The Intensive Care Unit ( Icu )

Critically ill patients that require mechanical ventilation are at risk of developing secondary infections that may increase length of stay and possibly even morbidity. This fragile patient population requires special attention and meticulous adherence to established nursing standards of care. These standards of care are founded on evidenced based practices. It is important that nurses receive education about why these standards are in place and what consequences can result due to not following the established care protocols.

It was the worst thing in my life. One sip of the wrong drink and my best friend, Brady, was in the Intensive Care Unit, with a small change of survival. How was I supposed to know that his ex-boyfriend was going to poison the water supply? No one is supposed to know about that, until it already happened.

Most mobile patients are able to reposition themselves, while others who are critically ill are not able to feel or respond to pain. Therefore, nurses need to assess those patients in repositioning to decrease the risk of developing pressure ulcers (REF).

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

The many benefits of increasing mobility in ICU patients can certainly be measured by length of stay in the hospital, rate of Hospital Acquired Infections, and occurrence of skin breakdown, but when we consider the human factor in this equation it is simply the right thing to do.

A degree of evidence related to protocol usage and outcomes was collected to determine if a researchable problem was obtainable and valuable. According to Davies (2011), research questions should concentrate on "real-world problems" (p. 75). Patients in the intensive care unit who are mechanically ventilated receive intravenous sedation on a regular basis. According to findings by Wøien, Vaerøy, Aamodt, and Bjørk (2012), as much as "30-60% of intensive

The progress of my project to develop a nurse driven sepsis screening tool and an algorithm for implementation on the intensive care unit (ICU) for early identification and prompt treatment of septic patients has progressed remarkably well. I have been productive in gathering current guidelines for sepsis with the aid of my preceptor who is a critical care nurse practitioner on the ICU. With his help, I have been able to assemble key pieces of research to create a sepsis screening tool, and a treatment algorithm with sepsis resuscitation bundles. Extensive research has been conducted to integrate evidence-based practice in my project. I have also spent time with the unit educator, critical care intensivists, and my colleagues in brainstorming and collecting ideas about my project.

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

The goal of this paper is to provide a policy to make changes to the Intensive Care Unit (ICU) at Mercy Hospital

The purpose of this theory is to express the nurses’ influences, actions, and outcomes with regard to caring for critically ill patients (McEwen, 2014). The synergy model for patient care was created to link nursing practice with patient outcomes and this is explicitly stated in the model’s concept. This requires nurses to be proficient in the multitude of nursing practice. When nurse competencies and patient needs synergize, optimal patient outcomes can result (AACN, n.d.; McEwen, 2014). During the early 1990s, the AACN strategically set forth to identify a model that described nursing practice. In 1993, the AACN Certification Corporation established a think tank to draft a document that identified nursing concepts of practice, specifically certified nursing

Healthcare in the United States is changing which has given rise to new hurdles that must be overcome. One of the issues that we are currently facing in many tertiary facilities is the need for set criteria involving intensive care unit admissions and discharges. Throughout the country the total number of intensive care unit (ICU) beds are on the rise, but the current supply still outnumbers the demand (Cognet & Coyer, 2014). The cost of staying in an ICU is continuing to increase with technology, and there are limitations that insurance companies and the government have set forth to the number of days a patient can reside there dependent upon his diagnosis and condition. Intensive care units will continue to undergo strain due to high census, and decisions to discharge patients will be effected (Wagner, Gabler, Ratcliffe, Brown, Strom, & Halpern, 2013). Typically, the decision to have a patient occupy an ICU bed is based upon whether or not they are sick enough to be there or if they are well enough to be discharged to a progressive care unit (PCU) or medical surgical unit (Meyer, 2003). A progressive care unit is a step down from an ICU, but has stricter criteria for admission than a medical surgical unit based upon the patients medical status. Not all facilities offer a PCU, but the need for this level of care is continuing to rise with the number of ICU admissions increasing. Standardized guidelines for patient placement in

As a specialty ICU, we care for patients with a variety of neurological illnesses, like ischemic and hemorrhagic strokes, brain tumors, seizure disorders, degenerative neuromuscular disease, encephalitis, and meningitis. Having seven years of ICU nursing experience has solidified my decision to specialize in acute care. I have found that I work best in a fast-paced, high-pressure environment. In the critical care setting, I am faced with new challenges each day. With these challenges come numerous learning opportunities that allow me to grow and improve as a

The inability to sleep is a source of anxiety and stress for patients in the intensive care unit (ICU); this inability can lead to cardiorespiratory disturbances, immune system dysfunction, impaired wound healing, hormonal and metabolic imbalances, cognitive changes, and delirium. Through the use of quiet times and nursing actions that encourage sleep, or, sleep hygiene bundles, nurses can assist in improving sleep quality in the ICU. These bundles include noise and light reduction, scheduling routine procedures outside of reserved sleep times, the use of earplugs and eye masks, and the grouping of nursing care activities to minimize sleep interruptions. The aim of this proposal, therefore, will be to implement a nurse-driven, sleep hygiene protocol, in order to improve patient care by promoting quality sleep in ICU patients. Barriers to implementation include staff resistance to the concept, concerns regarding patient care during sleep times and difficulties in coordinating care with other units. Studies used to gather information for this proposal were published between the years of 2011 and 2016 and were found in several databases: Academic Search Complete, Medline, and OVID Journals.

In terms of where America stands on medicine today, despite having the most expensive health care system, it lacks quality and efficiency in all voluntary measures. According to an op-ed on The New York Times newspaper it states, "… this country lags well behind other advanced nations in delivering timely and effective care." Essentially, what this does is shift health care systems' center of focus [patient engagement] to acute care, where a patient receives active but short-term treatment for severe injuries or illnesses. With that being said, the only thing left with a chance of hope is the betterment of national doctors to make that change —— change for a better health system. Those that are interested in the well-being of others, including themselves, by following these simple steps it will open up a path to become a phenomenal doctor.

The American Board of Medical Specialties [ABMS] recognizes palliative care as a medical subspecialty classified under internal medicine (ABMS, 2015). Currently, there are only 5,000 board-certified palliative care specialists in the US (Quill & Abernethy, 2013). The demand for palliative care physicians outweighs the supply. This opens the door for other medical disciplines, such as intensive care unit (ICU) doctors or anesthesia personnel to step-in and assume some care of this unique patient population. Only 75-85% of hospitals with greater than 300 beds provide palliative care services and palliative care is available in only 20% of smaller hospitals (fewer than 50 beds)(Morrision, Augustin, Souvanna, & Meier, 2011; Goldsmith, Dietrich, Du, & Morrison, 2008).