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-based practices, or "sacred cows," which lack evidence to support their ongoing use. The complex process of discontinuing or reducing the use of tradition-based practices is known as "de-implementation." Recognizing the importance of de-implementation is necessary to fully understand evidence-based practice. This article explores the de-implementation process, examining its barriers and facilitators. Three critical care exemplars of tradition-based practices are presented and examined through the lens of de-implementation. Barriers and facilitators related to de-implementing these tradition-based practices are described, with an emphasis on the roles of various stakeholders and the need to overcome cognitive dissonance and psychological bias.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Upvall MJ,Bourgault AM,Pigon C,Swartzman CAdoi
10.4037/ccn2019534subject
Has Abstractpub_date
2019-12-01 00:00:00pages
64-69issue
6eissn
0279-5442issn
1940-8250pii
30586journal_volume
39pub_type
杂志文章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：: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：:Critically ill patients require vigilant monitoring of tissue oxygenation, particularly oxygenation of the gut mucosa, because of the mucosa's fragile blood supply. With the advent of gastric tonometry, splanchnic tissue oxygenation can be measured in a minimally invasive and cost-effective manner. Requiring only a ga...
journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：1996-12-01 00:00:00
abstract：:Cardiac output and cardiac index values are traditionally used by critical care nurses as indicators of myocardial contractility. Due to the incidence of compensatory tachycardia in many critically ill patients, however, the value of LVSWI as an indicator of myocardial contractility is enhanced, because the formula fo...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1995-02-01 00:00:00
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 o...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2014847
更新日期：2014-02-01 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：:A 9-member educational task force and a 4-member panel of experts was used to establish the validity of the PEDS-BKAT, which was modified from version 4 of the adult BKAT for critical care nursing. A sample of 105 pediatric ICU nurses from 6 settings took the PEDS-BKAT. Test results include a mean score of 78.9 points...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1998-06-01 00:00:00
abstract：:The most common measurements of pulmonary hypertension include systolic and mean pulmonary artery pressures, PVR, and transpulmonary gradient. Pulmonary artery pressures greater than 50 mm Hg, PVR greater than 6 Woods units, and transpulmonary gradient greater than 15 mm Hg that are unresponsive to optimal vasodilator...
journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：
更新日期：2000-04-01 00:00:00
abstract：:Staff nurse preceptors are integral members of effective critical care orientation programs. Much of the success of the orientation experience and orientee satisfaction depends on them. A critical care preceptor workshop containing a review of the orientation program and the application of educational principles in cr...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1993-02-01 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：: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：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：: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：:IL-2 is a biotherapeutic drug and a biological response modifier. This drug has not been approved by the Food and Drug Administration for general use but continues to undergo clinical trials. Candidates for this therapy are patients with advanced carcinoma that has not responded to standard modalities of treatment. Ad...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1994-12-01 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：BACKGROUND:Pressure injuries, also known as pressure ulcers, are a serious complication of immobility. Patients should be thoroughly examined for pressure injuries when admitted to the intensive care unit to optimize treatment. Whether community-acquired pressure injuries correlate with poor hospital outcomes among cri...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2019530
更新日期：2019-06-01 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：:Although methemoglobinemia is not commonly seen in the ER or the critical care setting, it can be life threatening if unrecognized and left untreated. A detailed case history illustrates the symptoms and some of the possible precipitating factors, and outlines treatment for a successful patient outcome. ...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1990-03-01 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：CLINICAL RELEVANCE:Clostridioides (formerly Clostridium) difficile infection is among the most identified causes of health care-associated infections in US hospitals and remains a major public health problem. The incidence and severity of C difficile infection are high among critically ill patients. Treating critically...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2019841
更新日期：2019-10-01 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：:Heart failure is a burdensome cardiovascular condition associated with high rates of morbidity and mortality. The 3-month period after hospitalization is a vulnerable phase in which patients are at high risk for mortality and rehospitalization. To reduce risk during this period, patients with heart failure and reduced...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2018669
更新日期：2018-10-01 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：:Nurses in a full range of settings from acute to home care are increasingly exposed to the use and maintenance of central VADs. Although the advantages of central VADs are well recognized, the incidence and potential for complications associated with these devices should not be minimized. The major complication of cat...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
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journal_title：Critical care nurse
pub_type： 杂志文章
doi：10.4037/ccn2014842
更新日期：2014-06-01 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：:Transplant cardiologists in our hospital have performed the percutaneously placed axillary-subclavian intra-aortic balloon pump procedure since 2007. This procedure allows patients to mobilize and walk while they wait for a heart transplant, rather than remaining on bed rest as they would with a traditional femoral in...
journal_title：Critical care nurse
pub_type： 杂志文章,评审
doi：10.4037/ccn2019729
更新日期：2019-04-01 00:00:00
abstract：:Instruction in the use of the automated external defibrillator is now a mandatory component of ACLS certification. Here's a review of changes to the ACLS algorithm. ...
journal_title：Critical care nurse
pub_type： 杂志文章
doi：
更新日期：1992-06-01 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：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
