| 1. |
- Cordoza, Makayla, et al.
(författare)
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Impact of nurses taking daily work breaks in a hospital garden on Burnout
- 2018
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Ingår i: American Journal of Critical Care. - : AACN Publishing. - 1062-3264 .- 1937-710X. ; 27:6, s. 508-512
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Tidskriftsartikel (refereegranskat)abstract
- Background Nurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood. Objective To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks. Methods A prospective crossover trial was conducted of nurses assigned to either 6 weeks of a work break in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for a subsequent 6 weeks. The Maslach Burnout Inventory was administered at the beginning and end of each 6-week period, and a Present Functioning Visual Analogue Scale was completed at the start and end of each break to capture immediate psychological symptoms. Change scores were analyzed by using generalized estimating equations. Results For 29 nurses, for garden compared with indoor breaks, significant improvement was apparent in scores on the Maslach Burnout Inventory subscales for emotional exhaustion (4.5 vs -0.2; P < .001) and depersonalization (1.8 vs 0.0; P = .02) but not for personal accomplishment (-0.6 vs -0.0; P = .55). Compared with indoor breaks, total symptom scores on the Present Functioning Visual Analog Scale improved significantly when nurses took a break in the garden (garden vs indoor breaks, 4.0 vs 2.4; P = .04). Conclusions Taking daily work breaks in an outdoor garden may be beneficial in mitigating burnout for nurses working in hospital environments.
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| 2. |
- Desai, Priti P., et al.
(författare)
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Practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units
- 2020
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Ingår i: American Journal of Critical Care. - : American Association of Critical-Care Nurses. - 1062-3264 .- 1937-710X. ; 29:3, s. 195-203
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundProvision of developmentally appropriate support for child visitors in adult intensive care units (ICUs) would benefit patients and young visitors. Research on best practices for child visitation in adult ICUs is limited.ObjectivesTo explore the perceptions and practices of nurses working in adult ICUs in the United States regarding child visitation and the role of child life specialists in this setting.MethodsData were collected from 446 adult ICU nurses via a cross-sectional survey. The survey explored perceptions and practices regarding child visitation, access to child-friendly resources, and the feasibility of having a child life specialist in adult ICUs.ResultsSeveral participants (303, 67.9%) felt that children were at risk for psychological trauma from visiting an adult ICU. Some participants (122, 27.4%) reported that their ICUs did not have policies for child visitation. Logistic regression showed that nurses with a master’s degree were 1.8 times (P < .05) more likely to believe that young children (0-5 years) should visit. Nurses (105 of 197, 53.3%) were more likely to allow young children to visit if the patient was the child’s parent or if the patient was dying. Child-friendly resources were not routinely available. Nurses expressed that adult ICUs could benefit from child life specialists facilitating child visitation.ConclusionsNurses were inconsistently open to child visitation. Exceptions for older children (> 6 years), children whose parent was the patient, patients’ illness severity, and end of life allowed more child visitation. Ways to facilitate child-friendly visitation in adult ICUs are discussed.
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| 3. |
- Desai, Priti P., et al.
(författare)
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Practices and Perceptions of Nurses Regarding Child Visitation in Adult Intensive Care Units
- 2020
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Ingår i: American Journal of Critical Care. - : American Association of Critical Care Nurses. - 1062-3264 .- 1937-710X. ; 29:3, s. 195-203
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Tidskriftsartikel (refereegranskat)abstract
- Background Provision of developmentally appropriate support for child visitors in adult intensive care units (ICUs) would benefit patients and young visitors. Research on best practices for child visitation in adult ICUs is limited. Objectives To explore the perceptions and practices of nurses working in adult ICUs in the United States regarding child visitation and the role of child life specialists in this setting. Methods Data were collected from 446 adult ICU nurses via a cross-sectional survey. The survey explored perceptions and practices regarding child visitation, access to child-friendly resources, and the feasibility of having a child life specialist in adult ICUs. Results Several participants (303, 67.9%) felt that children were at risk for psychological trauma from visiting an adult ICU. Some participants (122, 27.4%) reported that their ICUs did not have policies for child visitation. Logistic regression showed that nurses with a master's degree were 1.8 times (P < .05) more likely to believe that young children (0-5 years) should visit. Nurses (105 of 197, 53.3%) were more likely to allow young children to visit if the patient was the child's parent or if the patient was dying. Child-friendly resources were not routinely available. Nurses expressed that adult ICUs could benefit from child life specialists facilitating child visitation. Conclusions Nurses were inconsistently open to child visitation. Exceptions for older children (> 6 years), children whose parent was the patient, patients' illness severity, and end of life allowed more child visitation. Ways to facilitate child-friendly visitation in adult ICUs are discussed.
