Urden, L. D., K. M. Stacy, and M. E. Lough. Critical care nursing, diagnosis and management. Mosby Inc, 2010. eBook.
HAI rates, nurse staffing, length of patient stay, and patient outcomes need to be evaluated in a collaborative manner. Nurses play a vital role within the health care system, and the effects of nurse staffing on patient stay, outcomes, and HAIs is a critical element in health care needing immediate attention. A positive increase in nurse-to-patient ratio, even by adding one additional nurse per shift, will decrease HAIs, patient length of stay, and patient mortality. Stronger educational programs within hospitals regarding infection control are also needed. A more informed and educated nursing staff will likely result in a better educated patient. Overall, staffing of nurses proves to be a critical link between patients and HAI rates.
Emergency room nursing is a very rewarding job. Unlike other specialty nursing units in the emergency room the nurse never aware of what might walk in the door next. This can be scary and for the adrenaline junkie exciting. With the fact the nurse never know what might walk in the emergency room nurse needs to have a large knowledge base. This includes that of infection control.
Sarah Dobinson is a patient at increased risk of infection she is an older patient in a hyper metabolic state secondary to trauma. To ensure Sarah’s safety a set of CVC guidelines have been developed using the most recent primary sources. These guidelines will focus on nursing interventions post insertion in an adult ICU setting they have been developed under four sections addressing the importance of hand hygiene and aseptic technique, changing of administra...
In the Intensive Care Unit (ICU), patients are being monitored very closely while their vital signs, their neurological status, and their physical status are being managed with strong medications, lifesaving machines, and the clinical knowledge and skills of trained ICU nurses. Outside of the ICU, it is essential for staff nurses to identify the patient that is clinically deteriorating and in need of urgent intervention.
Renal and hepatic function tests include creatinine test, blood urea nitrogen (BUN) test, alkaline phosphatase (ALP) test, bilirubin test, and others. Urinalysis includes urine osmolality tests and urine culture tests. The sooner one’s sepsis is diagnosed and managed, the better the chances are one has to survive. There are three identifiable stages of sepsis. The three stages are, in order, sepsis, severe sepsis, and septic shock. The stage of sepsis is achieved when an infection enters the bloodstream and enacts inflammatory responses throughout the body. This stage is not as life threatening as the next two stages but should be assessed and treated for as soon as possible. The stage of severe sepsis is achieved when an infection disrupts the flow of blood to the brain or renal organs resulting towards organ failure. There can be an occurrence of gangrene in the arms, legs, fingers, and toes exhibiting tissue death caused by blood clots. If treatment is not given quickly in this stage then septic shock is bound to occur. The stage of septic shock is achieved when the overall blood pressure drops drastically leading to respiratory, cardiac, or organ failure and likely death This stage demands
The initial cause of all further problems is the infection. This can occur anywhere in the body. The most common sites of infection that can lead to sepsis include: urinary tract, skin, abdominal, and respiratory. These infections can occur at any time, in any population; however, there are some groups of people who are at a higher risk. These include individuals who have been diagnosed with: diabetes mellitus, renal failure, heart failure, and chronic obstructive pulmonary disease (Leon, Hoyos, Barrera, De La Rosa, Dennis, Duenas, Granados, Londono, Rodriguez, Molina, Ortiz, Jaimes, 2013). The infection is the first step in patients who go into septic shock. Performing cultures and treating this infection e...
A typical emergency unit is a busy one and, to avoid confusion, care should be logically organized from the patient's entry until discharge. Walsh (1990:34) suggests that each patient has a primary nurse who will care for him or her from admission until discharge. This is in contrast with task based nursing, which Walsh suggests should have no place in the emergency unit. Primary care nursing has numerous advantages, namely, enhanced communication between administrative staff, nurse, patient and doctor, holistic care ensuring all care is rendered, increased patient security, knowing who he or she is dealing with and, finally, improved monitoring of the patient's condition.The hospital environment can be a confusing one so
According to the Clinical Excellence Commission (2014), approximately 6,000 deaths per annum are caused by sepsis in Australia alone. These mortality figures are higher than breast cancer (2,864) and prostate cancer (3,235) combined (Cancer Australia, 2014). Despite advances in modern medicine and increased understanding of the need for timely recognition and intervention (Dellinger et al, 2013), sepsis remains the primary cause of death from infection worldwide (McClelland, 2014). Studies undertaken by The Sepsis Alliance (2014) and Schmidt et al, (2014) state that 40% of patients diagnosed with severe sepsis do not survive.
Sole, M.L., Klein, D.G., & Moseley, M.J. (2013). Introduction to critical care nursing (6th ed). St. Louis, MO: Elsevier.
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Within the Surviving Sepsis Campaign they introduced guidelines and bundles which may beused as the basis of a sepsis performance improvement program. The Guidelines were based around a six-point action plan (...
Nurses form an important role in influencing patient safety from everyday tasks and gradually obtaining the patient vital signs have increasingly been seen as a chore instead of collecting clinical evidence. This then creates an extreme danger to patient’s as irregular monitoring of vital signs prevented early detection of deterioration in a patient’s condition, which postpones transfer to intensive care unit ( Kyriacos U et al 2011; Boulanger, 2009). Due to this, a...
Ali H Al-Khafaji, MD, MPH, FACP, FCCP(2010) Multisystem Organ Failure of Sepsis Retrieved 02/10/2011, from http://emedicine.medscape.com