Additional Information
Book Details
Abstract
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.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Quality\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Critical Care Nursing Clinics Of North America\r | xi | ||
| Preface\r | xiii | ||
| Back to Basics | 433 | ||
| Key points | 433 | ||
| The aging body | 435 | ||
| Resiliency and vulnerability | 436 | ||
| Functional status | 437 | ||
| Polypharmacy | 438 | ||
| Chronic conditions | 439 | ||
| Case study | 440 | ||
| Back to basics | 441 | ||
| Complexity and care of the older adult | 442 | ||
| References | 443 | ||
| Application of a Comprehensive Unit-Based Safety Program in Critical Care | 447 | ||
| Key points | 447 | ||
| Patient safety: issues and approaches | 448 | ||
| Comprehensive Unit-Based Safety Program | 449 | ||
| One intensive care unit’s experience with Comprehensive Unit-based Safety Program | 452 | ||
| Comprehensive Unit-based Safety Program: sparking the interest for patient safety | 452 | ||
| Acting on opportunities for improvement | 453 | ||
| Process implementation | 454 | ||
| The handoff experience from the view of the bedside RN | 456 | ||
| Outcomes | 457 | ||
| Summary | 458 | ||
| References | 458 | ||
| Incidence and Prevention of Delirium in Critical Care Patients | 461 | ||
| Key points | 461 | ||
| Introduction | 461 | ||
| Review of literature | 461 | ||
| Case study 1 | 462 | ||
| Metrics | 463 | ||
| Case study 2 | 465 | ||
| Implications for nursing practice | 466 | ||
| References | 467 | ||
| Stroke Care Using a Hub and Spoke Model with Telemedicine | 469 | ||
| Key points | 469 | ||
| Problem statement | 469 | ||
| Review of the literature | 470 | ||
| Implementation of the hub and spoke model | 471 | ||
| Case study | 472 | ||
| Discussion | 473 | ||
| Linkage to the complex adaptive system | 473 | ||
| Implications for practice | 474 | ||
| References | 475 | ||
| Application of a Robot for Critical Care Rounding in Small Rural Hospitals | 477 | ||
| Key points | 477 | ||
| Introduction | 477 | ||
| The solution | 478 | ||
| Faster access, improved finance and quality outcomes | 479 | ||
| Convenience for patients and families | 481 | ||
| Access to care between regions | 482 | ||
| Individualized patient care | 483 | ||
| Stroke care | 483 | ||
| Summary | 485 | ||
| References | 485 | ||
| Driving Sepsis Mortality Down | 487 | ||
| Key points | 487 | ||
| Introduction | 487 | ||
| Sepsis and health care: a systems view | 488 | ||
| Sepsis and the Human Body: A Systems View | 488 | ||
| Performance Improvement in a Complex Adaptive System | 488 | ||
| Strategies and tactics to improve sepsis care and reduce mortality | 489 | ||
| Goal Setting | 489 | ||
| Transparency in Reporting | 489 | ||
| Resource Availability | 490 | ||
| Alignment of Incentives with Goals | 490 | ||
| Engaged Leadership/Executive and Direct Caregiver Involvement | 491 | ||
| Multidisciplinary Approach | 491 | ||
| Continuous Quality Improvement Approach to Performance Improvement | 491 | ||
| Strong Nursing Leadership | 492 | ||
| Shared Governance Model | 493 | ||
| Standardization to Evidence-Based and Best Care Practices | 493 | ||
| Results | 493 | ||
| Process Improvements in Clinical Care | 493 | ||
| Reduction in Sepsis Mortality | 495 | ||
| Ongoing challenges and next steps | 495 | ||
| Summary | 497 | ||
| References | 497 | ||
| Implications and Interventions Related to Obstructive Sleep Apnea | 499 | ||
| Key points | 499 | ||
| Definition | 500 | ||
| Pathophysiology | 501 | ||
| Prevalence and risk factors | 501 | ||
| Surgical risk | 502 | ||
| Implementation of strategies for decreasing postoperative complications | 503 | ||
| Monitoring | 503 | ||
| Next steps | 504 | ||
| Screening | 504 | ||
| Summary | 507 | ||
| References | 507 | ||
| Therapeutic Hypothermia After Cardiac Arrest and Return of Spontaneous Circulation | 511 | ||
| Key points | 511 | ||
| Resuscitation and evaluation | 513 | ||
| Induction | 513 | ||
| Electrolytes | 514 | ||
| Techniques for Achieving Hypothermia | 515 | ||
| Coagulopathies | 516 | ||
| Shivering | 516 | ||
| Maintenance | 517 | ||
| Maintaining Target Temperature | 517 | ||
| Ventilation | 517 | ||
