Critical Care Nusing Specialitis

It is imperative to point out that Vanderbilt has employed a high quantity of NPs in different intensive care units (ICUs) in the hospital, since the inception of the role in Tennessee, the only exception has been the trauma ICU. Until now, only physicians and fellows were allowed to manage these patients.

This article is a example of a foundation of knowledge on the topic of therapeutic hypothermia. Gardner & MacDonald discuss that the typical post cardiac arrest patient does not survive or will recover with severe neurologic deficits as a result of ischemic brain injury from lack of blood flow to the brain (2013). The process of brain death is examined as well as the damange that occurs with reperfusion after ROSC. Damage particularly to the cerebral cortex, cerebellum and hypothalamus can leave the patient in a comatose state if revived (Gardner & MacDonald, 2013). This article is particuarlly valuable as it explains on a physiological level how TH protects the brain from reperfusion injury and improves neurologic outcomes and survivability. The article defends that TH is the best practice for preventing further neurologic damage after ROSC and provides a clinical example. The clinical example recounts a case in which a patient suffered an out of hospital cardiac arrest. Upon admission to the ICU the therapeutic hypothermia protocol was initiated and the patient was cooled below 35 degrees celcius for 24 hours. After rewarming the patient regained consciousness and within ten days was discharged from the hospital with normal neurologic function and as a survivor (Gardner & MacDonald,

In this modern time, the health care system has changed tremendously. Patients are getting sicker, nurses are burnt out, and reimbursement is getting stricter. To answer the growing needs of the population and the health care industry, the Institute of Medicine and the other organization in collaboration with an elite group of nurse leaders, developed a new nursing role that will respond to the expanding demand of the health care.

Since its development in the early 1950s, CPR has become the cornerstone for cardiac arrest treatment. Incorporating a variating ratio of chest compressions and ventilations, CPR has consistently demonstrated an improvement of outcomes when promptly and precisely administered to cardiac arrest victims. The American Heart Association (A.H.A) provides constant guideline updates as more current, more advanced research is made available. The most recent A.H.A update was released in 2005. At that time A.H.A introduced a new change in compression-to-ventilation ratios, switching from 15:2 to 30:2. This was done with the intent of increasing oxygen perfusion to starved tissues in adult victims. (1st Source) Their have been other innovative ideas about improving CPR, of which

Basically, the treatment of therapeutic hypothermia can be separated into three parts: induction, maintenance and rewarming (Walters et al., 2011). The process of hypothermia induction if often questioned. Is there an optimal time to begin mild therapeutic hypothermia that brings the most benefit? The data from the past experiments suggest that mild therapeutic hypothermia should be commenced within a short time from clinical comprehensive evaluation that suggests patient’s eligibility for this type of a treatment. Various animal studies suggest that early cooling becomes superior to delayed cooling because of its benefits on general outcome after suffering cardiac arrest (Janata & Holzer, 2009). According to Wolff et al. (2009), successful and early achievement of mild therapeutic hypothermia is one of the main elements contributing to the final neurological outcome. Therefore, the need for implementing new measures appears to be more than natural. In this experiment, there were forty-nine consecutive patients that were treated with mild hypothermia after suffering cardiac arrest. A closed-loop endovascular system proved to be the most suitable choice for achievement of rapid body cooling while allowing more precise control of mild therapeutic hypothermia. While the researcher team examined the correlation between the different time intervals of hypothermia achievement, it also closely monitored levels of neurone specific enolase,

Throughout history , nursing has existed for a long time and is continuously changing through time. It is one of the more important occupation worldwide and has a wide range of occupational duties. In modern times, nursing is known as one of the largest health professions with more than 3 million nurses from registered nurses to nurse practitioners nationwide. It is a profession that focuses on the care of individuals as well as families to help maintain and recover optimal health and quality of life. In the career field, nursing has a significant outlook in the future years as its growth is expected to increase tremendously. Without nurses, people around the world wouldn’t get the proper care they would desperately need if they were injured,

Most patients undergoing general anesthesia for surgical procedures require mechanical ventilation. One of the biggest challenges facing clinicians providing mechanical ventilatory support today is managing the balance between providing adequate gas exchange and avoiding lung injury associated with positive pressure ventilation. Patients with respiratory failure need adequate tissue oxygenation and acid-base balance; however, the lungs are fragile structures that can be injured by over-distension, alveolar collapse and reopening, and high oxygen exposure. This challenge in providing “lung protective ventilation” is made more difficult by the fact that lung injury is often heterogeneous and thus what may benefit gas exchange in one region (e.g., higher pressure) may worsen injury in another.

