Perspectives of Non-Speaking ICU Patients and their Families on Goals-of-Care and End-of-Life Discussions

Abstract

Objectives: The objective of this study was to explore how patients and their caregivers perceived their communication during goals-of-care/end-of-life discussions and decision-making in the intensive care unit (ICU). The patient participants were temporarily non-speaking due to their medical treatment and used augmentative and alternative communication (AAC) during their stay in the ICU. Results from patient participants were garnered when they reported their experience retrospectively. The long-term goal was to support strategies and assist in the development of AAC tools for patient participation during goals-of-care and end-of-life conversations.

Cultural adaptation in Quebec of the COMHON index: a tool for assessing the risk of pressure injury in critically ill patients

Addressing Barriers and Facilitators to Post-PICU Shared Care: Insights from British Columbia.

Abstract

Background: The sequelae of surviving a critical illness and admission to a Pediatric Intensive Care Unit (PICU) is called Post-Intensive Care Syndrome in Pediatrics (PICS-p). Survivors experiencing PICS-p may require ongoing comprehensive follow-up care. In British Columbia (BC), Canada, the province’s extensive land mass and sparsely populated regions, and the centralized location of the quaternary and tertiary PICUs complicate access to specialized post-PICU care, highlighting the need for a shared-care model between PICU specialists and community providers.

Ready for Practice! Virtual Simulation in Critical Care and Emergency Nursing Education

Abstract

Traditional orientations for nurses transitioning to critical care, critical care transport (CCT) and emergency department (ED) practice areas have relied on classroom lectures, apprenticeships and preceptored clinicals. Increasing patient acuity, workforce shortages, and limited clinical placement opportunities have challenged these traditional models. In the early 2000’s, simulation began to emerge as a strategy to accelerate readiness for transitioning into the practice area, enhancing clinical judgement, building confidence, and fostering interprofessional team competencies.

Nurses’ perceived feasibility and the clinical utility of the Nociception Level (NOL™) Index for pain assessment in critically ill adults

Abstract

Introduction: The Nociception Level (NOL™) Index monitors nociception and related pain using multiple physiologic parameters through a non-invasive finger probe and is currently undergoing validation for pain assessment in the Intensive Care Unit (ICU). This study aimed to describe its feasibility and clinical utility from nurses’ perspectives, which is crucial for its potential adoption in clinical practice.

Methods: This descriptive study involved ICU nurses who received a brief training (5-minute video and handout) as part of the validation process of the NOL Index in a medical-surgical ICU.

Exploring long-term impacts on ICU survivors: A concept analysis of post-intensive care syndrome

Abstract

Post-intensive care syndrome (PICS) has emerged as a concern for intensive care unit (ICU) survivors, particularly in the context of the increasing survival rates of patients with severe illness. This syndrome encompasses a range of physical, cognitive, and psychological impairments that can continue long after ICU discharge. PICS impacts survivors’ quality of life, with common manifestations including muscle weakness, memory deficits, and depression. Despite growing awareness, PICS remains underexplored in clinical practice,

Family member experiences with adult ICU multidisciplinary rounds: Transition from Observers to Participants

By Tannis Sidloski, MN, RN, CNCC(C), Marie Edwards, PhD, RN, Donna Martin, PhD, RN, and Kendiss Olafson, MD, FRCPC, MPH

Abstract

Background & Purpose: Family members’ participation in multidisciplinary rounds (MDR) is an accepted practice in neonatal and pediatric intensive care units (ICUs) with evidence this practice is occurring in adult ICUs. The purpose of this study was to explore family members’ experiences with participating in MDR in one Canadian adult ICU.

Intensive care nurse perspectives on family centred rounds in adult critical care units

By Felicia Varacalli, NP, MScN, RN, Gina Pittman, NP, PhD, and Jody Ralph, PhD, RN

Abstract

Background: Family-centred rounds (FCR) are a component of family involvement in critical care settings. Nurses’ active participation is vital in implementing FCR. However, there is currently

a lack of rigorous literature exploring nursing perspectives of FCR in adult critical care areas.

Purpose: This study explored nursing perspectives of FCR in six adult critical care units across four Southwestern Ontario hospitals.

Optimizing the role of nurses in critical care in weaning patients from the ventilator : a multiple-case study

Abstract:

Background:

Prolonged mechanical ventilation is harmful for patients requiring prompt weaning approaches from an interprofessional team with different and overlapping scopes of practice. Nurses play a key role in interprofessional teams, and optimization of their role can reduce the duration of mechanical ventilation.

Purpose: To understand the role of nurses in critical care in healthcare teams when weaning patients from mechanical ventilation.

Methods: Multiple-case study with concurrent mixed methods data collection was conducted in two critical care units following a pilot study in Québec,

Properties of moral distress experienced by Canadian intensive care unit nurses during the COVID-19 pandemic: An interpretive descriptive study

Abstract

Background & Purpose: In response to the multitude of ethical issues that arise in the delivery of care provided in intensive care units (ICUs), nurses working in this setting frequently experience moral distress. The properties of moral distress have been well defined. However, within the context of the coronavirus-disease 2019 (COVID-19) pandemic, less is known about the properties of moral distress experienced by ICU nurses. This subsequently affects the advancement of our knowledge,