Background Of The Study Of Icu

This prospective, pre-post quality improvement (QI) project was conducted at the University of Pittsburg Medial Center, Presbyterian Hospital, a tertiary academic medical center in Medical Intensive care unit (MICU). A multidisciplinary team consisted of physicians, pharmacists, and nurses, assessed in detail twenty-seven possible non-pharmacologic interventions that display positive impact on delirium. The remaining nine non-pharmacological interventions were combined into a protocol entitled “Give your patient M.O.R.E.” This acronym can be defined as music, opening of blinds, reorientation and cognitive stimulation, and eye/ear protocols. The purpose was to determine if the implementation of the evidence-based non-pharmacological protocol

Management of the acutely ill adult is a complex and perplexed procedure. It requires underpinning knowledge of the pathophysiology of the disease currently affecting the patient, as well as ensuring that professionals are equipped to deal with the development of a rapid deterioration. The National Institute for Clinical Excellence (2007) explain that patients are sometimes inadequately treated due to staff not acting in a sufficient time manner, and so a systematic assessment of the patient recommended by the Resuscitation Council (2006) should initially be followed (Jevon, 2009).

Hospital nursing professionals are faced with many stressful situations in the workplace and at home. Some nurses try to cope with stress by turning to alcohol. In my professional opinion, alcohol should never be used as a coping mechanism. Eventually one or two alcoholics drinks a week turn into daily excessive and uncontrollable use. Impairment at work leads to an inability to critically think and make safe decisions. Alcohol impairment slows reaction time and alters judgement (CDC, 2016). These symptoms lead to a dangerous environment for the patient, other staff members and anyone having contact with the intoxicated nurse (CDC, 2016).

Excited delirium syndrome is a rare but dangerous disease generally recognized by agitation, aggression, disorientation, and sometimes sudden death. Often associated with drug usage. There has been some documentation as early as the 1800s, but it manly started to come back around in the 1980s. These patients will often need to be restrained, usually by law enforcement, and pose a great danger to the crew’s safety until restrained and sedated. Excited deliriums cause is somewhat unknown. There is much conflict from researcher’s on the why and how.

The Glasgow coma scale is the scoring system that monitors and assesses the level of consciousness of a patient that has had a traumatic injury e.g. brain injury, car accident or sports injury (Braine & cook, 2016). The Glasgow coma scale is a score between 3-15 with 3 being the worst and 15 being the best. This scale is composed of 3 sections which are the best eye response this assessment is important to assess the arousal of the patient which reflexes the integrity of reticular activating system of the brain which assesses by 1. No eye opening 2. Opens to pain 3. Opens to voice 4. Opens spontaneously, the best verbal response this assessment reflects the integrity of higher cognitive and interpretive centres of the brain. The verbal response depends on the language centre in the temporal lobe and in the frontal lobe which assess 1. No verbal response 2. Incomprehensive sounds 3. Inappropriate words 4. Confused 5. Orientated and best motor response this assessment check the function ability of the cerebral cortex, the patient has to understand the commands and perform the movement accordingly, they assess the upper extremities by simple orders because they are more reliable than the lower extremities this is assessed by 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawals from pain 5. Localising pain 6. Obeys commands, these are the three sections that nurses needs to access (Elliot, Aitken & Chaboyer,

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence

The participants for this research project were recruited from treatment facilities throughout Eastern Europe and the Baltic regions; initial data was collected from participants while they were still in the intensive care unit, and then every three months until one year following discharge from ICU. Each participant was analyzed for the severity of their TBI on the basis of a number of different factors, including whether or not they required surgery and the amount of time they spent in the hospital immediately following the incident (Madjan et al. 798). After gathering information on how the patients were progressing with recovery one year post-incident, the researchers compared the causes of the TBI to pinpoint similarities in recovery among all the different groups, and they also evaluated which particular means of trauma produced the most disability for the patients, both within and between groups. In the traffic- related incidents category, drivers appeared to sustain more serious injuries to the brain than passengers, pedestrians, or cyclists; in the falls category, falls from a height greater than three meters resulted in the most severe damage; and in the miscellaneous category, patients who had survived gunshot wounds generally acquired more extensive damage than other participants in the group (Madjan et al. 800). The next set of data illustrated which of these categories resulted in the

The purpose of this study was to review the “literature on emotional distress among professionals in the ICU according the PRISMA method”, with an emphasis on the prevalence of burnout and compassion fatigue. “While the sometimes devastating personal and organizational consequences of compassion fatigue have been published previously, very few studies have addressed the effectiveness of preventive strategies. This review aims to provide a starting point for clinical practice guideline developers and summarizes interventions to prevent the negative consequences of emotional distress among healthcare professionals in the ICU.”. This review will be needed in the preventive section of this research paper.

There have been many studies documented in the literature regarding the reduction of CLABSIs. The majority of the studies have reported statistically significant decreases in CLABSI rates post-implementation of a quality improvement initiative (O‟Grady et al., 2011). Some studies used approaches in which multiple strategies have been implemented together to improve compliance with the use of evidence-based guidelines. A seminal study conducted by Pronovost et al. (2006), known as the Keystone ICU project, included a collaborative cohort of 108 ICUs within the state of Michigan. The strategies in this study included the use of five evidence-based bloodstream infection prevention practices for CVC insertions, use of a checklist to ensure adherence

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Keywords: intensive care, patient scenario, clinical practicum, pathophysiology, disease processes, interventions, diagnoses, assessments, health prevention, promotion, health outcomes

This may lead to illusions or hallucinations (Figueroa-Ramos, Arroyo-Novoa, Lee, Padilla, & Puntillo, 2009). Some signs of delirium are restlessness, anxiety, hallucinations, agitation, disorientation, and any abnormal behavior. Some causes of ICU delirium are due to drugs, stress, environmental factors, and sleep deprivation. Studies show a strong connection between sleep deprivation and delirium. Alterations in specific neurotransmitters are the basis of current research (Figueroa-Ramos, Arroyo-Novoa, Lee, Padilla, & Puntillo, 2009).

This scale determines the cognitive function of the patient and evaluates the eyes, speech, and body movements to determine what sort of damage the brain has undergone, as well as creating a baseline status to refer to while providing ongoing care. The Glasgow Coma Scale assessment tool helps the nurses and physicians determine what sort of care and interventions a patient may need to have in their plan of care. A patient with a score of 15 is able to use their eyes to look around, be able to communicate verbally, and have purposeful body movement; as this score decreases the level of care increases. A patient who has sustained a brain injury that presents with a GCS of 8 or less and also has an abnormal CT scan will have an ICP monitoring device placed which will give the nurse a mode of collecting accurate numerical data and measuring cerebral perfusion pressure to sustain brain tissue (Zink and McQuillan,

The first chapter opens up with snow on the ground in a small town in Portland, Oregon which for Mia’s family means snow day! On their way to visit Willow and Henry the family gets into a disastrous car crash. Mia’s parents dead on the scene, Mia and her brother, Teddy, struggle to stay alive. The accident takes place on a rural road outside the town. Following the accident, Mia is taken to the Intensive Care Unit of an unnamed hospital in Portland. Throughout the book Mia has flashbacks to different times in her life as her family comes in and visits her. Mia's reflections on her life bring in a number of other locations. Although the Intensive Care Unit is technically the setting for the remainder of the book, Mia's reflections on her life