Implementation of a swallow screening protocol in a tertiary adult intensive care unit: A quality improvement project

Abstract

Background: Post-extubation dysphagia occurs in 3% to 62% of adults who have received invasive mechanical ventilation in an intensive care unit (ICU). A stepwise approach to identify dysphagia includes a routine swallow screening in patients who are recently extubated followed by a formal assessment by a Speech and Language Pathologist (SLP), in the event of a failed swallow screen, has been suggested. This quality improvement project aimed to implement and evaluate a new post-extubation swallow screening process.

A rapid scoping review of barriers and facilitators of implementing delirium prevention practices in adult critical care

Abstract

Background: Delirium is a serious complication of critical care that can have lasting effects on the patient’s life. Much of the work to date about delirium has been focused on identifying delirium risk factors, developing tools for screening and recognizing delirium, and testing interventions to treat those diagnosed with delirium. Despite evidence, implementing known delirium prevention and management strategies remains abysmal. This review aimed to identify and summarize literature reporting on the barriers and facilitators of implementing delirium prevention and management practices in adult critical care.

CJCCN Volume 35, Number 2, Fall 2024

Assessing the impact of creating virtual windows on the incidence of delirium in a surgical intensive care unit: a before and after study

Abstract

Introduction: Delirium is a frequent and important problem in the intensive care unit (ICU), and non-pharmacological means of prevention are limited. The importance of the physical environment in the occurrence of delirium in intensive care has been reported, particularly the presence of windows and daylight. We organized a trial to evaluate if the installation of virtual windows in the form of paintings in rooms without an actual window can limit the occurrence of delirium in ICU patients.

Best Practice in Prolonged Mechanical Ventilation: A Qualitative Study of Healthcare Provider Perspectives

Abstract

Background & Purpose: Patients who require Prolonged Mechanical Ventilation (PMV) are a relatively small but complex and vulnerable subset of patients treated in the intensive care unit (ICU). Significant heterogeneity in practice patterns exists and best practice is largely unknown. The goal of this study is to engage healthcare providers (HCPs) to identify and describe best care practices for patients requiring PMV.

Methods: A qualitative descriptive method was used. Using purposeful sampling,

CJCCN Volume 34, Number 4, Winter 2023

Revising the Canadian Association of Critical Care Nurses Standards for Critical Care Nursing Practice: A Modified Delphi Protocol

Abstract

Background: Since 1992, the Canadian Association of Critical Care Nurses (CACCN) has set the Standards of Practice for Canadian critical care nurses. The current Standards were revised in 2017, after undergoing the fifth review since inception. The Association’s practice has been to review the Standards approximately every five years.

Aim: The aim of this protocol is to provide a transparent and replicable process for Standards revision.

The Development of a patient-oriented music intervention(POMI) for use in the adult intensive care unit: Acceptability to critical care experts

Abstract

Background & purpose: Pain is prevalent in the ICU at rest and during standard procedures. Clinical practice guidelines recommend a multi-modal approach to pain management,

CJCCN Volume 34, Number 3, Fall 2023

Identifying Opportunities for Antimicrobial Stewardship in a Tertiary Intensive Care Unit: A Qualitative Study

Abstract

Background: Antimicrobial stewardship (AMS) encompasses numerous interventions that seek to improve antimicrobial usage, as inappropriate use of antimicrobials may result in the promotion of antimicrobial resistance, patient harm, and increased costs. AMS is of particular interest in intensive care units (ICUs) where antimicrobial use is extensive. Few qualitative studies have sought to identify the perceived attitudes and beliefs of intensive care clinicians around AMS.

Objectives: To understand ICU nursing and physician priorities and preferences around AMS and possible AMS interventions for implementation in the ICU.