drowning for the family and friends of the victim has been well documented. The emergency services personnel also are at risk for crisis as a result of the unique stressors they face because of their involvement with these critically injured young children. Mitchell's model for CISD is a pro-active ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Because of their diverse education, experience, and practice settings, nurses are uniquely qualified to be first receivers, care givers, and leaders in any large-scale public health emergency. Many nurses, however, continue to feel inadequately prepared to function effectively in these types of situations. Great strid...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2007.10.008
更新日期：2008-03-01 00:00:00
abstract：:This article presents an overview of the focused subjective and objective assessment of the older adult for the critical care nurse. Discussion includes the distinguishing features inherent to older adults, and relevant evidence-based screening tools that the nurse can use in assessing the critically ill older adult. ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2013.09.006
更新日期：2014-03-01 00:00:00
abstract：:Traumatic cerebral vasospasm is a relatively frequent occurrence after an individual suffers a severe head injury, and therefore poses a real threat for these individuals. Although vasospasm is a physiologic defense response, it can cause a decrease in CBF, ischemia, infarction, and death. A review of the literature h...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：:Nutrition in acute spinal cord injury is complicated. Not every aspect of nutrition as it relates to the acutely injured spinal cord patient is known. The stress response to injury, fever, infection, sepsis, and surgery alter nutritional needs, as does the spinal cord injury itself. The sequelae of spinal cord injury,...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Clinician involvement in critical care research will be essential if we are ever to achieve optimal patient outcomes. Educators and unit leadership play a pivotal role in facilitating, mentoring, and coaching clinicians both conduct research on important issues or problems in critical care and to ensure that practice ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2001-03-01 00:00:00