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| 4. |
- Jones, Christina, et al.
(författare)
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Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study
- 2012
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Ingår i: American Journal of Critical Care. - Aliso Viejo, CA, USA : American Association of Critical Care Nurses. - 1062-3264 .- 1937-710X. ; 21:3, s. 172-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: Relatives of patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD).Objectives: The primary aim of this pilot study was to test whether the provision of an ICU diary to the patient and their relatives reduced the level of PTSD-related symptoms in the close family members.Methods: Observational study of close family members of Intensive care patients, with an Intensive Care Unit (ICU) stay of more than 72 hrs, recruited in two centres of a 12 centred randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of new onset PTSD on patients. The close family members of the patients were recruited to examine the additional effect of the provision of the patient diary on their PTSD-related symptoms.Results 36 family members were recruited and 30 completed the study. Where the patient received their diary at 1 month the family members showed lower levels of PTSD-related symptoms (p=0.03) at the 3 month follow-up compared to the control relatives.Conclusions: The provision of an ICU diary may be effective in aiding psychological recovery in families after critical illness.
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| 5. |
- Prendergast, Virginia, et al.
(författare)
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Oral Health, Ventilator-Associated Pneumonia, and Intracranial Pressure in Intubated Patients in a Neuroscience Intensive Care Unit.
- 2009
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Ingår i: American Journal of Critical Care. - : AACN Publishing. - 1062-3264 .- 1937-710X. ; 18:4, s. 368-376
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Tidskriftsartikel (refereegranskat)abstract
- Background Although oral health affects systemic health, studies of oral health during intubation among critically ill neuroscience patients are lacking. Furthermore, the effect of oral care on intracranial pressure among critically ill patients in a neuroscience intensive care unit is unknown. Objectives To describe changes in oral health and development of ventilator-associated pneumonia during intubation among patients in a neuroscience intensive care unit and to assess the influence of oral care on intracranial pressure. Methods Data on 45 consecutive intubated patients admitted to a neuroscience intensive care unit during 1 year were collected by using oral cultures and the Oral Assessment Guide throughout intubation and 48 hours after extubation. Occurrence of ventilator-associated pneumonia and intracranial pressures associated with oral care were recorded. Results Oral health, assessed by the Oral Assessment Guide, deteriorated significantly during intubation and improved to almost baseline levels 48 hours after extubation. During intubation, occurrence of oral gram-negative bacteria and yeast increased. The incidence of ventilator-associated pneumonia was 24% among patients enrolled for 4 to 10 days. During or after 879 instances of oral care, overall intracranial pressure did not increase. Among 30 instances in which intracranial pressure was greater than 20 mm Hg before oral care, pressure decreased during and 30 minutes after the procedure (P < .001). Conclusions Intubation may contribute to worsening of oral health among patients in neuroscience intensive care units. Execution of oral care does not seem to affect intracranial pressure adversely. Oral care should be explored further to promote good oral and systemic health in patients in neuroscience intensive care units and to determine its effect on ventilator-associated pneumonia.
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| 6. |
- Smulter, Nina, et al.
(författare)
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Validation of the confusion assessment method in detecting postoperative delirium in cardiac surgery patients
- 2015
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Ingår i: American Journal of Critical Care. - : American Association of Critical-Care Nurses. - 1062-3264 .- 1937-710X. ; 24:6, s. 480-487
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection, prevention, and treatment of delirium after cardiac surgery are important for quick postoperative recovery. The Confusion Assessment Method (CAM) may be an easy-to-use instrument for detecting delirium in clinical practice.Objectives: To compare the congruent validity of the CAM with the results from repeated assessments by using a combination of the Organic Brain Syndrome Scale and the Mini-Mental State Examination according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria for delirium.Methods: Patients aged 70 years or older undergoing cardiac surgery were assessed on postoperative days 1 and 4, and the 2 diagnostic methods were compared. The sensitivity and specificity of the CAM were examined. The reference method allowed categorization of delirium into subgroups of psychomotor activities and psychiatric symptom profiles, which were compared with the CAM results.Results: Postoperative delirium was diagnosed in 78 of 141 patients (55.3%). According to the CAM, 59 patients (41.8%) were categorized as delirious, 53 correctly. Thus, the sensitivity was 68% and the specificity was 90%, indicating false-negative rather than false-positive observations.Conclusion: Patients with psychomotor hyperactivity and mixed psychotic-emotional symptoms were more likely to have delirium detected via the CAM than were patients with less obvious clinical manifestations of delirium. Repetitive cognitive testing and psychogeriatric experience are probably necessary to improve the results obtained with the CAM.
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