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.

Unsettling the “I do not see colour” Ideology in Nursing

As a woman of colour, I have often heard the phrase “I do not see colour because we are all the same” from nursing professors, colleagues, and students. While I used to agree with this statement, I now realize how subtle biases impact patient care when nurses are socialized into thinking we are neutral caregivers. My colour-blind perspectives were well-intentioned at the time. However, as a nurse educator, I see how neutrality in nursing education obscures how racism contributes to health disparities,

Debriefing and Reflective Interventions to Address Moral Distress: A Narrative Review

Abstract

Moral distress is a common phenomenon found in all areas of nursing practice with a high prevalence in specialties such as critical care nursing. The under management of moral distress is associated with the development of burnout, issues with nursing turnover, and patient safety concerns. Identification of effective interventions to address moral distress remains a novel topic of investigation. The aim of this project was to explore the use of debriefings and reflective practices to address and alleviate moral distress.

Improving Family Communication in Critical Care

Abstract

Communication with family members in critical care is challenged by socioeconomic, environmental, and organizational factors. Ineffective communication between health care providers and family members results in psychological distress and anxiety among family members and can lead to misunderstanding of the patient’s condition and ineffective decision-making. This manuscript aims to explore barriers to effective communication, understand standardized communication tools, and support their implementation in critical care. An extensive search of various databases provided a variety of articles meeting the criteria of communication barriers in critical care,

A rapid realist review of practices for assigning remote telemetry responsibilities to new critical care nurses

Abstract

Background: Registered nurses in critical care units may have a variety of responsibilities in addition to direct patient care. Assuming roles over and above their patient assignment can be challenging for nurses new to critical care. Even though additional roles may include similar skill sets (e.g., electrocardiography), the demands of learning multiple new roles and responsibilities occur during a larger transition into specialty practice.

Aim: To identify and summarize literature that helps provide guidance and best-practice(s) regarding assigning telemetry to new critical care nurses.

Antecedents of burnout and turnover intentions during the COVID-19 pandemic in critical care nurses: A mediation study

Abstract

Background: Nurses working in critical care environments have experienced a great deal of psychological stress during the successive waves of the COVID-19 pandemic. Identifying factors which contribute to burnout and turnover intentions are important to retain intensive care unit (ICU) nurses.

Purpose: The purpose of this study is to identify factors that are directly and indirectly associated with burnout and turnover intentions in ICU nurses.

Methods: A cross-sectional design was used with survey data during the peak of the second wave of the COVID-19 pandemic.

“We were treading water.” Experiences of healthcare providers in Canadian ICUs during COVID-19 visitor restrictions: A qualitative descriptive study.

ABSTRACT

Purpose: To explore and describe the impact of COVID-19 restrictive visitation policies on healthcare providers (HCPs) and to identify ongoing challenges and pragmatic solutions that could inform recommendations for patient and family-centered care (PFCC) in the ICU during pandemic conditions. 

Methods: We conducted a qualitative descriptive study within a constructivist paradigm. We used two sources of data collected simultaneously: semi-structured interviews conducted remotely via video or phone and written comments gathered through open-ended response boxes in a questionnaire to explore the perspectives of HCPs working in Canadian ICUs during visitor restrictions resulting from the first wave of COVID-19.

Canadian intensive care nurses’ infection prevention and control adherence and institutional trust: An update 1-year into the pandemic

ABSTRACT

BACKGROUND: Nurses are key healthcare workers whose adherence to infection prevention and control (IPC) measures is integral to the prevention of nosocomial spread of SARS-COV-2. Institutional trust is an important correlate of adherence. After initially surveying nurses early in 2020, we sought to evaluate how perceptions of IPC measures and institutional trust changed one year into the pandemic.

METHODS: We adapted an internationally distributed cross-sectional questionnaire, incorporating validated scales for items including institutional trust,

Barriers and facilitators in the provision of palliative care in critical care: A qualitative descriptive study of nurses’ perspectives

Intensive care units are providing increasing amounts of palliative care. Accordingly, integrating palliative care as a component of comprehensive critical care has been identified as a necessity. The purpose of this study was to explore what critical care nurses perceive as barriers and facilitators in the provision of palliative care in the critical care setting.

The development and implementation of an evidence-based risk reduction algorithm for post-extubation dysphagia in intensive care

Abstract

Intubation and mechanical ventilation are often required to support critically ill patients. These are life-sustaining measures and when they are no longer necessary, patients need to be carefully transitioned back to breathing, eating, and talking on their own. Post-extubation dysphagia is defined as swallowing difficulty following extubation. This condition can affect up to 87% of critically ill patients and can cause serious health complications such as aspiration pneumonia, which could require re-intubation,