The problem of nurse shortage is not new to healthcare. Moreover, it becomes burning in critical and intensive care units where the workload is high, and nurses observe an increased risk of burnout (Pastores & Kvetan, 2015). Nurse shortage has a negative impact not only on nurses themselves. It also influences patients and can lead to negative patient outcomes due to less attention that a nurse gives to a patient (Ferrer et al., 2014). Therefore, there is a need for a strategic plan to address nurse shortage and thus contribute both to nurse retention and improved patient outcomes. The purpose of this paper is to present a strategic plan of an intervention aimed at reduction of nurse shortage in intensive and critical care units.

You may ask why it is important to develop these pediatric protocols in an effort to reduce time of mechanical ventilation. Since decreased time of mechanical ventilation has the potential to reduce the incidence of harmful ventilator associated infections, and decreases the risk of acquiring such infections, it is of utmost importance to the health and safety of these patients (Marelich, et al., 2000; Randolph, et al., 2003). Furthermore, mechanical ventilation poses a great risk of tracheal airway irritation and scarring (Randolph, et al., 2003). This can occur through the method of endotracheal suctioning, duration of suctioning, frequency of suctioning pose, and length of time the endotracheal tube is in place. All these factors can damage the patient’s airway, compromise the integrity of the endotracheal tube, and put the patient at risk for ventilator associated pneumonia (Grap, 2009).

Nurses have a central role on transforming healthcare system, which focuses on patient-centered care and deliver primary care in community setting rather than acute care setting. Nurses must have scientific knowledge and skills to provide higher quality care, minimize medical errors and promote the patient safety. Nurses have a crucial role in minimizing the rate of infection, facilitating the transition of a patient from hospital to home, prevention of diseases and promotion of health status (The national academic press, 2011). This paper summarizes the feedback shared by three nurse colleagues regarding how the practice of nursing is expected to grow and change due to the restricting of the U. S health care delivery system.

The aim of the Intensive and Critical Care Nursing is to better promote excellence of care in critically ill patients. Specialized nurses and their professional teams improve care. The articles provide an exchange of research, experiences of professionals, knowledge, and different skill sets, that are aiming to improve critical care nursing.

By removing these restrains nurses are given more opportunities to advance their roles in the healthcare system (Institute of Medicine, 2010). One of the implications to accomplish the goals of the Institute of Medicine would be that should be more active and contribute new ideas to change the focus from the specialty care to the primary care. The nurse should develop the ability to adapt to the change in the environment from patient's bedside to community based care. Attaining such a shift will facilitate the health care system to provide higher-quality care, reduce errors, and increase safety. Presenting care in this way and in these areas taps traditional strengths of the nursing profession (Institute of Medicine, 2010). According to the Institute of Medicine, among the much advancement that are resourceful, adaptive, and well-educated nursing profession have helped make achievable are is the renovation of technologically advanced hospital; the option for physicians to unite office and hospital practice; decrease the lengths of patient residence in a hospital setting; growth of national primary care capacity; care management for chronically ailing and elderly people; and better admittance to specialty care and focused consultation.

The tasks that are neglected are due to improper staffing levels in the hospital, forcing the nurses to place priorities on the most critical components of patient care. When provided with appropriate staffing ratios, the staff is better equipped to deliver patient care and the various unplanned task that arise in daily patient care. Studies have shown, “a higher proportion of RNs among the nursing staff is associated with shorter hospital stays and lower failure-to-rescue rates, inpatient mortality, cardiac arrest and hospital-acquired pneumonia rates” (Hinno et al., 2012).

The iron lung was produced for instances of polio that incapacitated the muscles fundamental for relaxing. The iron lung is an early counterfeit respirator. The patient's body is encased in a metal tank that utilizations gaseous tension changes to extend and get the mid-section dividers. In the 1920s, a physiologist named Philip Consumer developed this imaginative method for managing the respiratory issues of polio patients. The iron lung utilized a consistent force source which made it better than existing

With a plan to work in the critical care area, as a Clinical Nurse Specialist (CNS), articles with an ICU focus become high on the priority list for review. With ten years of experience as a basis, the writer’s opinion is that care of the severely ill has not changed in the area of mobility while in the ICU over that time. Patients in the ICU are traditionally on bed rest until just a day or two prior to discharge from the unit.