New technologies in critical care:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1995
|
| Schriftenreihe: | Critical care nursing clinics of North America
7,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVII S., S. 191 - 412 Ill., graph. Darst. |
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| 245 | 1 | 0 | |a New technologies in critical care |c Daphne Stannard, ... guest ed. |
| 246 | 1 | 3 | |a Psychosocial and environmental considerations |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1995 | |
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| 650 | 4 | |a Gesellschaft | |
| 650 | 4 | |a Critical Care |x Social Support | |
| 650 | 4 | |a Critical Care |x Technology | |
| 650 | 4 | |a Intensive care nursing | |
| 650 | 4 | |a Intensive care nursing |x Social aspects | |
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Datensatz im Suchindex
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| adam_text | NEW TECHNOLOGIES IN CRITICAL CARE
PSYCHOSOCIAL AND ENVIRONMENTAL CONSIDERATIONS
IN CRITICAL CARE
CONTENTS
New Technologies in Critical Care
Preface xv
Daphne Stannard
Critical Care Information Systems: Essential Infrastructure for Critical
Care Nursing Practice 191
Suzanne Bakken Henry, Kathryn J. Dolter, and Cheryl A. Reilly
In the three decades since the installation of the first bedside computer in
the shock ward at the University of California and Los Angeles County
Hospital, both computer technology and critical care practice have evolved
rapidly. The premise of this article is that critical care information systems
are an essential infrastructure for critical care nursing practice. This premise
is described in terms of the critical care environment, clinical decision mak¬
ing in critical care, increasing demands for information about quality and
costs, and national initiatives for the sharing of health care information.
Computers in Critical Care 203
Thomas D. East, C. Jane Wallace, Alan H. Morris, Reed M. Gardner,
and Dwayne R. Westenskow
This article reviews the current state of the art and future applications of
computers in critical care, with particular attention to ventilator and drug
delivery applications. Automated charting, alerts and alarms, and tools
for decision support (such as expert systems and closed loop control) are
discussed also.
Pulse Oximetry and Intuition in the Neonatal Intensive Care Unit 219
Elena M. Bosque
This article poses an argument supporting the position that it is important
for nurses to become involved, at every level, in the development of the
technology that they use. The advantages and disadvantages of one com¬
monly used technological device in the intensive care nursery, the pulse
oximeter, are identified. An example of how nursing intuition affected and
was incorporated into the design of a new neonatal pulse oximeter is
described.
CRITICAL CARE NURSING CLINICS OF NORTH AMERICA
VOLUME 7 • NUMBER 2 • JUNE 1995 ix
Advances in Cardiopulmonary Resuscitation 227
Mary J. Wong and Kathleen M. Lenihan
Approximately 500,000 deaths per year are the result of coronary artery
disease. Many of these deaths can be prevented by prompt action to provide
basic cardiopulmonary resuscitation (CPR) and early defibrillation. In recent
years, a number of new CPR methods have been developed in hopes of
improving cardiac output in an arrest situation. This article reviews the
physiology of blood flow during CPR and the different methods of CPR
administration.
The Costs and Benefits of Monitoring Perfusion in the Critically 111 239
Elizabeth F. Bearden
The care and management of the critically ill patient have seen major
advances in the past 20 years. Conventional perfusion monitoring technolo
ies, as well as new technological advances and their potential impact, are
discussed. The following monitoring technologies are reviewed: pulmonary
artery pressure, cardiac output, arterial oxygen, mixed venous oxygen, and
intramucosal gastric pH.
Current Status and Future Trends of Mechanical Circulatory Support 249
Kathy J. Vaca, Douglas P. Lohmann, and Debra A. Moroney
This article provides a brief overview of the ventricular assist devices (VADs)
available for patients with severe ventricular failure. The history of VAD
development and clinical results in the adult and pediatric population are
reviewed. Because the VAD role is expanding, nursing implications and a
critical analysis of the growing economic concerns regarding their use are
discussed.
Mobile Extracorporeal Membrane Oxygenation 259
Sherry C. Faulkner
Mobile extracorporeal membrane oxygenation (ECMO) is being offered by
select ECMO centers in the United States. Mobile ECMO can be performed
for the critically ill patient who is unable to be transported by conventional
ambulance transport. This article discusses the logistics and safety considera¬
tions associated with mobile ECMO.
Providing Comfort to Critically 111 Pediatric Patients: Isoflurane 267
Martha A. Q. Curley and Joyce A. Molengraft
Isoflurane is a fluorinated ether used primarily as an inhalation anesthetic.
Rapid titratable effects, limited metabolism, and a reliable mode of adminis¬
tration make isoflurane an appealing alternative to the use of intravenous
sedatives and narcotics in critically ill patients requiring prolonged mechani¬
cal ventilation. This article, in reviewing this novel approach to management
of patient discomfort, focuses on nursing practice issues and provides a
critical analysis of isoflurane use in the intensive care unit.
Subcutaneous Tissue Oximetry: Implications for Wound Healing and
Monitoring Critically 111 Patients 275
Deidre D. Wipke Tevis
Availability of oxygen and adequate blood flow to wounded tissues are
important factors for the prevention of impaired wound healing. Oxygen
is essential for the growth of new blood vessels, formation of collagen, and
the prevention of infection. Subcutaneous tissue oximetry, an experimental
technology for evaluating tissue oxygen and perfusion, is being researched
X CONTENTS
for use in the evaluation of hypovolemia, hemorrhagic shock, sepsis, and
wound healing. This technology eventually may assist in the management
of critically ill patients by promptly alerting physicians to decreased oxygen
delivery and allowing for more timely intervention.
