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

Special Collaborative Issue – CJCCN & CJCN

CJCCN Volume 35, Number 1, Spring/Summer 2024

Coping Strategies Used by Registered Nurses in Acute and Critical Care Settings: A scoping review protocol

Abstract

Background & Purpose: Acute and Critical Care (ACC) settings are a highly demanding and specific environment for registered nurses (RNs) to provide care in, and the use of coping strategies is key to supporting their work-related well-being. However, currently, there is a lack of comprehensive evidence on how RNs in ACC settings, specifically, cope with work-related stressors. Therefore, this review will summarize the international literature on coping strategies RNs use in ACC settings to deal with work-related stressors.

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.