Abstract:
BACKGROUND:Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS:We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS:This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK. RESULTS:The response rate was 59% (91/154), and responding nurses were experienced, with a mean PICU experience of 10·5 years (SD 8·09). The three main reasons for stopping or withholding enteral feeds were: the volume of GRV obtained (67%), the appearance of this gastric aspirate (40%) and the overall clinical condition of the child (23%). Most nurses reported checking GRV primarily to determine 'feed tolerance' (97%) as well as confirming feeding tube position (94%). Nurses' perceived harms from high GRV were: the risk of pulmonary aspiration (44%), malabsorption of feeds (20%) and the risk of vomiting (19%). GRV was measured frequently in this PICU, with 58% measuring GRV before every feed, 27% measuring every 4 h and 17% measuring every 6 h. The majority of nurses (84%) stated they would be worried or very worried if they could not measure GRV routinely. CONCLUSIONS:PICU nurses' decision-making surrounding initiating and withholding enteral feeds and determining 'feed tolerance' remains heavily based on GRV. PICU nurses have significant fears around patient harm if they do not measure GRV routinely. RELEVANCE TO CLINICAL PRACTICE:This nursing practice is likely to be one of the factors that impair the delivery of enteral nutrition in critically ill children, and as such, its validity and usefulness needs to be challenged and studied in future research.
journal_name
Nurs Crit Carejournal_title
Nursing in critical careauthors
Tume LN,Latten L,Kenworthy Ldoi
10.1111/nicc.12304subject
Has Abstractpub_date
2017-09-01 00:00:00pages
293-297issue
5eissn
1362-1017issn
1478-5153journal_volume
22pub_type
杂志文章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 imp...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2008.00290.x
更新日期:2008-09-01 00:00:00
abstract::The Cardiothoracic Centre Liverpool faced an acute nursing recruitment problem, which is accentuated in the specialist area of intensive care. To ensure that activity through the 20-bedded unit remains broadly in line with contracted levels, a number of initiatives were implemented to help maximise the financial and n...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Numbers of patients undergoing coronary angiography and angioplasty procedures have increased in England due to targets within the National Service Framework for Coronary Heart Disease. Little evidence is available regarding optimal bed-rest duration for patients post-femoral arterial sheath removal following these pr...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1362-1017.2005.00121.x
更新日期:2005-07-01 00:00:00
abstract:AIM:The aim of this paper is to reflect upon the management interventions of non-invasive ventilation (NIV) and diuretic therapy that were implemented for a patient admitted to an intensive care unit (ICU) with acute cardiogenic pulmonary oedema. BACKGROUND:Acute pulmonary oedema is a serious and life-threatening comp...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2011.00410.x
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Nurse-led (protocol-directed) ventilation weaning (NLVW) is utilized in adult intensive care and has shown to be safe and reduce ventilation times. Our paediatric intensive care unit (PICU) implemented a NLVW (and extubation) protocol in 2004, yet it was observed that some NLVW-trained nurses were not undert...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12055
更新日期:2014-11-01 00:00:00
abstract::The purpose of this study was to investigate the needs of relatives of patients on a cardiothoracic ICU, as perceived by themselves. An exploratory research design was used--a modified replication of a study carried out by Molter (1979) in the USA. Data were collected from a sample of convenience consisting of 14 rela...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1996-11-01 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:AIM AND BACKGROUND:Shift work, and especially night work, is associated with poor health. Nurses, work a variety of work schedules including night work. So far, few studies have specifically investigated sleep and health among intensive care nurses. DESIGN AND METHODS:We investigated sleep, sleepiness, fatigue, subjec...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2012.00504.x
更新日期:2012-07-01 00:00:00
abstract:AIM:the aim of this pilot study was to describe family members' satisfaction with the care provided in a Swedish intensive care unit (ICU) based on the following needs: assurance, information, proximity, support, and comfort, which are all included in the Critical Care Family Satisfaction Survey (CCFSS). BACKGROUND:kn...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2010.00388.x
更新日期:2011-01-01 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::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: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: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::A new high dependency unit is established for postoperative cardiac patients, from design to implementation Facilities were incorporated within financial, time and space constraints. Layout and use of space was determined for optimal working conditions and care of the patient. The choice of equipment was a vital part ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1996-07-01 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: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::The nature of the supervising relationship is explored in relation to an intensive care unit. The relationship between clinical supervision and individual performance review is discussed. Preparation and support for the supervisor's role is identified. Peer, group and external supervision arrangements are explored. ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 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: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
abstract:BACKGROUND:The aim of this study was to establish a standardized approach to the initial care of patients with diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS). DKA and HHS are metabolic emergencies. Effective and efficient management is the responsibility of the multidisciplinary team. The ad...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2007.00259.x
更新日期:2008-01-01 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:BACKGROUND:To avoid the possible complications of prolonged intubation, it is necessary and advisable to attempt weaning from the tracheostomy tube at the earliest opportunity. However, while weaning protocols have proven successful in reducing ventilation time of critical care patients, there is little evidence of the...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2008.00325.x
更新日期:2009-05-01 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::Quality of life is a dynamic, multi-dimensional concept, the essence of which is its individuality. In this study quality of life six to 12 months after intensive care was not significantly lower than quality of life prior to intensive care, assessed retrospectively. Family, leisure activities and people were seen as ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::This review examines, by means of a literature search, the needs of parents who have a critically ill child on adult intensive therapy units. These needs are compared with the needs of relatives of adult patients in ITUs. Whether nurses trained in adult nursing have the necessary skills, knowledge and attitudes to car...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1997-05-01 00:00:00
abstract:AIM:The aim of this reflective account is to provide a view of the intensive care unit (ICU) relative's experiences of supporting and being supported in the ICU. BACKGROUND:Understanding the relatives' experiences of ICU is important especially because a recent work has identified the potential for this group to devel...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12145
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:One of the most important bottlenecks in the organ donation process worldwide is the high family refusal rate. AIMS AND OBJECTIVES:The main aim of this study was to examine whether family guidance by trained donation practitioners increased the family consent rate for organ donation. DESIGN:This was a pros...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12462
更新日期:2020-09-01 00:00:00
abstract::The transcripts of two hand-overs in a critical care unit are ethnomethodologically examined. Specimens of nurses' practices in accomplishing forms of social order are identified. The hand-overs show how nurses transfer all sorts of taken-for-granted scientific, technological, medical, nursing, psychological and socio...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::A randomized controlled trial was conducted to compare the effectiveness of airflow- and waterflow-cooling blankets for febrile patients in intensive care unit. More patients in the airflow than in the waterflow-cooling blanket group reached the desired temperature of <38 degrees C at the end of 8h (94.1 versus 60.0%,...
journal_title:Nursing in critical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1362-1017.2005.00133.x
更新日期:2005-09-01 00:00:00
abstract::The care bundle is a new concept in critical care, which is currently being promoted by the National Health Service Modernisation Agency for Critical Care. Care bundles originated in North America and are described best as groups of evidence-based practice interventions. The theory behind care bundles is that when sev...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1362-1017.2003.00039.x
更新日期:2003-11-01 00:00:00