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.

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.

Identifying Serotonin Syndrome in the ICU: Case Report

Abstract

An 18-year-old female who presented with altered level of consciousness, myoclonus, and hemodynamic instability was admitted to the intensive care unit with suspected serotonin syndrome. Serotonin syndrome is an under-recognized disorder that can cause altered levels of consciousness, neuromuscular and autonomic dysfunction, and even death. Increasing critical care nurses’ and multidisciplinary team members’ awareness of serotonin syndrome will lead to more timely identification, avoidance of the use of synergistic medications, intervention, and outcomes for critically ill patients.

“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.

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.

Virtual reality as an adjunctive comfort measure in the intensive care and coronary care unit: A nurse-led quality improvement project

Abstract

Background:  Pain, discomfort, and anxiety in critical care units are complex, multifaceted experiences. Nurse-led implementations of adjunctive comfort measures in critical care settings are essential components in the holistic management of these experiences. Virtual reality is gaining popularity as an adjunctive comfort measure across acute care settings to promote patient comfort, though there is limited evidence examining the utility of virtual reality in critical care.

Purpose: Firstly,