Abstract:
BACKGROUND:Ventilator-associated pneumonia (VAP) has been identified as the most common nosocomial infection in intensive care units (ICUs) with associated health and financial costs. To date, more research has been carried out in adult ICUs than in paediatric units, thus prompting a review and investigation of the implications for paediatric practice. AIMS:To identify relevant paediatric literature surrounding VAP and use this in association with research carried out in the adult environment to establish the implications of VAP and possible management strategies. SEARCH STRATEGIES:A literature search was undertaken using databases within DialogDatastar to identify the extent to which VAP has been researched in both paediatric and adult centres. This information was used to try and gain a clearer concept of the impact and management of VAP in the paediatric setting. Key words and combinations included VAP, intensive care, paediatric, antibiotics, positioning, suction, economics, management, nosocomial and morbidity and mortality. RESULTS OF ANALYSIS: Despite the documented significance of VAP in terms of its financial and health implications, discrepancies and inconsistencies exist surrounding the identification and treatment of VAP. This is reflected in paediatric centres by a dearth of literature on the subject and the lack of a national standard as to the management and prevention of VAP. Inappropriate management of VAP plays an important role in the development and spread of multiresistant bacteria within hospitals. CONCLUSIONS:While inadequate paediatric research exists, extrapolating from adult research suggests that the financial and health costs of VAP are substantial and can be reduced by introducing simple low-cost measures. Such measures include improving education surrounding VAP and its implications and making small changes in practice to improve and maintain oral hygiene standards. IMPLICATIONS:With a growing cohort of paediatric patients requiring short- and long-term ventilation, progress must be made in identifying the extent and impact of VAP in paediatric ICUs and among the community ventilated patients. This will require changes in practice and attitudes towards VAP for which an appropriate knowledge base would need to be established using audit and research. These issues are particularly relevant in the current environment given the links with multiresistant strains of bacteria within hospitals and the community.
journal_name
Nurs Crit Carejournal_title
Nursing in critical careauthors
Turton Pdoi
10.1111/j.1478-5153.2008.00290.xsubject
Has Abstractpub_date
2008-09-01 00:00:00pages
241-8issue
5eissn
1362-1017issn
1478-5153pii
NCR290journal_volume
13pub_type
杂志文章,评审abstract::The nature of informed consent is bound within legal and moral duties. An analysis of informed consent includes the elements of understanding, disclosure, competence, voluntariness and authorisation, all of which can be affected by a variety of factors. Nurses can make a unique contribution to informed consent situati...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Critical care consensus groups recommend providing bereavement support; however, little is known about what cardiac intensive care patients' families would find useful and beneficial in their grieving process. AIM AND OBJECTIVES:To describe cardiac intensive care unit (ICU) patients' families' opinions on s...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12439
更新日期:2019-07-01 00:00:00
abstract::Identification and evaluation of pain in critical care patients may be difficult because of communication problems. Moreover, at present there are very few nursing studies that examine the attitudes of critical care nurses towards the assessment of patients' pain. This study was designed to determine the approach of c...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1046/j.1478-5153.2003.00006.x
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Changes in patient profile, and in the health care environment, altering socioeconomic conditions and advances in science and information technology challenge the nursing profession, in particular intensive care nursing. All these changes will undoubtedly affect the way we will practice in the (near) future....
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2010.00409.x
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Critically ill patients are at high risk of developing pressure ulcers resulting in serious untoward patient and health care system outcomes. Pressure ulcer prevention is therefore an important patient safety priority and establishing a structured approach to pressure ulcer risk assessment to identify pati...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12173
更新日期:2015-11-01 00:00:00
abstract:AIM:This article is a literature view of student nurses' experiences of critical care and the value of their experience to the nursing community. To explore the literature in relation to the value of critical care as a learning environment, the experiences and perceptions of student nurses in critical care and the impa...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12053
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Brain death is the total loss of all brain and brain stem functions, and its diagnosis is often confirmed by an apnoea test, which relies on disconnecting the patient from the ventilator. Auto-triggering or auto-cycling is defined as a ventilator being triggered in the absence of patient effort, intrinsic re...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12029
更新日期:2013-09-01 00:00:00
abstract::A brief summary of the reasons why a pregnant woman may require intensive care is outlined. The clinical relevance of the physiological changes occurring in pregnancy is discussed. The haemodynamic differences and their relevance to monitoring are highlighted. ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract:INTRODUCTION:Delirium in the intensive care unit (ICU) is associated with increased mortality, longer hospital stays, and increased odds of institutionalization after discharge. Delirium is a significant complication that occurs frequently in ICU yet lacks a standardized treatment protocol. Because of the limited effec...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12594
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:The intensive care unit (ICU) is not only a place to recover from injuries incurred during accidents and from serious illness. For many patients, it is also a place where they might die. Nursing care does not stop when a patient dies; rather, it continues with the care of the deceased and with family support...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2012.00525.x
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Sustaining high-quality, critical care practice is challenging because of current limits to financial, environmental, and social resources. The National Health Service in England intends to be more sustainable, although there is minimal research into what sustainability means to people working in critical ca...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12493