Environmental Hazards in the Technological Age 287
Claire E. Sommargren
The proliferation of technology in critical care has intensified the potential
for illness or injury due to physical hazards, which are hazards associated
with the transfer of energy from the environment to a person. These are
generated most commonly by machines or medical devices. Known and
suspected physical hazards, including radiant energy, electricity, and noise
are discussed, along with their health implications and effective preventive
strategies. Areas for future research are identified.
Ethical Practice in a Technological Age 297
Theresa S. Drought and Joan Liaschenko
Our culture highly values technology, and believes that technological solu¬
tions are the answer to most human problems. The role of nursing, however,
is to hold foremost the overall well being of the patient and to advocate
for the patient, not for the technology. This article discusses the technological
imperative and its relationship to an ethical nursing practice.
Psychosocial and Environmental Considerations in Critical Care
Preface 305
Sandra B. Dunbar
Procedural Distress in Critical Care Settings 307
Laura A. Porter
The diagnostic and treatment procedures experienced by critically ill
patients are major sources of procedural distress. Procedural distress is
defined broadly as unpleasant physical sensations and negative psychologi¬
cal states associated with specific diagnostic or treatment procedures.
Although research in this area is limited by small sample sizes, findings
suggest that mechanical ventilation is a particularly difficult procedure to
experience, especially endotracheal suctioning and the weaning process.
Interventions to reduce distress should focus on the preparation of patients
for distress, the identification of procedural distress, and appropriate inter¬
ventions for specific procedures.
Optimizing Sedation in Critically 111, Mechanically Ventilated
Patients 315
Kathryn S. Bizek
Patients on mechanical ventilators may experience discomfort, fear, anxiety,
and pain. Sedative and adjunctive medications often are prescribed on an
as needed basis. This article reviews current trends in sedation administra¬
tion and suggests strategies for optimizing sedation management. Pharma
cologic properties of commonly used medications are presented.
Patient Environment Interactions in Critical Care 327
Linda Felver
This article examines patient environment interactions in critical care from
the perspective of chronobiology. Critically ill patients have reduced control
CONTENTS Xi
over an environment that they cannot leave voluntarily. These patients have
endogenous biologic rhythms that were synchronized to their prehospital
ization environment. They exhibit transient physiologic responses to envi¬
ronmental stimuli, and their biologic rhythms may be re entrained by
patterns of stimuli that are different from their customary environment.
Nursing interventions based on principles of chronobiology may optimize
patient environment interactions in critical care settings.
Promoting Sleep and Rest in Critically 111 Patients 337
Kathy P. Parker
The circumstances surrounding the admission of a patient to a critical care
unit have a particularly negative effect on both the quantity and quality of
sleep. Critical care nurses play an important and challenging role in the
promotion of effective sleep and rest. Developing a plan of care that not
only addresses the acute, life threatening needs of patients but also promotes
sleep and rest may seem impossible. This article provides a brief review of
normal sleep, discusses barriers to sleep and rest in the critical care setting,
and presents research based interventions to promote sleep.
Innovative Sensory Input for the Comatose Brain Injured Patient 351
Alice E. Davis and Jacqueline J. White
Coma following brain injury may last days or months and is associated
with decreased quality of life for survivors and families. One intervention
postulated to improve coma recovery is sensory stimulation. This article
critically examines current theoretical perspectives and empirical data
related to sensory stimulation, discusses the usefulness of sensory stimula¬
tion programs (SSP) in critical care settings, and poses strategies for imple¬
mentation of an SSP. Future directions for nursing practice and research
also are addressed.
Physical Restraint of Critically 111 Patients: A Human Issue 363
Jean Ortiz Pruitt
Physical restraints modify the behavior of an individual through the limita¬
tion of movement. Despite awareness of physical, psychological, and ethical
problems associated with the use of physical restraints on elderly patients,
the practice remains widespread in critical care units and appears to be an
accepted standard of care. Legal and ethical issues as well as personal
dilemmas complicate and influence the decision to use restraints. This article
reviews the current literature about physical restraints and presents sugges¬
tions for practice and research regarding their use in critical care.
Developing Family Focused Care 375
Marita G. Titler, Cheryl Bombei, and Debra L. Schutte
Critical care nurses have a responsibility to provide care from a family
systems perspective in which illness is not an isolated, time limited event,
but instead a highly stressful situation that evolves from the family s history
and contributes dynamically toward its future. This article discusses nurse
family relationships, strategies to promote family focused care, and mecha¬
nisms to make family focused care a reality.
Creating an Ethical Practice Environment: A Focus on Advocacy 387
Cindy Hylton Rushton
In order for nurses to be effective advocates, they must practice in an
environment that fosters competency, collaboration, communication, and
ethical values. This article addresses the meaning of advocacy, explores
whether nurses can be effective advocates in complex practice environments,
Xii CONTENTS
identifies barriers to advocacy, and suggests individual and systems
approaches to support advocacy in critical care.
Supporting Nursing Innovations in a Cost Conscious Environment 399
Suzanne K. White, Bradi Bartrug, and Wanda Bride
Our rapidly changing health care environment requires critical care nurses
to develop creative and innovative approaches to patient care. Empowering
and enabling these nurses are the only ways that health care institutions
will be able to meet the challenges of the future. This article describes two
examples of innovations that have contributed to cost containment within
a coronary care unit.
Index 407
Subscription Information Inside back cover
CONTENTS Xiii
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| title | New technologies in critical care |
| title_alt | Psychosocial and environmental considerations |
| title_auth | New technologies in critical care |
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| title_fullStr | New technologies in critical care Daphne Stannard, ... guest ed. |
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| title_short | New technologies in critical care |
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