Critical Care Nursing Clinics Of North America

Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC). Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses. Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family’s physical, psychosocial and spiritual concerns, and aligning treatments with each patient’s goals, values, and preferences. PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.

In consultation with Consulting Editor, Dr. Jan Foster, Drs. Garbee and Danna have put together a state-of the-art issue of the Critical Care Nursing Clinics devoted to Quality Outcomes and Costs. Clinical review articles are specifically devoted to the following: Information Technology, Electronic Medical Records, and Practice Alerts; Telehealth Use to Promote Quality Outcomes and Reduce Costs; Impact of a Mobility Team on ICU Patient Outcomes; MACRA and MIPS Impact on Quality and Cost Outcomes; Leadership’s Impact on Quality, Outcomes, and Costs; Big Data Sets Use for Quality, Outcomes, and Cost; Pediatric Quality Metrics Related to Quality Outcomes and Cost; Geriatric Outcomes Related to Quality and Cost; Mental Health/Behavioral Health Metrics; Obstetric Quality Outcomes and Cost; Emergency Department Throughput; and Veteran Outcomes. Readers will come away with the latest information they need to improve quality and improve out comes in critically ill patients.

In consultaton with Consulting Editor, Dr. Cynthia Bautista, Dr. Bartos has put together a comprehensive and succint look at strategies to improve wellness for the critical care nurse. Expert authors have submitted clinical review articles on the following topics: Self-Assessments for Mental Wellness in Critical Care; Developing a Wellness Company for Critical Care Nurses; Self-Care Tips and Tricks for the Critical Care Nurse; Building Resilience in the Critical Care Nurse; The Impact of Rotating Shift Work on Self-Care Behaviors of the Critical Care Nurse; Mitigating the Stress of the Critical Care Nurse; Building a Program of Wellness for Critical Care Nurses; Evaluating the Secondary Stress of Critical Care Providers; Compassion Fatigue in the Intensive Care Unit; Creativity as a Means of Self-Care for Trauma ICU Nurses; and Supporting Self-Care Behaviors throughout the Critical Care Bereavement Process. Readers will come away with the information they need to improve self-care behaviors and mental wellness.

In consultation with Consulting Editor, Dr. Cynthia Bautista, Guest Editor Christi Delemos has created an issue of Critical Care Nursing Clinics that gives the readers an opportunity to discover critical care nursing practices from critical care nurses around the world. Authors will have the opportunity to share the contributions of critical care nurses to health care globally. Current challenges in managing critical care patients anywhere in the world are discussed; articles are specifically devoted to ICU Nursing Priorities in the United States; Caring for Traumatic Brain Injury Patients: Australian Nursing Perspectives; Use of Diaries in ICU Delirium Patients: German Nursing Perspectives; Caring for Patients with Aneurysmal Subarachnnoid Hemorrhage: Nursing Perspectives from the UK; Critical Care Nursing in India; Nursing Priorities in Critical Care Nursing in the Philippines; The Glasgow Coma Scale: A European and Global Perspective on Enhancing Practice; and Care of the Patient with Acquired Brain Injury in Latin America and the Caribbean. Readers will come away with new perspectives of care for the critical care patient.

In this issue of Critical Care Nursing Clinics, Guest Editor Justin Dilibero brings his considerable expertise to the topic of resuscitation. Top experts in the field cover key topics such as trauma, sepsis, burns, pediatrics, cardiac arrest, and more. Provides in-depth, clinical reviews on resuscitation for critical care nurses, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 12 relevant, practice-oriented topics including improving resuscitation outcomes in severe traumatic brain injury; targeted temperature management after cardiac arrest; family presence and support during resuscitation; the role of the tele-ICU; and more.

This issue contains a series of articles focused on various initiatives aimed at improving the quality of patient care delivery and promoting safe passage across the continuum of care. Exemplary, evidence-based nursing practice is the cornerstone of quality care, and this issue highlights many ways in which nurses have led changes to optimize patient outcomes. In addition, quality care enhances cost-effectiveness by reducing avoidable complications and diminishing avoidable hospital readmissions, a concept more important than ever due to value-based purchasing and the Affordable Care Act. Articles are specifically devoted to prevention of delirium in critical care patients, palliative care in the intensive care unit, prevention of pressure ulcers, fall prevention in high-risk patients, prevention readmissions, preventing sepsis mortality, and nursing interventions in the elderly critical care patient, to name a few.

In this issue of Critical Care Nursing Clinics, guest editor Dr. Melissa Nunn, Instructor of Clinical Nursing at LSU Health New Orleans School of Nursing, brings her considerable expertise to the topic of Pediatric Intensive Care Nursing. Top experts in the field present systematic, evidence-based processes for decision making and care, addressing topics such as palliative communication in the PICU; dialysis care in the PICU; caring for hematology/oncology emergencies in the PICU; nurse-led rounds in the PICU; asthma care protocol implementation in the PICU; and more. Contains 12 relevant, practice-oriented topics including acute pain management protocols in the PICU; kangaroo care implementation; unplanned extubations in the PICU; pediatric delirium screening in the ICU; battling alarm fatigue within the PICU; and more. Provides in-depth clinical reviews on pediatric intensive care nursing, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In collaboration with Consulting Editor, Dr. Cynthia Bautista, Dr. Judy Davidson has put together a comprehensive issue on family and patient experience in the ICU. Expert authors have contributed clinical review articles on the following topics: Humanizing Intensive Care: From Theory to Practice; FiCare; Patient's Own Pets in the ICU; Sleep in the ICU; Implementation of a Patient and Family-Centered ICU Peer Support Program at a Veterans Affairs Hospital; Understanding the Experiences of Patients and Families in the ICU: More than Engagement; Implementing a Patient and Family Communication Bundle in the ICU; Integrating Primary Palliative Care into the ICU: The Critical Care Nurse Communicator Program; Bereavement Care in the Adult ICU: Directions for Practice; A review on the Use of Diaries; Supporting Families of Patients with Rare or Unusual Critical Illnesses; and Meeting the Special Needs of Families of CTICU patients. Readers will come away with the information they need to improve family and patients experiences in the ICU.