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Establishing and sustaining enteral feeding in critically ill children is challenging and has met with many problems. AIMS AND OBJECTIVES:The aim of this study was to investigate (a) how actual calorie intake compared with estimated caloric requirements and (b) whether feeding guideline adherence resulted i...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2010.00420.x
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:chronic critical illness (CCI) is a complex syndrome with a high risk of dying in hospital. Intensive care unit nurses are well-positioned to lead conversations integrating palliative and end-of-life care, yet have reported limited involvement. AIM:To generate further understanding of nurses' experiences of...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12154
更新日期:2017-07-01 00:00:00
abstract:AIMS AND OBJECTIVES:To determine the effectiveness of an oral health care program for preventing ventilator-associated pneumonia (VAP). BACKGROUND:Research has shown a significant correlation between oral bacteria and VAP, indicating that an oral health care program plays a very important role in VAP prevention. DESI...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12037
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Co-administration of multiple intravenous (IV) medicines down the same lumen of an IV catheter is often necessary in the intensive care unit (ICU) while ensuring medicine compatibility. AIMS AND OBJECTIVES:This study explores ICU nurses' views on the everyday practice surrounding co-administration of multip...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12497
更新日期:2020-05-01 00:00:00
abstract::Allowing children to visit adult intensive care units (ICUs) has been an area of controversy. There is a lack of recent research dealing with visits by children and physicians' views and whether differences exist between the views held by nurses and physicians regarding visits by children. The aim of this study was to...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2007.00209.x
更新日期:2007-03-01 00:00:00
abstract::Factors influential in the occurrence and timing of heart attacks are summarised. Patients' and partners' experiences of heart attack are reviewed. Evidence is presented for the efficacy and effectiveness of cardiac rehabilitation programmes. A three elemental model for cardiac rehabilitation is introduced. Key recomm...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00
abstract::This descriptive study explores the effects on nurses of treatment-withdrawal decisions made in ten ICUs and two SCBUs in Southern England. The study focused on the decision-making process, the reasons given in support of a decision to withdraw, the actions taken subsequently and the nurses' roles throughout the proce...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::Recent interest in continuity of care has meant that the illness trajectory experienced by intensive care unit (ICU) patients has received more attention. Using continuous quality improvement as a framework, this paper describes information obtained during a 3-year period relating to ICU patients' long-term experience...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1046/j.1478-5153.2003.00020.x
更新日期:2003-07-01 00:00:00
abstract:AIMS:This study was carried out to determine the effects of open and closed suction systems on haemodynamic parameters of the patients who underwent open heart surgery. BACKGROUND:Nurses should work meticulously and carefully as many complications may develop if the method used to perform suctioning is not appropriate...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12094
更新日期:2015-05-01 00:00:00
abstract::This paper describes the introduction and subsequent evaluation of a 12-h shift system in a large ITU in the northeast of UK. To date, only a small number of studies has evaluated nurses working the 12-h shifts in critical care areas. To evaluate the level of staff satisfaction, data were collected by means of a quest...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1046/j.1478-5153.2003.00016.x
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Continuous positive airway pressure (CPAP) is a common treatment modality for acute respiratory failure (ARF) in critical care. Historically, a tight-fitting mask is used to provide respiratory support. This however is not without risks to the patient. The helmet CPAP is a new product that provides the same ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2011.00478.x
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:International and national standards for ICUs have been developed to ensure patient safety and provide effective and efficient service in these units. However, global economic crises along with shortages in professional health care staff affect the ability of ICUs to meet and maintain these standards. AIMS ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12066
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND AND AIMS:A trend towards lighter sedation has been evident in many intensive care units (ICUs). The aims of the survey were to describe sedation practice in European ICUs and to compare sedation practice in Nordic and non-Nordic countries. DESIGN AND METHODS:A cross-sectional survey of ICU nurses attending ...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/nicc.12003
更新日期:2013-07-01 00:00:00
abstract:AIMS AND OBJECTIVES:This paper aims to undertake a review on the current evidence available on therapeutic hypothermia (TH) following cardiac arrest. BACKGROUND:The use of TH has been associated as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. Within th...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2008.00267.x
更新日期:2008-05-01 00:00:00
abstract::It has been recommended that nursing staff who are new to paediatric intensive care should be offered an orientation programme There is no guidance currently available to influence the content or duration of such a programme on a national level A multi-centre research study was carried out to identify the existing pro...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:As many delirium manifestations (e.g., hallucinations or fears) are linked to patients' experiences and personality traits, it is suggested that interventions should be tailored to optimize its management. The inclusion of family members, as part of an intervention, has recently emerged as a solution to deve...
journal_title:Nursing in critical care
pub_type: 杂志文章,随机对照试验
doi:10.1111/nicc.12288
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have d...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/nicc.12273
更新日期:2017-05-01 00:00:00
abstract:AIMS AND OBJECTIVES:To critically review evidence on the effects of psychological support during intensive care unit (ICU) treatment on adult ICU patients' psychological and physiological outcomes. Evidence from intervention studies on imagery and relaxation has been included, as well. BACKGROUND:Stress and negative e...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2009.00383.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12348
更新日期:2019-01-01 00:00:00