Abstract:
:Background Vanderbilt University Hospital's original rapid response team included a critical care charge nurse and a respiratory therapist. A frequently identified barrier to care was the time delay between arrival of the rapid response team and arrival of the primary health care team. Objective To assess the impact of adding an acute care nurse practitioner to the rapid response team. Methods Acute care nurse practitioners were added to surgical and medical rapid response teams in January 2011 to diagnose and order treatments on rapid response calls. Results In 2011, the new teams responded to 898 calls, averaging 31.8 minutes per call. The most frequent diagnoses were respiratory distress (18%), postoperative pain (13%), hypotension (12%), and tachyarrhythmia (10%). The teams facilitated 360 transfers to intensive care and provided 3056 diagnostic and therapeutic interventions. Communication with the primary team was documented on 97% of the calls. Opportunities for process improvement were identified on 18% of the calls. After implementation, charge nurses were surveyed, with 96% expressing high satisfaction associated with enhanced service and quality. Conclusions Teams led by nurse practitioners provide diagnostic expertise and treatment, facilitation of transfers, team communication, and education.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Kapu AN,Wheeler AP,Lee Bdoi
10.4037/ccn2014847subject
Has Abstractpub_date
2014-02-01 00:00:00pages
51-9issue
1eissn
0279-5442issn
1940-8250pii
34/1/51journal_volume
34pub_type
杂志文章abstract::Scientists are only beginning to fully understand the purpose of sleep and its underlying mechanisms. Lack of sleep is associated with many diseases, including infection, and with increased mortality. Lack of proper sleep is an important problem in the intensive care unit, and interventions have been designed to impro...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2012689
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Preparation of drug solutions used with electronic syringe infusion pumps plays a crucial role in the delivery of an accurate drug concentration. Is there a correlation between drug concentrations during syringe pump infusion and preparation protocols? METHOD:Norepinephrine, insulin, and sufentanil were prep...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2016756
更新日期:2016-08-01 00:00:00
abstract::Everyone experiences stress. That stress may be related to work (internal), community (external), or family; it may be cumulative or related to a particular critical incident. The cost related to treating acute stress is staggering, both to individuals and to organizations. Critical care nurses are well educated in th...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:2003-02-01 00:00:00
abstract::This 6-month retrospective study provided our medical center with a profile of the population of patients readmitted within 31 days of discharge. We found that chronic illness and age greater than 65 years were the high risk factors related to patient readmissions. These 2 attributes are common in critical care patien...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::Errors related to health care devices are not well understood. Nurses in intensive care and progressive care environments can benefit from understanding manufacturer-related error and device-use error, the principles of human factors engineering, and the steps that can be taken to reduce risk of errors related to heal...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2012925
更新日期:2012-08-01 00:00:00
abstract::Clinical practice must be based on evidence. When evidence suggests that a certain practice may be ineffective or even harmful, that practice should be discontinued. The Choosing Wisely campaign, an initiative of the ABIM (American Board of Internal Medicine) Foundation, is intended to bring attention to tradition-bas...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019534
更新日期:2019-12-01 00:00:00
abstract::Malnutrition is common in critically ill patients and is associated with poor outcomes for patients and increased health care spending. Enteral nutrition is the method of choice for nutrition delivery. Enteral nutrition delivery practices vary widely, and underfeeding is widespread in critical care. Interruptions in e...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2014243
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. OBJECTIVES:To ex...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020251
更新日期:2020-08-01 00:00:00
abstract::Clostridia are organisms which, in the right environment, can cause a rapidly spreading, fulminant myonecrosis. Early diagnosis and a combined management program are clearly paramount to a successful outcome. Knowledge of this disease and ongoing meticulous assessment are the tools that a nurse must use when dealing w...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans. EVI...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2020799
更新日期:2020-12-01 00:00:00
abstract::Music therapy is an effective intervention for critically ill patients for such purposes as anxiety reduction and stress management. The therapy is readily accepted by patients and is an intervention patients thoroughly enjoy. The MAIT is one resource that nurses caring for critically ill patients can use to implement...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::The congenital heart defect of HLHS is nearly uniformly fatal without intervention. As surgeons gain experience with the techniques the success rates are improving; more infants with HLHS are being offered hope for survival and quality of life. The critical nature of this diagnosis, the relatively new treatment option...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::Status epilepticus is a medical emergency that requires rapid diagnosis and treatment. Nonconvulsive status epilepticus is frequently underdiagnosed and therefore undertreated, which can lead to permanent neuronal damage resulting in disability or death. Despite the frequent occurrence and morbidity associated with st...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2016892
更新日期:2016-04-01 00:00:00
