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. EVIDENCE REVIEW:An evidence-based question was developed and an extensive review of the literature was completed, resulting in a structured plan for the intensive care units to manage a surge of patients critically ill with COVID-19 in March 2020. Twenty-five sources of evidence focusing on pandemic intensive care unit and COVID-19 management laid the foundation for the team to navigate the crisis. IMPLEMENTATION:The Critical Care Services task force adopted recommendations from the CHEST consensus statement on surge capacity principles and other sources, which served as the framework for the organized response. The 4 S's became the focus: space, staff, supplies, and systems. Development of algorithms, workflows, and new processes related to treating patients, staffing shortages, and limited supplies. New intensive care unit staffing solutions were adopted. EVALUATION:Using a framework based on the literature reviewed, the Critical Care Services task force controlled the surge of patients with COVID-19 in March through May 2020. Patients received excellent care, and the mortality rate was 0.008%. The intensive care unit team had the needed respiratory and general supplies but had to continually adapt to shortages of personal protective equipment, cleaning products, and some medications. SUSTAINABILITY:The intensive care unit pandemic response plan has been established and the team is prepared for the next wave of COVID-19.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Bader MK,Braun A,Fox C,Dwinell L,Cord J,Andersen M,Noakes B,Ponticiello Ddoi
10.4037/ccn2020799subject
Has Abstractpub_date
2020-12-01 00:00:00pages
e1-e16issue
6eissn
0279-5442issn
1940-8250pii
31134journal_volume
40pub_type
杂志文章,评审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::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::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::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::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: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:Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units. OBJECTIVES:To describe the success of an 18-bed neurological intensive care unit in using several nurse-i...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2017742
更新日期:2017-06-01 00:00:00
abstract::Knowledge of the physiologic changes, conditions, and therapies of pregnancy that increase the risk of pulmonary edema enables nurses to influence the outcome of their patients who develop medical complications while undergoing tocolytic therapy. Cooperation between perinatal and critical care nurses ensures optimal c...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 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::Postoperative nausea and vomiting is a dreaded, uncomfortable, and unpleasant patient experience that is also a factor contributing to adverse outcomes in postoperative recovery. The key to management of this concern is to identify high-risk patients and to develop a systematic method of assessment, intervention, and ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011470
更新日期:2011-12-01 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::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::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::More patients in the intensive care unit are surviving their critical illnesses because of advances in medical care. This change in survival has led to an increased awareness of the emotional consequences of being critically ill. Posttraumatic stress disorder has been identified in approximately 9% to 27% of criticall...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2015758
更新日期:2015-06-01 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::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::In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinic...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2012877
更新日期:2012-04-01 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::To prepare a presentation, the critical care staff member must be willing to invest time and effort. Time and effort combined with an organized approach to the development process should result in a quality presentation. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract::The results of this evaluation indicate that specially trained critical care nurses can remove femoral sheaths with an acceptable margin of safety. As a result, these nurses can provide quality, cost-effective care to angioplasty patients. However, before this procedure is included as part of the RN's responsibility, ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1996-04-01 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
abstract::Critical care nurses are constantly challenged to provide safe, high-quality patient care at a low cost with increasingly scarce resources while implementing the latest evidence-based practices into their own clinical practice. This article is the first in a 4-part series to provide a practical quality improvement gui...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2014177
更新日期:2014-12-01 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::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::BACKGROUND Many hospitals have well-planned nursing competency assessment programs, but these are meant to measure competency in traditional bedside roles, not in tele-intensive care unit (tele-ICU) nurses practicing remotely. OBJECTIVE To determine whether current tele-ICU programs have a formal competency assessment...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011552
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The outcome focus for survivors of critical care has shifted from mortality to patient-centered outcomes. Multidimensional outcome assessments performed in critically ill patients typically exclude those with primary neurological injuries. OBJECTIVE:To determine the feasibility of measurements of physical f...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020681
更新日期:2020-06-01 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::Both pharmacological and nonpharmacological methods are used to control shivering in therapeutic hypothermia. An evidence-based protocol based on the most current research has been developed for the management of shivering during therapeutic hypothermia. Meperidine is the drug of choice and provides the greatest reduc...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011618
更新日期:2011-12-01 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::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