| Glucose Management | 518 | ||
| Perfusion | 518 | ||
| Infection Control | 518 | ||
| Skin Care | 519 | ||
| Pharmacology During Therapeutic Hypothermia | 519 | ||
| Psychosocial Patient and Family Support | 520 | ||
| Rewarming | 521 | ||
| Neuroprognostication | 521 | ||
| Summary | 522 | ||
| References | 522 | ||
| Open Access in the Critical Care Environment | 525 | ||
| Key points | 525 | ||
| Introduction | 525 | ||
| Summary/Discussion | 526 | ||
| Problem | 526 | ||
| Review of literature | 526 | ||
| Case study | 527 | ||
| Summary/Implications for practice | 530 | ||
| References | 531 | ||
| Review of Evidence About Family Presence During Resuscitation | 533 | ||
| Key points | 533 | ||
| Introduction | 533 | ||
| Background | 534 | ||
| Review of evidence about family presence during resuscitation | 534 | ||
| The Origins of Research | 535 | ||
| Health Care Provider Attitudes About Family Presence | 535 | ||
| International Health Care Provider Perspectives of Family Presence | 537 | ||
| Voices of Patients and Families | 539 | ||
| Studies of health care provider, family, and patient views about family presence | 539 | ||
| Family perspectives about family presence | 540 | ||
| Patient perspectives | 541 | ||
| Public perspectives | 542 | ||
| Interventions to influence Health care provider attitudes about family presence | 542 | ||
| Education | 543 | ||
| Guidelines and Policies | 543 | ||
| The Impact of Experience | 544 | ||
| The authors’ experience with family presence during resuscitation | 544 | ||
| Discussion | 546 | ||
| Summary | 547 | ||
| References | 547 | ||
| Palliative Care in the Intensive Care Unit | 551 | ||
| Key points | 551 | ||
| Importance of the problem | 551 | ||
| Review of the literature | 552 | ||
| Case studies | 554 | ||
| Case | 554 | ||
| Case | 555 | ||
| Relation to the complex adaptive system | 556 | ||
| Implications for practice | 557 | ||
| References | 557 | ||
| Driving Hospital-Acquired Pressure Ulcers to Zero | 559 | ||
| Key points | 559 | ||
| Literature review | 560 | ||
| Change process | 561 | ||
| Education | 561 | ||
| Turning patients | 562 | ||
| Documentation | 562 | ||
| Barriers identified | 564 | ||
| Practical application | 565 | ||
| Summary | 566 | ||
| References | 566 | ||
| Fall Prevention in High-Risk Patients | 569 | ||
| Key points | 569 | ||
| Introduction | 569 | ||
| Review of literature | 570 | ||
| Oncology Patient Characteristics | 571 | ||
| Interventions in the Oncology Population | 572 | ||
| Quality improvement project | 572 | ||
| Case study | 574 | ||
| Implication for practice | 577 | ||
| References | 578 | ||
| Overview of Extracorporeal Membrane Oxygenation in Cardiogenic Shock | 581 | ||
| Key points | 581 | ||
| Transformation of the cardiovascular intensive care unit | 582 | ||
| Cardiogenic shock and mechanical circulatory support | 582 | ||
| Cardiogenic Shock | 582 | ||
| Mechanical Circulatory Support | 583 | ||
| Complications | 584 | ||
| The development of an extracorporeal membrane oxygenation program | 584 | ||
| Considerations for starting an extracorporeal membrane oxygenation program | 586 | ||
| Summary | 588 | ||
| References | 588 | ||
| Transitional Care Models | 589 | ||
| Key points | 589 | ||
| Transitional care pilot | 590 | ||
| Appropriate patient identification and predicting risk of readmission | 591 | ||
| Remote monitoring | 592 | ||
| Expansion of the transitional care model team | 593 | ||
| Role of the Social Worker | 593 | ||
| Role of the Pharmacist | 594 | ||
| Role of the Registered Nurse | 594 | ||
| Dissemination to system hospitals | 594 | ||
| Interdisciplinary Team | 594 | ||
| Changes in Workflow | 594 | ||
| Risk Stratification and Remote Monitoring | 595 | ||
| Weekly Team Meetings | 595 | ||
| Implications for nursing practice | 595 | ||
| Lessons learned | 596 | ||
| Summary | 596 | ||
| References | 596 | ||
| The Application of the Acute Care Nurse Practitioner Role in a Cardiovascular Patient Population | 599 | ||
| Key points | 599 | ||
| Statement of the problem/Importance of the problem | 599 | ||
| Review of the literature | 600 | ||
| Case study | 603 | ||
| Challenges and barriers | 605 | ||
| Summary | 605 | ||
| References | 606 | ||
| Index | 607 |