abstract::IABP timing challenges the nurse not only with a waveform analysis but also an understanding of complex physiologic concepts crucial to patient management. Optimizing timing through assessment of the five points of the IABP waveform permits the critical care nurse to increase the hemodynamic benefits of IABP therapy, ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Children admitted to the ICU with status asthmaticus require continuous nursing assessment of respiratory status and monitoring of the response to therapy. Nurses must be aware of the progression of respiratory distress and of the expected response to treatment and the side effects that can occur with each therapy. By...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1998-02-01 00:00:00
abstract::A patient with a new tracheostomy will face threatening changes upon discharge from hospital support. Nurses, particularly in the critical care unit, frequently and closely support a patient and family through new and often difficult situations during hospitalization. The patient leaving the hospital with a new trache...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::The patient in septic shock who develops vascular insufficiency secondary to purpura fulminans is a challenge to the healthcare team. Initial management is directed toward reversing the disease process by administering antibiotics immediately and initiating life-support measures. Emergency measures include optimizing ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. OBJECTIVES:To establish the prevalence of compassion satisfa...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2015392
更新日期:2015-08-01 00:00:00
abstract::During the springs and summers of 2009 to 2012, military and nongovernment organization nurses served side by side on hospital ships USNS Comfort and USNS Mercy to offer free humanitarian clinical services to developing nations in Central and South America and Southeast Asia. Translators were engaged to facilitate com...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2013584
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Hospital-acquired pressure ulcers are serious clinical complications that can lead to increased length of stay, pain, infection, and, potentially, death. The surgical progressive care unit at Sharp Grossmont Hospital, San Diego, California, developed the multidisciplinary Healthy Skin Project to decrease the...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2013290
更新日期:2013-06-01 00:00:00
abstract::Hematologic assessment is part of the routine assessment of acute and critically ill patients. Nurses must be aware of the reference ranges for complete blood cell counts and common coagulation profiles. A case study is presented of an elderly patient, taking warfarin for atrial fibrillation, who falls and sustains a ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2012596
更新日期:2012-10-01 00:00:00
abstract::The most common cause of death due to the H1N1 subtype of influenza A virus (swine flu) in the 2009 to 2010 epidemic was severe acute respiratory failure that persisted despite advanced mechanical ventilation strategies. Extracorporeal membrane oxygenation (ECMO) was used as a salvage therapy for patients refractory t...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011186
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Delirium is a common neuropsychiatric diagnosis in intensive care units and often leads to extended hospital stays and an increased rate of complications. Delirium can be classified as hypoactive, hyperactive, or mixed. Hyperactive delirium is often accompanied by agitation, which is a predictive factor for ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020697
更新日期:2020-04-01 00:00:00
abstract::Because of the potential severity of the associated complications, nurses have an essential role in the care of patients with HAT. Bedside nurses have the opportunity to report information that may indicate a change in a patient's condition after administration of heparin. This information could lead to diagnosis of h...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Sjo2 monitoring has several important limitations, such as catheter reliability, sampling error, and lack of regional specificity. However, combining Sjo2 monitoring with other available technologies can facilitate optimization of treatment and improve outcomes in patients with severe brain injuries. ...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:2001-12-01 00:00:00
abstract:TOPIC:Acute respiratory distress syndrome is a complex respiratory disease that can be induced by influenza virus infection. Critical care providers are uniquely positioned to manage this pathological progression in adult patients through evidence-based practice. CLINICAL RELEVANCE:Influenza and subsequent acute respi...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020746
更新日期:2020-10-01 00:00:00
abstract::Leadless pacemakers will most likely be the future of cardiac pacing. Leadless pacing employs a single-chamber system to pace only the right ventricle and is fully self-contained, which eliminates the need for leads. These systems, implanted by using a transcatheter sheath, are indicated for patients who need right ve...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2017453
更新日期:2017-04-01 00:00:00
abstract::Family engagement in rounds has been recommended to improve communication, but its impact on patient outcomes is unknown. At the authors' institution, nurses encouraged family presence at rounds as part of a larger project to enhance communication during rounding. In the case reported here, family engagement resulted ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019647
更新日期:2019-10-01 00:00:00
abstract::Designed for independent study, this module explores some of the common, but often missed, pupillary abnormalities and eye movement irregularities. Part 3 concludes the module and provides the posttest and answer keys for the posttest and the three review exercises in Part 2. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::Provision of nutritional support to critically ill patients can be challenging. Critical care nurses must be aware of which patients require specific nutritional support, when to initiate nutritional support, and by which route to provide nutritional support. Consultation with a dietitian or nutritional support servic...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:2001-08-01 00:00:00